NRP/508 Current Issues for Advanced Practice Registered Nurses essay

NRP/508 Current Issues for Advanced Practice Registered Nurses essay

How state-specific regulations impact nurse practitioners

State-specific regulations impact NPS by determining if they can provide patient care with or without the supervision of physicians.   Some states have state scope of practice laws permits NPs to have full practice authority, meaning that NPs have the authority to see patients and prescribe medications independently with no physician supervision.  Other states have scope of practice laws requires collaboration between the NP and a physician which impede NPs to fully utilize their education and training and assist enable more patients to access care in the face of the current physician shortages.  As Cabbabe (2016) indicates, indicate disparities in scope of practice regulations across states have a direct impact on NPs as the level of physician supervision practice opportunities for nurse practitioners as they may locate physicians with whom to collaborate with.

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Regulatory barriers that still exist for NPs in Arizona and California states

Restrictive practice laws are that still exist for NPs in California State. Arizona scope of practice laws requires NPs to be supervised by physicians when provided patient care.  Although NPs in California have the necessary training to provide a wide range of services, they are impeded from delivering these services by state scope of practice law. Federal regulations in regard to NPs reimbursement is a barrier that continues to exist for NPs in both Arizona and California.  In Arizona, Medicare reimburses NPs with independent practices 85% of the physician rate for similar services.  NPs in California are also reimbursed at a reduced rate and are billed under the name of the supervising physician (Cabbabe, 2016).

The progress that has been made and what remains to be done

A bill has that would offer NPs full practice authority has been introduced in California. The AB 890 bill was in February introduced to the Assembly in February 2019. Under the legislation, NPs will be capable of performing certain functions without the requirement of being supervised by a surgeon or physician. What remains is for the bill to be evaluated in 2020 (Canady, 2019). NRP/508 Current Issues for Advanced Practice Registered Nurses essay

The different roles of the advanced practice registered nurse

The four core roles of the APRN are nurse practitioner (NP) clinical nurse specialist (CNS), certified nurse-midwife (CNM) and certified registered nurse anesthetist (CRNA). A NP is an APRN who offers health care in a community-based or outpatient ambulatory setting. The NP offers comprehensive care to individuals with complex problems, directly manages medical and nursing care for healthy individuals or those with chronic conditions. A CRNA offers surgical anesthesia under the supervision and guidance of a physician who possesses advanced knowledge of surgical anesthesia.  A CNM provides independent care for females during pregnancy, labor, and childbirth and also takes care of the newborn.  Other services include gynecological services like family planning, pap smears and treating vaginal infections.  A CNS is an expert clinician in a particular practice area such as geriatric, critical care or a disease specialty (Potter et al, 2016).

Professional opportunities available to develop interprofessional relationships within advanced practice nursing

The emergence of interprofessional collaboration along with interprofessional practice as a scheme of providing individualized patient care and decreasing present disintegration of health care services in the 21st century offers an exceptional opportunity for the APRN to take on a major role (Farrell et al, 2015). Interprofessional collaboration involves the collective participation of numerous providers working with caregivers, patients, communities and families to deliver high-quality care. NRP/508 Current Issues for Advanced Practice Registered Nurses essay. APRNs should be invested as partners in interprofessional collaboration to create valuable outcomes for the community, families, and patients they serve.

The ethical issue that may be faced by a nurse practitioner

The absence of a clinical indication for prescribing drugs is a key ethical issue that may be faced a NP. Often, patients are seen by the APRN and request a certain drug. The APRN must make sure that prescribed medication is medically necessary.  I would address the issue by can explaining to the patient the risks of prescribing the medication inappropriately without performing tests on the patient.   As Demler (2019) indicates, prescriptions must be written following performance and documentation of an examination to prevent harming the patient and avert legal consequences for the APRN.

The concepts of profession and professionalism as they pertain to the APRN

Professional means having skills and knowledge in advanced practice nursing and doing what one is obligated to do. Professionalism means offering quality care while being respectful, responsible and advocating for patients.  It also includes the ability of the APRN to have clear communications and self-reflection on actions and behaviors that enable the APRN to s develop both personally and professionally (Ghadirian et al, 2014).  Professionalism for RNs means compliance with, in all practice settings and roles to the practice standards for registered nurses and includes attitudes, values, qualities, and behaviors that demonstrate the RN is ethical, visible, knowledgeable and accountable. Professional for APNs means adherence to advanced practice nursing ethical codes and professional standards. NRP/508 Current Issues for Advanced Practice Registered Nurses essay

