Maintain a positive attitude towards progress towards full practice authority for NPs

The nurse practitioner (NP) scope of practice is regulated by the state government. Currently, 21 states and Washington, D.C., have passed laws giving nurses full practice privileges. This enables NPs in these conditions to independently diagnose, make treatment decisions, order and interpret diagnostic tests, and prescribe medications without physician supervision. Research clearly confirms the security, effectiveness and quality of care provided by nurses as a protected alternative to medical care (Horrocks et al. 2002, Mundinger et al. 2000). Moreover, this model of nursing care is supported by the Institute of Medicine’s landmark 2010 report titled . This document comprehensively examines ways to expand access to high-quality take care of people within the United States and supports NPs practicing to the total extent of their licensure and education. This movement is gaining momentum as national parties have made huge strides in lobbying for full power over the practice.

A recent article in “” tells the story of a nurse in rural Nebraska who, after graduating from college, was unable to practice in her field because she couldn’t find an allied physician with whom she could work at an inexpensive price and inside an inexpensive distance. The article goes on to explain the newest laws in Nebraska, which in April 2015 became the twentieth state to adopt laws allowing nurses to practice and not using a collaborating physician. While the general tone of the article was supportive and dropped at light problems with access to health care in rural America, the title suggests that members of the legislature should undertake efforts and responsibilities that they’ve not been trained to perform (i.e., a physician and not using a doctor). In fact, the laws has little to do with the practice of a nurse and not using a “doctor”; The impetus for full-fledged practice is the will to eliminate barriers to access to health care resulting from old, outdated laws and regulatory barriers that prevent nurses from performing the total scope of responsibilities and providing the total range of services for which we trained. Moreover, nurses don’t need to eliminate collegial collaboration with physicians or any members of the health care team. We all understand that true, high-quality care requires a team of providers from multiple disciplines. Nurses don’t lobby for “doctor” without “doctor” because the title suggests. Essentially, the NP movement to expand laws to support scope of practice will provide greater patient access to proven high-quality care, expanding the health care workforce to enable access to care in geographic regions where patients have limited access to high-quality care .

As nurses, we must proceed to support laws and promote our career, and proceed to teach the general public about misconceptions in regards to the career. There were over 400 comments under the article. Reading them reveals overwhelming support from the general public and the healthcare community, but unfortunately also highlights persistent public and healthcare provider misconceptions in regards to the role and scope of practice of nanoparticles within the US, in addition to misconceptions in regards to the goals of full authority in practice. One of the doctor’s comments is as follows: “I may be biased, but I have yet to meet a nurse with the competence, (I believe) intelligence, and sense of responsibility of my doctor.” Another physician writes, “If NPs want an independent practice, so be it. They only need to offer their very own medical malpractice insurance and won’t be affiliated in any way with any physician, supervising or not. Take full responsibility for all your personal medical decisions and see the way it seems. It’s just fair.” (Tavernase, 2015). Comments like these make the subject appear to be a turf battle when actually a lot of the country’s doctors and physicians work together seamlessly in our health care system.

The American Association of Nurse Practitioners (AANP) is a number one advocate for removing barriers to NP practice. In one, they best summarize the goals of “removing barriers and outdated legislation and regulations that do not recognize the advanced education and clinical preparation of NPs to provide the full range of services they are licensed to provide.”

Recently, the Pennsylvania Coalition of Practicing Nurses (PCNP) held a lobby day in support of House and Senate laws to support full practice power. PCNP spent numerous effort and time to make sure that the PA regulations were implemented. To date, the PA has not yet adopted this laws. What varieties of struggles have you ever faced in your state to achieve full authority to practice? Are you fully licensed to practice in your state, and in that case, have there been any noticeable changes to your each day practice? Have the doctors, patients and other nurses in your life supported this work? Share your thoughts in a comment below.

Bibliography:
AANP Issue Brief: Remove barriers that hinder nurses from practicing their career. Source:
http://www.aanp.org/images/documents/federal-legislation/issuebriefs/Issue%20Brief%20-%20Removing%20Barriers.pdf

Committee on the Robert Wood Johnson Foundation Initiative for the Future of Nursing on the Institute of Medicine. The way forward for nursing: leading change, improving health. Washington, DC: National Academies Press; 2011

Horrocks, S., Anderson, E., & Salisbury, C. (2002). A scientific review of whether primary care nurses can provide equivalent care to physicians. 324, 819

Mundinger, M. O., Kane, R. L., Lenz, E. R., Totten, A. M., Tsai, W., Cleary, P. D., Friedewald, W. T., Siu, A. L., & Shelanski, M. L. (2000). Primary care outcomes in patients treated by nurses or physicians: a randomized trial. 283 section 1, 59-68

Tavernise, S. (2015). Doctors and not using a doctor. May 25, 2015. Retrieved from http://www.nytimes.com/2015/05/26/health/rural-nebraska-offers-stark-view-of-nursing-autonomimy-debate.html