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Currently, there are too many variations with respect to the rules governing NPs' scope of practice. So, as well as you, I would love to see all 50 states have the same scope of practice and regulations for NPs. Unfortunately, there are too many barriers that won’t allow for this to happen any time soon. However, progressively more incentives are created for states with restrictive laws to revise the scope of practice regulations in order to allow for greater use of nurse practitioners. According to LeBuhn (2010), some policy makers have already begun to “ see the scope of practice as a tool to promote the goals of healthcare reform: improved access, quality care and lowered costs. ”
LeBuhn, R (2010). Reforming scope of practice. Retrieved
Association, A. N. (2010). Nursing Scope and Standards of Practice. (2nd ed.) Maryland: American Nurses Association. Retrieved January 20, 2014 from http://media.wix.com/ugd/8c99f2_4fde86431966e34f2e03bbb137edfee3.pdf
In 2011, Barbara Safriet published an article “Federal options for maximizing the value of Advanced Practice Nurses in providing quality, cost-effective health care” from a legal perspective. The article focused on the benefits of utilizing Advance Practice Nurses to the full extent of their abilities as well as the current barriers that APNs encounter in their practice. The aim of this paper is to discuss two regulatory provisions to full deployment of APNs in current health care system, as well as three principle causes of current barriers to removal of the restrictive provisions for the APN. Furthermore, I will discuss the critical knowledge presented in the article and how it relates the APN practice. This article was incorporated into a two-year initiative was launched Institute of Medicine (IOM) and by the Robert Wood Johnson Foundation (RWJF) in 2008 which addressed the urgency to assess and transform the nursing profession.
Noone, J. G., Cleary, B. L., Moulton, P., Wiebusch, P. L., Murray, J. L.,Yore, M., & Brunell, M. L. (2010). Toward standardization (Part 1): assessment of state and national nursing workforce data sources. Policy, Politics, & nursing Practice11(3), 173-183. Doi10.1177/1527154410390521
The Nurse Licensure Compact (NLC) enables nurses to practice in other states besides the one in which they reside. There are currently 24 states included in the NLC, which includes Tennessee and neighboring Missouri, Arkansas, and Mississippi. Eligibility for a multistate license requires that a nurse legally reside in a compact state (National Council of State Boards of Nursing, 2014). There are no additional applications required to apply for a compact license. Only one multistate license can be active at a time. Therefore when issued a compact license, any previously active compact licenses are made inactive. Also it is important to note that nurses are required to practice according to the nurse practice act of the state for which they are actually practicing in rather than their primary state of residence. Therefore a nurse could be subject to disciplinary action in the states of practice. The nurse’s home state license is recognized in all compact states unless the nurse is under disciplinary action or restriction. With the compact licensure in place, the question is then raised to whether there is an increased risk for disciplinary actions in compact states opposed to non-compact states.
Access to quality healthcare is a growing concern in the United States especially in light of healthcare reform coverage expansions made possible by the Patient Protection and Affordable Care Act of 2010. It is estimated that 94% of all Americans will acquire healthcare coverage under the law, an increase of nearly 30 million people (King, 2011). This dramatic influx of patients into the healthcare system has projected to cause an immediate increase in added pressure on an already challenged healthcare workforce (King, 2011). Notably, at a time when healthcare demands are growing, graduate rates from medical schools remain unchanged while advanced practice registered nurse (APRN) graduate rates are rising (Cipher, Hooker, Guerra, 2006). The increased availability of APRNs, along with enhanced delivery of healthcare skills, gives the role a unique advantage in the current state of healthcare. These specialized advanced practice nurses provide services often at a patient’s first (and in some cases, primary) point of contact into the healthcare system (Brassard, 2013). Due to this, many states have started to take action to mitigate the increased healthcare system burden by enhancing the APRN’s scope of practice by broadening prescriptive authority. This has been shown to be one of the fundamental ethical avenues of increasing not only access to healthcare, but also efficiency and quality of care (Ross, 2012).
Dimension of Nursing Practice: Practice- Provides leadership in the application of the nursing process to patient care, organizational processes and/or system, improving outcomes at the program or service level.
