I have been called to testify in front of a regulatory committee that is reviewing the credentialing and clinical privilege rules for Advance Nurse Practitioners. APN credentialing refers to a process whereby an advanced practice nurse is granted the authority to offer patient care especially in hospital settings after establishing that he/she has met all the established standards in relation to education, licensure, skills as well as training and is qualified to execute the task (Hamric et al., 2013). Notably, the Advance Nurse Practitioners can order, administer or dispense drugs under the delegated authority of the physician and as dictated by the agreement or protocol. However, in the state of Georgia, they have no authority to issue written…
Advance Practice Registered Nurse (APRN) and a registered nurse (RN) are mandated to follow the regulations in their states of practice. In terms of regulations, an APRN has focused scope of practice which has limitation to practice, unlike the RNs with broad scope of practice (Hudspeth,2009). In the state of Texas, an APRN practices in areas beyond the scope of the RN, such as diagnosing and prescribing. For instance, once an APRN is educationally prepared as an acute care NP, the practice can only be acute and not primary care setting except further education is provided to practice in primary care setting, this believed, that the APAN does not have the didactic and clinical content to practice in a different area (Texas board of nurses…
The opportunity to be credentialed as Advance Nurse Practitioners allow them to have appropriate and essential clinical privileges to practice especially in hospital setting. However, in some states, APRN practice is still severely restricted by hospitals whether or not they have credential and privilege APRNs. However, The American Nurses Association (ANA) is looking into many strategies to address this barrier and ensure that APRNs can obtain appropriate clinical privileges. clinical privileges allow APRNs authorization to provide specific care or treatment in a particular setting. When obtaining licensure, it is recommended that the NP carefully review the state's advanced practice nursing act and contact the state Board of Nursing to clarify…
This is a study outlining the differences in competencies between the nursing prepared associate degrees in Nursing versus a prepared Baccalaureate degree in nursing. In this study areas of differences in practice and reasons why it is important for associate’s degree in nursing to achieve a Baccalaureate degree will be outline. Writer will create a picture of the prepared associate degree in nursing and Baccalaureate in their different scope of practice, the positions held in the field of nursing, pay scales and job markets. Writer will explain the educational preparation background between an associate degree in nursing and the Baccalaureate. A scenario to show the differences between an associate and Baccalaureate nurse will also be explained…
Even with the vast amount of advances in the healthcare field, we continue to see restrictions limiting availability to patient care. With the growing population, there is a shortage of primary physicians especially in rural areas. Advanced practice registered nurses collaborating with physicians to provide care has had a positive effect on the health care system, yet there are barriers that still exist. This paper lists issues with collaborative agreements, restrictions to APRNs scope-of-practice, and benefits of allowing APRNs to practice at their full scope-of-practice. Issues with Collaborative Agreements The nursing profession has grown exponentially since the 1970’s, when nurse practitioner education advanced from…
Lyder (2012) recognized that the APRN, through experience and education as being primed to step in and fill the gap as providers of primary care. However, full acceptance of the APRN as an equally qualified autonomous provider of care continues to exist despite this growing need. This paper will address the barriers that arise from the philosophy and goals, model of care delivery and systems model, that contribute to the continued lack of acceptance of the APRN as an autonomous primary care provider. Philosophy and goals.…
The State of Texas currently has many restrictions on Advance Practice Registered Nurses (APRN). We are one of thirty-two states in the United States that require Nurse Practitioners to work in a collaborative/supervisory relationship with a physician. Connecticut recently became the 18th state to allow Nurse Practitioners to practice independently (Lowes, 2014). Bill SB 751 for the 84th legislature was introduced by Senator Jose Rodriguez. This bill is aimed at granting Nurse Practitioners in our state autonomy from physician supervision and full prescriptive authority.…
APRNs are a highly respected and integral part of the healthcare system. They have the necessary knowledge and skills to care for patients in the absence of any other providers and can tremendously improve access to health care in rural areas of the jurisdiction. While most NPs practice in primary care, many NPs practice in a variety of healthcare settings, including hospitals, nursing facilities, clinics and private practices. By allowing NPs practice independently, it will allow patients direct access to the services. Therefore, Extending the ability of NPs to deliver services in more situations and more areas of the state.…
The scope of practice for APRNs consists of “parameters within which advanced practice nurses may legally practice”, defining “what they can do for and with patients, what they can delegate, and when collaboration with others is required.” 1 This scope of practices varies not only across APRN roles – CNS, CRNA, NP, CNM – but also across individual states.1 For the FNP specialty, scope of practice entails diagnosis and management of illnesses in the primary care setting for individuals across the lifespan. The three benchmarks of APRN practice and education are advanced practice nurse competencies, professional advanced practice registered nurse competencies, and Master’s and Doctor of Nursing Practice Essentials.2 APN competencies, which distinguish…
There have been significant, ongoing changes in the healthcare workforce over the past decades. Nursing needs have shifted due to a variety of manifestations ranging from a shortage of primary care physicians to a greater demand for chronic disease management. Advanced Practice Registered Nurses (APRN) are crucial to helping fill these voids. These highly educated nurses can be very beneficial to healthcare organizations as a part of an integrated team. Several studies have displayed the added value and outcomes that the APRN provides to different disciplines of nursing care.…
Discuss the significance of the issue for nursing Advanced Directives are significant to nursing as part of the whole healthcare system. Those include providing control to individuals, reducing conflicts in the healthcare setting and decreasing healthcare cost. It was reported by Health Canada (2008) that the reason why advanced care planning has caught the attention of the healthcare system is that the Canadian population is aging and more of chronic illnesses can be seen, which causes a burden on the system. Those who live longer with the chronic illnesses may have preferences of what they want before dying and what way they want it.…
In the state of Indiana, the law requires physician supervision of nurse practitioner's prescribing medications. This supervision is something that will serve as a barrier to those practicing, acting as a hindrance to autonomy. Yee, Boukus, Cross and Samuel (2013) found that the level of supervision was dependent on factors such as the culture and traits of the supervising physician (p. 2). However, they also found that delegation from physician to nurse practitioner was more prevalent in practices where supervision was required by law (Yee, Boukus, Cross, & Samuel, 2013, p. 2).…
What is the difference between an APRN and a physician? An Advanced Practice Registered Nurse (APRN) is a nurse who has had advanced training through a Master’s level program. The APRN has the ability to autonomously assess, diagnose, prescribe, and treat patients. A physician also has advanced medical training that allows them to assess, diagnose, prescribe, and treat patients.…
‘Crossing professional boundaries’: barriers to the integration of nurse practitioners in primary care. Education for Primary Care, 18, 480 – 487. Mundinger, M., (1994). Advanced-Practice nursing—good medicine for physicians?…
Advanced practice nurses serve a wide range of diverse populations all across the United States. No matter the environment advanced practice nurses serve in, patients obtain quality individualized care. Primary care environments are commonly the first place where rare diseases or conditions become identified through an array of testing from diagnostics to laboratory collections. As unexpected diseases continue to arise among patient populations, advanced practice nurses advocate for patients by relying on additional funding, resources, and additional support medically, clinical research, and federal funding. Through aggressive motivated professional commitments, and government funding, patients who face rare diseases then would no longer be…