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Why scope of practice is important in nursing
Nursing scope of practice
Nursing scope of practice
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Restraint of trade is becoming a more commonplace as nurse practitioners (NPs) attempt to expand or work within their full scope of practice (Horton, 2013). In the health system, many NPs are being restricted by physicians to oversee patients, as well as restricting the mileage with which one can collaborate with a physician. This affect patient’s care and productivity. The issue with restraint of trade is that physicians are not wanting to collaboration with NPs and the ones who do collaborate do so to meet the legal requirement only on paper. Issues with restraint of trade are that physicians are afraid NPs are going to take away their work, their income and patients (Horton, 2013). In true view, collaboration is working together with nurse
The article Troubled Nurses Skip from State to State Under Compact exposed nurses under disciplinary actions in one compact state were being able to continue practicing in another compact state. The article discusses the case of one particular nurse, Craig Peske, who was fired from a Wisconsin hospital in 2007. Peske was suspected of stealing Dilaudid, “when in a three-month period he signed out 245 syringes full of the drug – nine times the average of his fellow nurses” (Webe...
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).
Yee, T., Bokus, E., Cross, D., & Samuel, D. (2013). Primary care workforce shortages: nurse practitioner scope-of-practice laws and payment policies. National Institute for Health Care Reform, 13, 1-7.
Professionalism and staying within professional boundaries is not only a critical part of maintaining your patient’s trust, but it is also a law that nurses must follow to remain practicing. Patients are vulnerable to the nurse in this position, so the nurse must be careful not to break this trust. Professional boundaries are the gap between the nurse’s professional position and the vulnerability of the patient. Nurses are required to abide by privacy standards to protect the patient and to practice a therapeutic relationship. A therapeutic relationship is the medium between under-involvement and over-involvement, and is the zone where nurses should remain. One reason why it is so important that nurses do not overstep their boundaries, is that nurses are respected, trusted, and valued by patients. It is important to keep this reputation to be successful in this field (Black, 2014).
According to American Nurses Association (ANA), (2010) “the nurse promotes, advocates for and strives to protect the heath, safety and right of the patient” (p. 6). Nursing responsibilities should be acted at the highest standard and must be based on legal and ethical obligations.
In the United States, depending upon the state in which they work, nurse practitioners may or may not be required to practice under the supervision of a physician, frequently referred to as a “collaborative practice agreement”. However, in consideration of the shortage of primary care/internal medicine physicians, many states are eliminating or lessening the restrictive authority which allows and nurse practitioners the ability to function more autonomously (AANP 2015).
Pericak, Arlene "Increased Autonomy for Nurse Practitioners as a Solution to the." The Journal of the New York State Nurses Association 42.1-2 (2011): 5-7. New York State Nurses Association. New York State Nurses Association. Web. 24 Oct. 2013
1. The role of the Nurse Practitioner in Primary health Care in Ontario is to work collaboratively with the interprofessional team, patients, and patient’s families in order to communicate diagnoses, order and interpret diagnostic tests, prescribe medication, and to provide treatment using a holistic approach. The Nurse Practitioner does not replace other health care professionals, but works together with them focusing on “health promotion, disease and injury prevention, cure, rehabilitation and support” (Ontario PHCNP Program, 2014). The Canadian Nurse’s Association believes that the Nurse Practi...
Fewster-Thuente, L., (2015). Working together toward a common goal: A grounded theory of nurse-physician collaboration. MedSurg Nursing, 24(5), 356-362. Retrieved December 2, 2016 from
Traditionally nurses have taken a subordinate role in making decisions regarding patient care. With increasing emergence of advanced nurse practice, ethical issues that relate to independence of practice arise. After years of legislative debate some states are trying to fill the primary care physician shortage with nurses who have advanced degrees in family medicine. There are currently 18 states in America that have allowed DNPs to practice without physician oversight (Vestal, 2013). While many state and federal legislations bear concerns about patient’s s...
At the same time, collaboration which played an important role as a relationship between this both professions involved (Sayed& Sleem 2011). However, doctors and nurses have a complicated relationship over the year, which were affected by social status, gender, power and perspectives 9. In addition, the power between nurses and doctors affected toward nurse-doctor relationship throughout 1970-1980s (McKay & Narasimhan (2012). Studies suggest that there is a serious need to promote positive changes toward inter professional collaboration between doctors and nurses improve patient outcomes and increase nurses’ job satisfaction2,3,4(Bartholomew 2008).. Nevertheless, the nurse-doctor relationship had been improved by 1990s. It is obviously shown when the nurses are able to challenge the doctors, discuss together, changing information and gain more
Collaboration is a complex process that requires intentional knowledge sharing and joint responsibility for patient care. Sometimes it occurs within long-term relationships between health professionals. Within long-term relationships, collaboration has a developmental trajectory that evolves over time as team members leave or join the group and/or organization structures change. On other occasions, collaboration between nurses and physicians may involve fleeting encounters in patient arenas (Lindeke PhD RN, CNP, & Sieckert, BAN,
86-89). According to McCormack & McCance (2010), nurses are within their professional care capacities to deliver patient-centered or person-centered processes. The main components of an effective process include the following: “working with patient’s beliefs and values; engagement; having sympathetic presence; sharing decision-making and providing for physical needs” (p. 89). Since nurses are at the forefront of engagement with the patients in a continuous basis, they are in the best position to address and shape policies not only within their organizations, but also at the national level. However, values in the healthcare industry, relative to guidelines and policies, will only be formed through intelligible advocacy, discussion, debate, collaboration, and influence. Therefore, advancing the nurses’ professional care expertise through interdisciplinary collaboration across the healthcare profession, opportunity for advanced educational programs, and promotion to executive position within an organization is of the best interest in addressing and improving the healthcare system. The intended outcomes will result to a cost-effective, quality, and safer patients’ clinical care.
In every nurse's career, he or she will face with legal and ethical dilemmas. One of the professional competencies for nursing states that nurses should "integrate knowledge of ethical and legal aspects of health care and professional values into nursing practice". It is important to know what types of dilemmas nurses may face
Today, nurses account for roughly two-thirds of all medical care providers (Clarke, 2012, pg.320) and in part receive an amount of recognition that is far less than physicians and surgeons. Many nurses face a lack of respect from the patients they medically assist, and even their co-workers including primarily the doctors and other professionals who reside over them. The relationship between doctors and nurses is often noted as problematic filled with barriers that result in a form of tension between who is detected as more resourceful and professional (Pullon, 2008, pg.140) often with the doctor consuming the greatest amount of recognition. In fact, doctors in respect to primary care tend to label themselves as the “biomedical part of primary care” (Pullon, 2008, pg.139) with nurses and other health occupations below them being seen as a supplementary component to a consultation. Activities such as injections, basic inspections and administering medications are just a few examples of medical acts that are performed both by nurses and doctors, but