Policy And Advocacy For Improving Healthcare Paper
Policy And Advocacy For Improving Healthcare Paper
Advanced practice registered nurses are a special category of nurses with a post graduate education in nursing who can either work in the general capacity or as specialists. APRNs are prepared with knowledge, clinical education, skills as well as the scope of practice in nursing to meet the various patients’ needs. However, despite of the educational and other qualifications, there are issues with the independence of practice among APRNs which significantly hinder accessibility of care among patients seeking specialized services from the APRNs (Boyle & Mumba, 2018)Policy And Advocacy For Improving Healthcare Paper. Various states have varied policies regarding the scope of practice of APRNs with several policies proposed to allow APRNs to work in full scope of education and working experience.
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At least 24 states have allowed advanced practice registered nurses to work indigently and they include Alaska, Arizona, Colorado, Minnesota among others. In these states, the APRNs can either operate or own a nurse practitioner private practice without the oversight of the physician. Restricting APRNs to work under the supervision of a physician has been one of the barriers to practice among APRNs and it has reduced the productivity of the nurses leading to poor patient outcomes. States that have limited the APRN scope of practice such as Texas have been criticized for introducing barriers to full practice of APRNs (Germack, 2021)Policy And Advocacy For Improving Healthcare Paper.
With the increasing nurse shortage, the laws that restrict the practice of APRNs have been termed to be punitive because allowing APRNs to practice in their full scope of education and skills will help ease the burden of nurse shortage, thereby improving patient outcomes. According to Dillon and Gary, (2017), full practice authority (FPA) among NP is essential to improve accessibility to care.
References
Boyle, M. K., & Mumba, M. N. (2018). Barriers and facilitators for implementing the nurse practitioners full prescriptive authority: A systematic literature review.
Dillon, D., & Gary, F. (2017). Full practice authority for nurse practitioners. Nursing administration quarterly, 41(1), 86-93.
Germack, H. D. (2021). States should remove barriers to advanced practice registered nurse prescriptive authority to increase access to treatment for opioid use disorder. Policy, Politics, & Nursing Practice, 22(2), 85-92 Policy And Advocacy For Improving Healthcare Paper.
Advanced Practice Registered Nurses, or the APRNS, are governed by the Board of Nursing defined by the Nursing Practice Act and the several laws and regulations each state has. The main practice issue with APRNS is independent practice (NCSBN, n.d.). This problem is that specific legal requirements and physician involvement limit the services APRNS can provide. Thus, making it more difficult for patients to access these types of providers fully. The scope of practice for all APRNS varies depending on state and specialty.
In Texas, the Board of Nursing is who oversees evaluating applications, disciplinary actions, and issuing and renewing of nursing licenses. In New Mexico, the Board of Nursing is also in charge. The criteria of both organizations to give credentials are similar. Still, there is a very different scope of practice between Texas and New Mexico. Texas has very restrictive APRNS practice laws compared to those of New Mexico. For example, in New Mexico, NPs are allowed to diagnose and treat without physician involvement. A formal relationship with a doctor is required and documented in writing in Texas. This relationship varies from state to state and requires supervision, delegation, authorization, and collaboration between the doctor and the Nurse Practitioner. New Mexico does not require doctor authorization for NPs to prescribe medications, but Texas does.
Texas Nurse Practitioners are allowed to prescribe medications only under physician supervision. They may only prescribe a 30-day supply and are not allowed to prescribe class II medications. Nurse Practitioners must include the supervising physician’s name, address, DEA number, and phone number when prescribing. Furthermore, APRNS are not allowed to sign death certificates or handicap parking permits in Texas but can sign worker’s compensation claims and be officially named primary care providers (ThriveAP,2013)Policy And Advocacy For Improving Healthcare Paper.
New Mexico made national headlines as it has one of the most favorable and liberal laws regarding APRNS. New Mexico does not require physician supervision allowing more freedom in their practice. According to New Mexico state law, Nurse Practitioners can practice independently, make decisions regarding their patients, families, or community’s health care needs, and carry out health regimens. Furthermore, New México’s NPS may prescribe schedule II to V without physician authorization and sign death certificates and handicap permits (ThriveAP,2013)Policy And Advocacy For Improving Healthcare Paper.
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In my resident and practice state, Texas laws and regulations are restricting our practice as APRNS. Regardless of the strict Texas laws and regulations, it will ensure physician supervision for the length of my career. As an APRN, I will provide my patients with exceptional care. In my practice, the restriction of not being able to prescribe class II medications and a supply of 30 days or less limits the scope of practice of nurses and interferes with patient care.
As previously stated, each state has different scopes of practice, regulations, and titles but has similar education requirements standards (Milstead &Short, 2019, pp. 65)Policy And Advocacy For Improving Healthcare Paper. All Advanced Practice Registered Nurses should always work within their scope of practice, following their state’s guidelines and regulations through the Board of Nursing and if the state requires it to be overseen by a physician.
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