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Learning Objective #1: Explain how to integrate the role of the APN in a high-risk obstetric clinic within the scope of practice as delineated by certifying organizations.

Learning Objective #2: Explain ways a women’s health nurse practitioner can function in a high-risk obstetric out-patient clinic and how the WHNP enhances continuity of care.

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The purpose of the presentation is to discuss how an APN in a high-risk obstetrical clinic can enhance “collaboration” in the management and care of pregnant women. This APN role was developed through the ANGELS Program, which is an innovative program, which began in 2002 whose mission, is to ensure that all pregnant women in Arkansas have access to the best perinatal care so that all mothers and babies will have every chance at the best outcome. The role of one APN in the ANGELS program will be the focus of this presentation. Although ANGELS employs several APNs to implement the various aspects of the complex program, this APN role is support person to the maternal-fetal medicine specialists (MFM). This role is accomplished in many ways, including direct patient care, case management, patient advocate, and resource for in- and out-patient registered nurses in the medical system. Other opportunities this nurse has enjoyed in this role are preceptor for APN students, scholarly writing, supervisor/mentor for other program APNs, and coordinator for statewide annual perinatal conferences. The focus of this discussion will emphasize how this APN functions in the high-risk obstetrical setting. Pregnant patients with complex medical, social, and other problems cannot be managed solely by the busy MFM. The APN acts as the direct caregiver in these cases, deferring to the specialist only in times of unclear diagnosis and plan and is the one constant provider the patient sees in the clinic, speaks to after clinic hours for problems or questions, and will see in the hospital for any admissions, not as an in-patient provider, but as a patient advocate and confidant. In summary, this position has pushed advanced practice nursing beyond traditional roles and has advanced this nurse's professionalism and knowledge significantly.