Historically, the American Medical Association (AMA) has continuously contended the progression of nursing practice, in particular advanced nursing practice (Keeling & Bigbee, 2005). They have done so by opposing the advances of nursing practice claiming the broader and more specialized roles of advanced practice nurses (APNs), which includes diagnosing and prescribing, encroaches on physician practice and claim nurses are not educationally sufficiently prepared to take on these roles (Summers & Summers, 2007). The medical profession posits APNs should be supervised by physicians in their advance practice roles. Examples of such opposition are evident in for example AMA’s posting of a recent speech given by Nancy Nielsen (2009) stating that the AMA will oppose a proposed bill to allow APNs to classify themselves as primary care providers; or as presented and discussed at the recent 34th AMA Annual Meeting (AMA, 2010), in which a strong opposition to autonomous practice of APNs was discussed and the position of physician supervision of APNs practice was advocated.
This opposition not only hinders the advancement of cost efficient healthcare, it also stands in direct opposition to the newly proposed Patient Protection and Affordable Care Act (U.S. Congress, 2010), which recognizes APNs practice and working relationship with physicians to be one of collaboration, not submission, and recognizes the need for the expansion and recognition of APNs’ role in order to increase the availability of healthcare to all Americans.
In order to allow for APNs to be efficient in providing care to their patients, those APNs diagnosing and treating patients, need to be able to have the authority to prescribe treatments, inclusive of medications, f...
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...Summers, H. J. (2007). Changing poor portrayals of nurses in the media: The center for nursing advocacy. In D. J. Mason, J. K. Leavitt, & M. W. Chaffee (Eds.), Policy & politics in nursing and health care (5th ed., pp. 184-194). St. Louis, MO: Elsevier Saunders.
Tucker, S. (2003). Preparing CNSs for prescriptive authority. Clinical Nurse Specialist, 17(4), 194-199. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/12869866
United States of America Congress. (January 5, 2010). In U.S. Government Information (Ed.), An Act (One Hundred Eleventh Congress of the United States of America). Retrieved from http://democrats.senate.gov/reform/patient-protection-affordable-care-act-as-passed.pdf
Weinkam, K., Bailey, L., & Goodman, H. J. (Eds.). (2003). What is the RN scope of practice? (The BRN report, pp. 7-9). Retrieved from http://www.rn.ca.gov/pdfs/forms/brnfall2003.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.
The model discusses the impact of new regulations on education for APRN, Licensure Accreditation, Certification & Education Document, certification and practice. The model is implemented to grasp the general understanding and definition of advance practice registered nurse APRN role, inconsistencies with state by state recognition of APRN roles, and determining eligibility for APRN licensure (Consensus Model for APRN Regulation, 2015). The consensus model definition of APRN is a nurse who is educationally rounded to assume the responsibility of assessing, diagnosis, treating, teaching health promotion and disease maintenance, acquired advanced clinical knowledge and skills to provide direct patient care, has passed a national certification examination, and licensed to practice in one of the four roles (Consensus Model for APRN Regulation, 2015).
In fact, there have been numerous studies supporting the clinical performance and outcomes of NPs. A systematic review covering the literature from 1990-2008 found that patient outcomes of care provided by APRNs in collaboration with physicians were similar to and in some manners, exceeded those of physicians alone (Newhouse et al., 2011) Newhouse, et al’s review added to the available evidence that APRNs provide safe, effective, quality care to specific populations (2011). In their review, they did not separate outcomes of NPs with full practice authority from those with reduced or restricted practice. Due to the patchwork of state regulation and restrictions on NP practice, it may be challenging to compare the outcomes of NPs with full independent practice from those with reduced or restricted practice. Furthermore, the AANP states “there are numerous studies that demonstrate nurse practitioners consistently provided high-quality and safe care” (n.d.). They go on to state “in the more than 100 studies on care provided by both nurse practitioners and physicians, not a single study has found that nurse practitioners provide inferior services” (AANP, n.d.). The Federal Trade Commission (FTC) has also reviewed the literature and determined there is not a significant difference in the outcome of NPs and physicians that would necessitate the anti-competitive nature of scope-of-practice regulations and restrictions on advanced practice nursing (Federal Trade Commission [FTC],
This discussion board is about the nurse’s scope of practice. The purpose of this posting is to discuss the definition and standards of the nurse’s scope of practice as defined by the American Nurses Association (ANA) and by the Ohio Board of Nursing with an example of how to use the standards of practice. Per the ANA, when determining the nurse’s scope of practice there is no one specific explanation that can be provided due to the fact that registered nurses can have a general practice or a practice that is very specialized. The limits that are placed on a RN’s scope of practice will depend on a registered nurse’s education, type of nursing, years as a nurse, and the patients receiving care. At the basic level, every nurse’s practice
Nursing is a knowledge-based profession within the health care sector that focuses on the overall care of individuals. According to The American College of Nurse Practitioners (ACNP), “defines nurse practitioners as registered nursed who have received graduate-leveling nursing education and clinical training, which enables them to provide a wide range of preventative and acute health care services to individuals of all ages. They deliver high-quality, cost effective care, often performing physical examinations, ordering tests, making diagnoses, and prescribing and managing medication and therapies”. Nurse Practitioners are able to specialize in a particular area, such as family and adult practice, pediatrics, and women’s health; and refer patients to other specialist when necessary. Some Nurse practitioners work under the supervision of a physician; while others run their own practices.
