Nurses: Barriers to practicing to the fullest extent of their education and training In this dynamic healthcare climate, Advanced Practice Registered Nurses (APRNs) will play an instrumental role in health outcomes of diverse populations. Currently, there are more than 250,000 APRNs who hold masters and doctoral degrees and who are nationally certified (Brooten, Youngblut, Hannan, & Guido-Sanz, 2012). Due to the demand for healthcare services, the employment of APRNs is expected to increase 31% from 2012 to 2022 (Bureau of Labor Statistics, 2014). Several factors contribute to this increase in demand, including passage of the Affordable Care Act (ACA), the ever-increasing aging baby boomer population, and the renewed interest in health promotion
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One of the greatest barriers to accessible care is overly restrictive state scope-of-practice laws and regulations (IOM, 2011). Unfortunately, this variation has an indirect impact on accessible patient care because the degree of physician involvement may affect opportunities and payer policies (Yee, Boukus, Cross, & Samuel, 2013). While some states allow “full practice authority” i.e., Washington, Oregon, and Nevada, most states, i.e., Alabama, Tennessee, and Georgia, do not. Full practice authority means that nurse practitioners (NPs) are required by their licensing state to meet educational and practice requirements for licensure, maintain national certification, and are held accountable to the public and state boards of nursing to maintain standards of care and professional conduct (AANP, 2014). Only about one-third of the United States has adopted full practice authority for NPs …show more content…
In addition, many commercial heath insurance plans don’t recognized APRNs as primary care providers; therefore, educated and experienced APRNs are forced to practice as employees for physician practices instead of employers of their own practices (Yee et al., 2013). So, what is the answer to this dilemma? The answer is multi-factorial; however, the elimination of variations in state scope-of-practice and licensure laws and regulations are imperative to remove barriers to independent practice. Standardization of APRN laws would provide nationwide consistency so there will be uniformity in the quality of medical care (Round, Zych, & Mallary, 2012). The 2011 IOM report also encourages APRNs to assume active leadership roles as members of the healthcare team. Collaboration with physicians is an opportunity to educate them about the roles of APRNs while helping to strengthen relationships to achieve more favorable outcomes in the quest for autonomous practices (Maylone, Ranieri, Griffin, McNulty, & Fitzpatrick, 2009). Professionalism, respect, and quality patient care are core principles of physician-APRN collaborations, not the inability to control one’s
One of the greatest barriers to accessible care is overly restrictive state scope-of-practice laws and regulations (IOM, 2011). Unfortunately, this variation has an indirect impact on accessible patient care because the degree of physician involvement may affect opportunities and payer policies (Yee, Boukus, Cross, & Samuel, 2013). While some states allow “full practice authority” i.e., Washington, Oregon, and Nevada, most states, i.e., Alabama, Tennessee, and Georgia, do not. Full practice authority means that nurse practitioners (NPs) are required by their licensing state to meet educational and practice requirements for licensure, maintain national certification, and are held accountable to the public and state boards of nursing to maintain standards of care and professional conduct (AANP, 2014). Only about one-third of the United States has adopted full practice authority for NPs …show more content…
In addition, many commercial heath insurance plans don’t recognized APRNs as primary care providers; therefore, educated and experienced APRNs are forced to practice as employees for physician practices instead of employers of their own practices (Yee et al., 2013). So, what is the answer to this dilemma? The answer is multi-factorial; however, the elimination of variations in state scope-of-practice and licensure laws and regulations are imperative to remove barriers to independent practice. Standardization of APRN laws would provide nationwide consistency so there will be uniformity in the quality of medical care (Round, Zych, & Mallary, 2012). The 2011 IOM report also encourages APRNs to assume active leadership roles as members of the healthcare team. Collaboration with physicians is an opportunity to educate them about the roles of APRNs while helping to strengthen relationships to achieve more favorable outcomes in the quest for autonomous practices (Maylone, Ranieri, Griffin, McNulty, & Fitzpatrick, 2009). Professionalism, respect, and quality patient care are core principles of physician-APRN collaborations, not the inability to control one’s