An Analysis on the Ability of Nurse Practitioners to Prescribe Controlled Substances

Also in the state of Florida nurse practitioners authority to prescribe does not include controlled substances (Florida Senate, 2008). Another point of difference between both professions lies the fact that physician assistants can work only under the supervision of a physician, while the nurse practitioners are more independent in performing their duties, they do not have to work under a physician, and they can open their own practice. The PA’s working time depends strictly on the working hours of the physician, while the working hours of the nurse practitioners depend on the nurse and the laws of the state governing them (Cresswell, 2013). In the year 2013, the number of practicing NPs in the USA were 155,000 and the number of physician assistants was 83,600 (Garment, 2013). Although there are a few differences that exist between these two professions, they are equally important in the provision of quality health care for all

In the United States, health care accessibility, quality, and affordability continue to be ongoing topics of discussion that effect many Americans on a regular basis. The need for affordable, quality healthcare continues to grow, not only due to a growing elderly population, but also as a result of the Affordable Care Act which has allowed millions of previously uninsured Americans access to health insurance and therefor better access to healthcare services (Patient Protection and Affordable Care Act, 2010). According to the Institute of Medicine (IOM) the projected demand increased for healthcare have led to a call for expansion of primary care services by policy makers (Institute of Medicine, 2010; National Governors Association, 2012). Since Advanced Practice Nurses or Nurse Practitioners (APNs or NPs will be used interchangeably for the purpose of this paper) are one of the fastest growing groups of healthcare providers, and continue to practice and provide care in a range of settings including primary care, it is important to investigate and address any potential barriers to practice. This author believes that allowing APNs to write prescriptions for commonly used controlled substances will help improve timeliness and flexibility in health care delivery; studies have shown that there is a positive impact on high

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.

State law is made up of two different forms: statues and regulations (Buppert, 2015). Under the established rules and regulations, an ARNP can: (a) monitor and alter drug therapies; (b) initiate therapies for certain diagnosis’; (c) perform additional functions as may be determined by rule; (d) and order diagnostic tests and appropriate therapies (The Florida Legislature, 2016). A practitioner licensed under chapters 458, 459 or 466, must maintain supervision for directing certain course and medical treatment (The Florida Legislature, 2016). Within the context of advanced nursing practice and the Florida Statues chapter 464.003(2), an ARNP may diagnosis, treat, alter medication regimes, diagnose, prescribe and operate, which are approved by a joint committee composed of three members appointed by the Board of Nursing, three members appointed by the Board of Medicine and the State Surgeon General or his/her designee (The Florida Legislature, 2016). On the other hand, the federal government regulates nurse practitioner practice through statutes passed by Congress and regulations (Buppert, 2015). According to Buppert (2015), federal law can override state law, and when federal and state law conflict with one another, federal law usually triumphs. Due to these state and federal statutes and regulations, this can impose a huge threat and impact to NP practice since the BON and the Nurse Practice Act usually help

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

Drug policy is a crucial topic in the country today. Substance abuse, as well as drug-related crime rates, are a huge problem. This is a fact. The way to fix the problem of substance abuse, however, is widely disagreed upon. Some think that stricter laws regarding drug possession and use would solve the problem, while others believe that loosening the restrictions would be a better option. The issue of legalizing drugs, especially marijuana, is one that is debated all the time. In fact, in 1995, a survey was conducted on the most important policy issues and eighty five percent of the country placed drugs at the top of the list (Falco 1996). Many states are actually beginning to decriminalize, and even

While the demand of healthcare need increasers the United States facing a physician shortage. In recent years the number of nurse practitioners (NPs) and physician assistants (PAs) has significantly increased and they are taking the part in providing healthcare cervices to the majority of patients. I believe nurse practitioners and physician assistants can practice independently from doctors and be free of oversight. Expanding the scope of NPs and PAs is essential to overcome the healthcare crisis we are facing; it will increase patient satisfaction and stabilizing the healthcare economy.

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.

According to reports found on the web page MEDPAGETODAY (2014) there has been an increase in the independent practice for advanced practice registered nurses (APRN). The article quotes data from the American Association of Nurse Practitioners (AANP) which reports 17 states and the District of Columbia allowing “full practice” with this meaning the APRN evaluates, diagnoses, orders testing, prescribes medication and initiates and manages treatments. 21 states require “collaborative agreement” with a physician and 12 requiring supervision of a physician. Collaborative agreement scope of practice varies by state and institution of employment.

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).

There is an increasing demand for nurse practitioners, which makes this a crucial period in the development of their practice and profession. Nurse practitioners must face increased opportunity and continuing opposition towards independent practice all while defining their role in health care delivery and establishing their connections. The practice of nurse practitioners still varies widely across the states. These inconsistencies make it difficult for nurse practitioners as well as patients when practice

In 2013, the prescriptive scope of practice was expanded for Physicians Assistants to include Schedule II drugs in limited circumstances (South Carolina Academy of Physician Assistants, 2013). These include a one time dosing in a hospital setting and renewals of medications prescribed by an MD (South Carolina Academy of Physician Assistants, 2013). Hopefully, the South Carolina Board of Nursing will, aggressively, pursue both full practice and increased prescriptive authority of Schedule II drugs, for APNPs, in the near future.

I enjoyed reading your NP interview and was intrigued about how different states have such different scopes of practice for NPs. During my interview with a NP from Texas at an oncology clinic, I remember one of her challenges she faced was not having the autonomy to prescribe schedule II pain medications for oncology patients. She did say that the NPs in Colorado had more autonomy on pain meds they could prescribe, giving them more autonomy in their practice. I did some research about the differences from state to state and wanted to see if there was any research that proves if more or less autonomy for NPs is better or worse for patient’s outcomes.

One disheartening problem with practice authority is that it varies from state to state. “Variability in state regulation of NP practice limits the full deployment of these proven healthcare providers, threatens the quality and safety of NP-delivered care, and limits consumer choice in healthcare access” (Lowery, 2015). Some states allow full practice independence for APRN practice, while other states command all-inclusive dependency on a collaborating physician. The states that require the collaborating physician also have some variances, as some locations require the physician to physically be inside the same building with the practicing APRN and other locations require the physician to be within a certain number of miles of the practicing APRN. “Scope of practice for NPs is