Advanced practice registered nurses play a significant part in extending access to health care by providing primary care and specialty care services to clients. Advanced practices registered are mentors, educators, researchers, and administrators. According to Health Resources and Services Administration, “Ninety-six percent of the NP workforce reported being in clinical practice, providing direct patient care” (Health Resources and Services Administration 2016). Furthermore, “Nearly three percentages were in faculty positions and approximately one percent was in administrative positions”(Health Resources and Services Administration 2016).
Potter, P.A. & Perry, A.G. (2009). Fundamentals of Nursing (7th ed.). St. Louis, Mo.: Mosby Elsevier.
Brykczynski, Karen A. “Role Development of the Advanced Practice Nurse,” in Advanced Nursing Practice: An
...sa, H. Cashin, A. Buckley, T. Donoghue, J. (2014). Advancing advanced practice — clarifying the conceptual confusion. Nurse Education Today 34 (2014) pp. 356–361
Advanced Practice nursing (APN) is considered the usage of a broader scope of constructive, logical and research-based expertise related to the health and well-being of patients, within a varying disciplines (DeNisco & Barker, 2013). What is the future position of APNs in the progression of our healthcare system? What role will this writer assume, educator, practitioner, population health coach, or all three? The use of theory, primarily Sister Callista Roy’s Adaptation Model, and EBP give this writer a firm foundation to develop and modify her own practice framework.
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, to learn and understand the scope of practice of an RPN in order to be accountable for all my actions as a future nurse. The reason I feel I need further development in IV therapy is because, in my current clinical setting at the hospital, the majority of the patients I have cared for are on IV therapy. As a nursing student, we have just started learning about IV therapy. I will also use the CNO standards for medication when administering an IV solution because it is a medication and the 10 rights need to be applied (CNO, 2015).
Nurses make up the greatest sector of health care workers, and are vital to meeting the objectives of the 2010 Affordable Care Act (ACA). Identifying the barriers that nurses face, and recommending a plan to overcome those barriers, were the goals of the Robert Wood Johnson Foundation (RWJF) and the Institute of Medicine (IOM) in their two-year movement to “assess and transform the nursing profession” (The National Academies of Sciences, 2016). This paper will recapitulate the IOM report, Future of Nursing: Leading Change, Advancing Health. It will also recognize the position of the RWJF and the American Association of Retired Persons (AARP) on the Future of Nursing: Campaign for Action. It will stress the implication of the IOM report as it
Image and profession go hand in hand. Image plays a very important yet controversial role in the nursing profession. The image of nursing is often inaccurate and falls short of the fair and correct portrayal of what the role of nursing truly is (Summers, 2010). With an inaccurate portrayal of what nursing really is comes the challenges of the profession. Popular stereotypes in nursing coming from both the past and today media and expectations take away the true meaning and role of the modern profession. Some common stereotypes include but are not limited to: unskilled, a way to marriage, and a physician’s helpmate. These stereotypes lead to many problems within the nursing profession including poor working conditions, insufficient support
Potter, P. A., & Perry, A. G. (2009). Fundamentals of nursing (Seventh ed.). St. Louis, Mo.: Mosby Elsevier.
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.... ...