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Advanced practice nursing has grown and developed through the guidance of different frameworks and models helping to define one group of nurses from another. Acknowledging and licensing nurses who go beyond the basic skills set of nurses started the journey of advancement. Hamric developed a model that would apply to all the different advanced practice nurse roles to define characteristics to support the growth of the practice. All of the elements in the model Hamric designed are essential in providing optimal potential. The top three that I find most important are direct clinical practice, clinical and professional leadership, and ethical decision making.

Direct clinical practice is imperative to the definition of APN. It is one of the central competencies identified in the Hamric model. The nursing training, bed side care and hands on approach is what sets APN aside from other mid-level practitioners in the medical field. The better the direct clinical practice the better the patient or research outcome will be.

Clinical and professional leadership is the second element of the nursing model that I chose. Advanced practice nursing provides the umbrella term for all nurse specialists. If it were not for nurse leaders we would not have the developed system that allow us to practice at the graduate level. Professionally we need nurse involvement at the local, regional and national organization levels. Leadership goes far beyond patient care, it incorporates a certain advocacy as well. Leaders need to be strong and confident, balanced with critical thinking skills, and goal focused. 

The last characteristic I chose is ethical decision making. APN enables much more autonomy than a registered nurse. Ethical decision making blends technical data and clinical knowledge with emotional and spiritual knowledge. It is a very gray area that tends to go beyond evidence based practice. "A problem becomes an ethical or moral problem issues of core values or fundamental obligations are present" (Hamric, 2014). An APN needs to have strength and competence in order to make the appropriate decision. This can be a deciding factor in the outcome of treatment or patient goals. 

Reference

Hamric, A., Hanson, C., Tracy, M., & O'Grady, E. (2014). Advanced Practice Nursing: An Integrative

Approach. (5 ed.). St. Louis: Saunders.