Aprn Interview 1

INTERVIEW WITH AN APRN-CNP 1
An Interview with an APRN-CNP with Analysis
Nicole Sesser BSN, RN
Youngstown State University
Nurs 7003: Role Development
Dr. Kim Ballone DNP, APRN-CNP
Mrs. Wendy Thomas MSN, APRN-CNP, FNP
June, 21st, 2023

The concept of the Advanced Practice Nurse began in the late 1950s through Dr. Eugene
A. Stead, Jr. and a nurse, Thelma Ingles. Together, they created the first Masters program for
nursing which expanded the autonomy of nurses (Joel,2018). Since that time, the role of the
APRN has become more dynamic and progressive and has led to better patient care. Nurses and
physicians work closely with APRNs to direct health care. In the following interview with
Bethany Tittle MSN, APRN-CNP, we discuss her role as an APRN and what challenges she
faces in today’s health care system.
“Tell me about yourself.” Bethany Tittle stated she is an Advanced Practice Registered
Nurse (APRN) in the Cardiovascular Intensive Care Unit at St. Elizabeth Health Center in
Youngstown, Ohio. She graduated with her BSN in 2010 and her career began at the Cleveland
Clinic in Cardiothoracic Intensive Care. In 2016, she obtained her MSN, APRN-CNP at Kent
State University, and in 2017, took a job at Mercy Health in the Cardiovascular ICU (B. Tittle,
personal communication, May 30th, 2023).
“Describe your APRN position and what is your specialty?” Bethany stated that she
works in the ICU with primarily post open heart surgery patients. She described her role as being
responsible for the critical care portion of the patient after surgery. Managing these patients starts
with pain management, stabilization of hemodynamics and any post-operative complications,
and then weaning the ventilator in order to extubate the patient. She also mentioned that she
manages the direction of care with patients on devices such as Extracorporeal Membrane
Oxygenation (ECMO), Intra-aortic Balloon Pump (IABP) and Impella. These patients often have
Pulmonary Artery Catheters (Swan-Ganz) and require the APRN to have extensive knowledge of
heart failure (B. Tittle, personal communication, May 30th, 2023).

“Do you see an APRN influence in today’s health care system?” She stated that she sees
and influence of the Advanced Practice Nurse in today’s health care system through bridging the
gap of patient care between physicians and bedside nurses. APRNs have the ability to follow the
patient more closely than a single physician or resident caring for a large number of patients.
With the nursing shortage has come a large volume of new and inexperienced nurses. APRNs
can use a team-based approach with their extensive knowledge and autonomy to help guide
nursing care and the overall care of the patient (B. Tittle, personal communication, May 30th,
2023).
“What are some barriers that APRNs face?” Barriers that the Advanced Practice Nurse
faces often involve issues with autonomy. Bethany goes on to describe that legally in the state of
Ohio, it is within her scope of practice to provide specific services and write orders for things;
however, some facilities limit this scope. For example, she explained that legally, she can write
orders for restraints, but at Mercy Health only a physician can write restraint orders. This limits
her ability to care for the patient and can cause disadvantages to the patient and to the
collaborating physician (B.Tittle, personal communication, May 30th, 2023).
“What changes would you like to see made for APRNs?” Bethany explained that she
would like to see more autonomy for APRNs. Autonomy can be dependent upon the facility
where the APRN is practicing and can be limited or expanded. Advanced Practice Nurse
autonomy can have benefits to patients and physicians (B.Tittle, personal communication, May
30th, 2023). Currently, about half of the states in the U.S. allow Nurse Practitioners to practice to
the full extent of their licensure without physician oversight. Ohio operates at a “reduced
practice” level, reducing the ability of the NP to engage in at least one element of NP practice.
State law requires a regulated collaboration with at least one outside health discipline in order for
the NP to provide patient care (Carlson, 2023).
It is clear that Advanced Practice Nurses provide an impact in today’s healthcare system
but continue to struggle with issues surrounding autonomy to practice. Hospitals and other
facilities differ from one another in policies regarding APRN practice. In the future, more
standardization of the APRN role with APRNs practicing at their fullest extent will be beneficial
to patients and physicians. As more underserved and rural populations require healthcare, the call
for more APRN autonomy will become increasingly apparent. The future is bright for Advanced
Practice Nurses.
References
Carlson, K. (2023, May 31). Aprns enjoying increasing autonomy. APRNs Enjoy Increasing
Autonomy. https://nursesusa.org/article_aprn_enjoy_increasing_autonomy.asp
Joel, Lucille A. (2018). Advanced practice nursing: Essentials in role development (4th ed.).
Philadelphia: FA Davis.

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INTERVIEW WITH AN APRN-CNP 1

An Interview with an APRN-CNP with Analysis

Nicole Sesser BSN, RN

Youngstown State University

Nurs 7003: Role Development

Dr. Kim Ballone DNP, APRN-CNP

Mrs. Wendy Thomas MSN, APRN-CNP, FNP

June, 21st, 2023

faces in today’s health care system.

personal communication, May 30th, 2023).

with pain management, stabilization of hemodynamics and any post-operative complications,

heart failure (B. Tittle, personal communication, May 30th, 2023).

collaborating physician (B.Tittle, personal communication, May 30th, 2023).

the NP to provide patient care (Carlson, 2023).

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