A Nurse Practitioner

This particular nurse practitioner (NP), Diana Hayes, seems like somebody who has done this job for decades; in reality she obtained her acute care NP (ACNP) degree in 2014, less than 2 years ago and got her advanced practice license in Tennessee the same year. Her current role working as an intensivist NP in the trauma unit at Vanderbilt Medical Center is part of a recently launched program that brought NPs into the care of the sickest patients in the hospital.

Loretta Ford, is commonly known as the pioneer of the nurse practitioner role. The NP role was shaped by Ford, in collaboration with pediatrician Henry K. Silver in 1965, in response to the need for providers for well-child care, in community based settings (Zaccagnini & Waud White, 2017). Though many texts, Zaccagnini included, cite a physician shortage as the impetus for the creation of the role, Ford herself disputes the emphasis on this shortage, as one of several “myths” many of which continue to influence the NP movement (Towers, 2011). This creates a view of NPs as “physician extenders” or substitutes for physicians, and diminishes the role of the NP (Sullivan-Marx et al., 2007). The creation of the NP was in conjunction with nursing leadership, who were focused on creating graduate nurses for clinical specialization (Towers, 2011). The lack of providers simply created an opportunistic environment for nurses to reclaim the role that public health nurses had historically held, focusing on wellness, health promotion and disease prevention (Zaccagnini & Waud White, 2017). The first NPs were certified in the area of pediatrics, but soon began to develop focus on other populations, such as whole families, gerontology, women’s health, or psychiatry.

First, the state licensure regulates NP practice and it has been a big issue since NPs are not able to practice to the fullest extent despite of their education and training. NPs practice is regulated by state licensure and only about one-third of the nation has adopted full practice authority licensure and practice laws for NPs (Hain & Fleck, 2014). The American Association of Nurse Practitioners (AANP) reports that, under a full practice authority model, NPs are still required to meet

been restricted on what they can and can’t do including signing certain documents and orders they can prescribe. With the Affordable Care Act the demand for primary care providers is growing (Gadbois, Miller, Tyler, & Intrator, 2015). This means that the need for APRNs is rising and the need change is approaching. In the primary care setting, there is a variety of medical staff working including medical assistance, LPNs, and RNs. This can become more for the APRN when delegating medication administration. When the APRN cannot delegate medication administration the quality of patient care is sacrificed and is not productive in providing care to the patients.

ACNPs have been propelled to the forefront as health care providers for the acute & critically ill as a response to a mandated eighty-hour weekly work limit for physician residents. The Accreditation Council

This paper explores the perception of clinical practitioners to the change in policy related to the advanced practice registered nurse (APRN) full practice authority. The author conducts a one-on-one, open-ended interview of 5 nurse practitioners and 5 physicians licensed to practice in Maryland on their perceptions of the recent passage of the Advanced Practice Registered Nurse Full Practice Authority. A literature review was conducted in a policy report by the professional nursing organization, and discussion within the peer-reviewed article supported an overview, regulatory differences among 50 states, including the District of Columbia. Their policy implication for enhancing APRNs role nationally. The author discusses a critical component

A baby was just born at 26 weeks gestation. Just over half the normal 40 weeks a baby should stay inside the mother. The baby is immediately whisked away and taken to be evaluated and prepared for a long journey ahead. Ever since I could remember babies and the nursery at the hospital have fascinated me. Whenever we would go visit a friend who had a baby, I would find myself peaking over the windows into the nursery. I have known for a while that working in the neonatal intensive care unit is what I want to pursue. Recently I have been looking into nurse practitioners and furthering my education beyond my BSN. Being able to care for these infants in the most critical stages of their life, and being able to provide them the support they need to survive outside the womb seems so satisfying . Neonatal nurse practitioners have years of education, deep history, detailed job description, high demands and some legal issues.

Since the inception of the Nurse Practitioner (NP) role in the 1960s, NPs have thrived in the delivery of primary healthcare and nurse case management. Despite patient satisfaction with NPs ' style of care, nurses have been critical of NPs, while physicians have been threatened by NP encroachment on MD practice. Balancing assessment, diagnosis, and treatment with caring defines NPs ' success as primary care providers. Understand the role and Scope of Practice of NPs is sometimes difficult for some to understand. The purpose of this paper is to define the role and history of NP, compare and contrast licensure versus certifications, understand NP Scope Of Practice and Standards of Care, discuss how the State Practice Acts regulate FNP practice, discuss credentialing and privileging, and differentiate between legislative and regulatory processes.

With the passing of the Affordable Care Act in 2010 approximately 32 million more people will be insured throughout the United States. The need for healthcare workers and providers will be in drastic demand to provide care to these insured Americans. The 2010 IOM report details out how the advanced practice nurse can be a valuable asset in primary, chronic and transitional care and their skill set should be used to promote better healthcare across the nation (IOM, 2010). This impact of this report should help progress advanced practice nurse’s ability to practice without individual state regulation and be governed under one body to server in and outside of the hospital setting

5. Brief factual summary: This case involves a 2014 three-year Recruitment Agreement (“Agreement”) among Hospital, Physician, and Practice. Practice and Physician terminated their employment relationship 6 months into the guarantee period of the Agreement. Subsequently, Physician entered into her own private practice in the community and continues to meet her obligations under the Agreement. Practice and Physician disputed which party would retain certain

The purpose of this paper is to identify the type of facility and the resident being served. In addition, this paper will identify the role of the Nurse Practitioner (NP), and the regulatory issues as it supports this role.

As resistant as some states’ legislative and regulatory bodies are to grant APNs autonomy of practice, the damage being done by over-regulation is clear (Safriet, 1992). Physicians are forced into a position to either supervise the APN’s practice or be constantly consulted for approval of their practice decisions. Safriet (1992) described that in and of itself, this constant supervision may appear to patients that the APN is not competent to provide adequate or care equivalent to that of a physician. If the role of the APN is to bridge gaps in health care by relieving the medical establishment of some of the patient load by performing the same function as a physician in a primary care setting, it seems wholly unnecessary to restrain their scope of practice in those areas. This type of restrictions affect cost and patient care accessibility (Safriet, 1992). This was a problem stated in the article, however 25 years later, populations of patients remain unseen or cared for and APNs continue to be underutilized (Safriet, 1992). Rigolosi and Salmond (2014) cite the American Association of Nurse Practitioners (AANP) when they state that not utilizing nurse practitioners due to practice restrictions costs $9 billion annually in the US (p. 649).

This legislation was introduced in hopes of reconsidering the law by allowing independent practice of the advanced practice registered nurse (APRN) in the state of Pennsylvania. Pennsylvania law currently states that an APRN must work under the direct supervision of a physician (Fairman, Rowe, Hassmiller, & Shalala,

The first major point that I would like to address is the APRN’s scope-of-practice that currently varies among the states. For instance, a majority of the states require the APRN to practice under the physician supervision while other states do not. Due to the restricted prescriptive authority, the authority to order, interpret tests, diagnose and treat diseases, without physician supervision or collaboration, the APRN is only able to provide their care to the extent that is dictated by political verdict (IOM, 2011). However, that can greatly limit knowledgeable and trained APRNs in providing care to their full extent. Also there is no evidence showing that the APRN less capable than physicians to give safe, effective, and efficient care.

Recently, I have been reading publications regarding the “debate” over what type of patients should be seen by which licensed professional. Frequently this discussion revolves around the use of Nurse Practitioners, or Physician Assistants versus Physicians. Well-discussed arguments for both are abundant.