Historical factors contributing to the development of advanced practice nurse roles

Increased demand for healthcare services and shortage of physicians, particularly those practicing in remote regions are historical factors contributing to the development of advanced practice nurse roles. According to Woo et al (2017), the acuity and complexity of care have intensified with increased occurrence of chronic conditions as well as multimorbidity among the elderly population. The advanced practice role has its roots from the 1960s when the role was introduced as a solution to the shortage of physicians in underserved and rural populations.  Over the years the APRN role has expanded in response to changes in healthcare needs and advancements in scientific knowledge.  As a result of the expanding APRN role within health care, the requirement for formal training and education became more commonplace. NRP/508 Current Issues for Advanced Practice Registered Nurses essay

 

References

Cabbabe, S.  (2016). Should Nurse Practitioners Be Allowed to Practice Independently? Missouri Medicine, 113(6), 436-437.

Canady, V. (2019). California bill would grant full practice authority to nurse practitioners. Mental Health Weekly, 29(9), 1-3.

Demler, T.  (2019). Pharmacotherapeutics for Advanced Nurse Practice, Revised Edition. Burlington, MA: Jones & Bartlett Learning.

Farrell, K., Payne, C., & Heye, M. (2015). Integrating interprofessional skills into the advanced practice registered nurse socialization process. Journal of Professional Nursing, 31(1), 5-10.

Ghadirian, F., Salsali, M., & Cheraghi, M. (2014). Nursing professionalism: An evolutionary concept analysis. Iranian Journal of Nursing and Midwifery Research, 19(1), 1-10.

Potter, P., Perry, A., Stockert, P., & Hall, A. (2016).  Fundamentals of Nursing E-Book. St. Louis, MO: Elsevier Health Sciences.

Woo B., Lee, J., & Tam, W. (2017). The impact of the advanced practice nursing role on quality of care, clinical outcomes, patient satisfaction, and cost in the emergency and critical care settings: a systematic review. Human Resources for Health, 15, 63. NRP/508 Current Issues for Advanced Practice Registered Nurses essay

 

Week 2 Assignment Content

Prepare a 1,050-word paper using the findings from the Regulated Scope of Practice Learning Team assignment to guide you in addressing the questions below:

States chosen were:  Arizona (AZ) Full Practice and California (CA) Restricted Practice.

How do the state-specific regulations impact NPs? (7 pts)

What regulatory barriers continue to exist for NPs in each state? (7 pts)

Where has progress been made, if any? (5 pts) NRP/508 Current Issues for Advanced Practice Registered Nurses essay

What remains to be done? (5 pts)

Explain the four different roles of the advance practice registered nurse: nurse practitioner, certified nurse midwife, clinical nurse specialist, and the certified registered nurse anesthetist. (10 pts)

What professional opportunities are available to develop interprofessional relationships within advanced practice nursing? (5 pts)

Describe at least one ethical issue that may be faced by an NP. Explain how you as an NP would address the issue. (5 pts)

Describe concepts of profession and professionalism as they pertain to the APRN. What is different as an RN for a profession and professionalism as compared to an APN? (10 pts)

Analyze historical factors contributing to the development of advanced practice nursing roles. What has happened over time that has made APRNs what they are today? (6 pts)

Cite and reference using APA guidelines. Literature must be within the last 6 years and must be scholarly works (peer-reviewed). (10 pts) NRP/508 Current Issues for Advanced Practice Registered Nurses essay

Related Readings and texts:

  1. Hain, D., & Fleck, L. (2014). Barriers to NP practice that impact healthcare redesign. Online Journal of Issues in Nursing, 19(2), 23-31.

 

  1. Hamric, A. B., Hanson, C. M., Tracy, M.F., & O’Grady, E.T (2019). Hamric and Hanson’s advanced practice nursing: an integrative approach (6th ed.). St. Louis, MO: Elsevier.
  2. 2: Conceptualizations of Advanced Practice Nursing.
  3. 3: A Definition of Advanced Practice Nursing in Hamric and Hanson’s Advanced Practice Nursing.
  4. 9: Consultation in Hamric and Hanson’s Advanced Practice Nursing.
  5. 11: Leadership in Hamric and Hanson’s Advanced Practice Nursing.
  6. 15: The Primary Care Nurse Practitioner in Hamric and Hanson’s Advanced Practice Nursing.
  7. 22: Understanding Regulatory, Legal, and Credentialing Requirements
  8. NRP/508 Current Issues for Advanced Practice Registered Nurses essay