My plans after obtaining my advanced degree is to acquire licensure to practice as AGNP in the state of Texas. The Texas BON acknowledges that APN education, experiences, and competency levels vary, hence, holds individual APN accountable for knowing and practicing within their own scope of practice and competency always. The APN’s education is the grounds to their scope of practice: however, the APN can expand the scope of practice within the role and population-focus, as long as it remains within limits of the law. The Texas BON restricts the scope of practice for the APNs. The Nurse Practitioner Supervision Laws require¬¬¬¬¬ APN to work under physician supervision within seventy five mile perimeter. In addition, there is the Texas ' Nurse Practitioner Prescribing Laws which require APNs to prescribe medications under physician supervision and APNs are not allowed to prescribe schedule two drugs. All prescriptions written by the NPs must include the supervising physician 's name, address, Drug Enforcement Administration (DEA) number and phone number (Texas BON,
National Council for the State Boards of Nursing, APRN background, (2012). Report of the nursing policy and legislative efforts. Retrieved from https://www.ncsbn.org/428.htm#Nurse_Practitioner_Certification
Nurse practitioners have not necessarily more but different responsibilities than those that are held by registered nurses. NPs have more freedom to make and oversee the carrying out of health care plans for patients. NPs are also able to follow guide lines more closely to those of a physician. Registered nurses (RNs) are able to advise and aide less skilled medical personnel. They are also able to order, examine, and explain different diagnostic tests as directed by a physician. All nurses have the responsibility to monitor and chart the conditions treatments and reactions of the patients. Nurse Practitioners are able to perform all these responsibilities along with many others not granted to less trained
Both Nurse Practitioners and Nurse Practitioner-students work closely with patients to monitor their health and provide care for acute and chronic illnesses. However, in the academic-clinical setting, the NP-student may only perform this function at the discretion of the supervising NP. Although work environments and responsibilities bestowed upon these distinctive nurses can be quite different, Nurse Practitioners, Registered Nurses and students is bound to the same laws and regulations governed by all states and territories that have enacted a nurse practice act (NPA). The NPA itself is insufficient to provide the necessary guidance for the nursing profession, therefore each NPA establishes a state board of nursing (BON) that has the authority to develop administrative rules or regulations to clarify or make the governing practice law(s) more specific (NCSBN
The Doctorate of Nursing Practice (DNP) represents the terminal practice degree for the field of nursing.
I need further development in knowing what the scope of practice of an RPN is because at clinical I am unsure of the difference in roles of the RPN’s that are working on the units compared to the Registered Nurses (RN’s). I feel that knowing and understanding the scope of practice of an RPN is crucial, in order to ensure the safety of the patients, but also to protect your license as a nurse. Also, it is important to understand your role as a nurse to ensure the patients’ needs are being met, and to ensure you stay within your scope of practice while providing care. The CNO’s scope of practice statement is, “The practice of nursing is the promotion of health and the assessment of, the provision of, care for, and the treatment of, health conditions by supportive, preventive, therapeutic, palliative and rehabilitative means in order to attain or maintain optimal function” (College of Nurses of Ontario, 2015). The goal I set for myself is, I will learn and understand the scope of practice of an RPN in order to be accountable for all my actions as a future
These nurses will work in various health care settings. All of these nurses have a legal outline to work in. Each kind of nurse has their own scope of practice. This is regulated by the nursing governing bodies. Nurses have to work within their scope of practice to deliver a good service to clients with quality and they are permitted only to work within the scope of practice.
I want to be a nurse, specifically a nurse practitioner. I have always been fascinated with the medical field and see a bright future in it for me. I have the opportunity of meeting new people every day with a variety of personalities. There is always something new to discover in this field. A nurse practitioner's job is to be able to diagnose and treat illnesses. They also prescribe medicine and run physical exams. I am highly interested in pursuing the career of a nurse practitioner because the healthcare field is always in need for medical professionals, it pays well, and I am helping people at the same time.
To briefly summarize, the report identifies nurses as an important factor in enabling access to high quality, affordable health care. This was supported by the development of four fundamental recommendations. The first suggests that nurses be allowed to practice within the scope of their degree. This becomes evident in the differences in state laws that pertain to nurse’s who have acquired advanced degrees, such as the nurse practitioner.... ...