Monday, December 5, 2016

NPD Roles: Generalist vs. Specialist

Mary G. Harper, PhD, RN-BC is the Director of Nursing Professional Development for ANPD. Certified in NPD, she obtained her MSN at the University of Florida and her PhD at the University of Central Florida. Dr. Harper co-chaired the work group that revised the Scope and Standards for Nursing Professional Development in 2016. 

The publication of the new Nursing Professional Development: Scope and Standards of Practice (Harper & Maloney, 2016) has ushered in an opportunity for nursing professional development practitioners to clearly articulate what we do. It also challenges us to demonstrate our value to our organizations. The new document recognizes our expanded scope of practice and delineates distinct roles for our specialty informed by research (Warren & Harper, 2016). In addition, it makes mentoring/advocating for our profession and specialty a standard of practice. 

One of the more groundbreaking concepts of the new scope and standards is the introduction of “NPD practitioner” as an umbrella term to represent those who practice NPD. Practitioners may function at two levels: generalist and specialist. A generalist is an NPD practitioner with a baccalaureate degree with or without NPD certification or a graduate degree without NPD certification. A specialist is someone with a graduate degree AND certification in NPD. If the graduate degree is not in nursing, the baccalaureate must be (Harper & Maloney, 2016).

Differentiation of the generalist and specialist roles is the result of several factors. First, we recognize that many individuals who practice NPD are baccalaureate prepared. In spite of the requirement for a graduate degree as the minimal preparation for NPD in prior editions of the scope and standards, the reality is that many nurses who practice NPD do not have graduate education. Recent research indicates that nearly 40% of our colleagues have baccalaureate or associate degrees (Harper, Aucoin, & Warren, 2016). The new scope and standards now acknowledges that not all members of our specialty have graduate degrees.

In addition to nurses without graduate degrees, the requirement for certification in NPD is a baccalaureate degree. So while a nurse could become certified in the specialty, that individual did not meet the minimal requirement of the scope and standards to identify as a member of the specialty. The new scope and standards has rectified that. 

Finally, the American Nurses Association (ANA, 2010), which defines and approves specialty nursing practices, requires that a nursing specialty must be able to differentiate the responsibilities of the graduate prepared nurse in the specialty. This requirement was initiated shortly after the publication of the 2010 Nursing Professional Development: Scope and Standards of Practice (ANA & NNSDO, 2010), so the previous edition of the scope and standards did not identify two levels of NPD practitioners. 

The new designations of generalist and specialist have been met with overwhelmingly positive responses. Some NPD practitioners indicate that the designation provides a mechanism for career advancement within the specialty. Others applaud the ability to differentiate role functions in the practice environment. Still others state that the differentiation supports the focus on advanced education and certification.

Unfortunately, not all responses to the new differentiation of NPD practitioner levels have been positive. Some NPD practitioners indicate that the new terminology creates additional role confusion. Role confusion in NPD is not new. A plethora of titles currently exist with little consistency among organizations. Many of our diverse titles make it difficult to differentiate between academic nurse educators and NPD practitioners. While we share many similarities with our academic colleagues, our practice has unique differences, particularly in the areas of identification of practice gaps, gap analysis (needs assessment), and evaluation of educational activities. 

Others who are not thrilled with the new levels of NPD practitioners posit that their graduate or doctoral levels of education should be sufficient for recognition as an NPD specialist. While advanced education is one requirement for recognition as an NPD specialist, it alone is not sufficient. Graduate education does not typically provide specialty knowledge. Most master’s degrees in nursing education focus on the roles and responsibilities of the academic educator with little or no content on the NPD specialty and its unique scope of practice. Certification provides evidence of knowledge in the specialty.

One of the most common questions we’ve received about the NPD specialist designation in the new scope and standards is “What if I’m certified in another specialty? Can I still be recognized as an NPD specialist?” Unfortunately, no. Many, if not most of us, were selected for our NPD roles because we were excellent clinicians. Being an excellent clinician does not mean that an individual is automatically a good learning facilitator (think of the expert clinician who struggles when serving as a preceptor to help the novice nurse transition to the role of a professional nurse). NPD is its own unique specialty and requires a unique set of competencies. As a result, certification in critical care nursing, pediatric nursing, or even as an academic nurse educator does not demonstrate knowledge of the NPD specialty.

The purpose of certification is to demonstrate competence in a specialty. As a group, NPD practitioners do not excel in this area. Two national research studies have demonstrated that only 16  20% of the NPD practitioners who participated were certified in NPD. On the other hand, approximately 50% were certified in a clinical specialty. While dual certification may be indicated for some NPD practitionersespecially those who are unit basedthe lack of certification in NPD is alarming. 

In the current complex healthcare environment, NPD departments are being challenged to demonstrate their value to their organizations or face reduction in forces or even elimination. The days of simply reporting numbers of classes conducted or numbers of staff participants are gone. We must be able to demonstrate how we contribute to the organization’s goals related to patient safety and quality, staff satisfaction and retention, and financial stability. NPD practitioners who are not certified in the specialty may lack the knowledge and skill to measure educational outcomes in a meaningful way.

I challenge you to read our new scope and standards and allow it to guide your practice.  Become immersed in our specialty. If you’re not certified, become certified. If you don’t have a graduate degree, get one! Look for meaningful ways to contribute to your organization. Learn to articulate what you do so that others in the organization, and especially the C-suite, recognize your value. Get involved in your professional association on both a local and national level. If there is not an ANPD affiliate in your area, start one. Continue your own professional development. Advocate for our specialty!

References
American Nurses Association. (2010a). Recognition of a nursing specialty, approval of a specialty nursing scope of practice, and acknowledgement of specialty nursing standards of practice.  Retrieved from: http://www.nursingworld.org/MainMenuCategories/Tools/3-S-Booklet.pdf

American Nurses Association and National Nursing Staff Development Organization. (2010). Nursing professional development: Scope and standards of practice. Silver Spring, MD: ANA.

Harper, M.G., Aucoin, J., and Warren, J.I. (2016). Nursing professional development organizational value demonstration project. Journal for Nurses in Professional Development, 32(5), 242 –247.

Harper, M. G. & Maloney, P. (2016). Nursing professional development: Scope and standards of practice (3rd ed.). Chicago, IL: ANPD.

Warren, J. I. & Harper, M. G. (2015, July). Nursing professional development role delineation study. Presented at the ANPD Annual Convention, Las Vegas, NV.

No comments:

Post a Comment