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PubMed · 7767800

Advanced nursing practice.

J E Steel
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Abstract

The focus on advanced practice is now critical, as the nation begins to reform our health care system. President Clinton has called for a plan that incorporates "security, simplicity, savings, choice, quality, and responsibility". These are major efforts for health care providers, including nurses who deliver direct care and designers of these health care systems. The future work of the advanced nurse practitioner evolves from today's practitioners and their vision. Now, nurses in advanced practice can help design and implement systems of the future. The author highlights some of the issues involved in advanced practice, remarking on how advanced practice might be implemented in the critical care setting. The specifics of implementation is the responsibility of specialists in acute care. As a primary care nurse practitioner, the author provides ideas of application and examines some of the barriers to the continuing growth of nursing practice.

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CertificationCritical CareForecastingHumansJob DescriptionNurse CliniciansNurse PractitionersProfessional AutonomyJournal Article

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J E Steel. 1994. Advanced nursing practice.. https://doi.org/10.1097/00044067-199402000-00011

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The application process leading to certification by the Education Commission for Foreign Medical Graduates (ECFMG) was studied using the group of 9,491 graduates of foreign medical schools who initiated their applications in 1988. Using the ECFMG's database, these applicants' countries of citizenship, examination histories, certification status, and exchange visitor status were determined for a period of seven years and 9 months, ending in September 1995. Within that time, 45% of these applicants became ECFMG-certified, and 26% of that group entered residency programs accredited by the Accreditation Council for Graduate Medical Education. Of the total number of non-U.S. citizens (2,243) who entered such programs, 61% did so as exchange visitor physicians. The remainder had other kinds of visa status, such as permanent resident, or had become U.S. citizens. Although U.S. citizens and non-U.S. citizens achieved certification at the same rate (45%), the U.S. citizens had greater success in obtaining positions in graduate medical education (GME). Seventy-four percent of the ECFMG-certified certified U.S. citizens entered GME, versus 57% of the ECFMG-certified non-U.S. citizens. The status of the 55% of the 9,491 applicants who did not obtain certification is discussed; a portion of this group of this group continues to pursue certification. Details and requirements of the ECFMG certification process are also described.

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