Autonomy In Their Practice

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

There is a growing trend where physicians are choosing different specialties instead of choosing primary care, primarily due to the low reimbursement rate in primary care. According to Iglehart (2014),” the Association of American Medical Colleges (AAMC) still projects a shortage of 130,000 physicians by 2025, split almost equally between primary and specialty care” (para. 1). With this decline comes an answer, an increase in the number of nurse practitioners providing patient care, reported 154,00 in 2012 and growing every year (Iglehart, 2014). This increase in nurse practitioners’ helps fill that gap, allow greater health care access to the community, especially special populations. By gaining access to healthcare were a nurse practitioner is the provider not only with the special population have high quality affordable health care, a trusting long lasting relationship will develop. This relationship will break the barriers of; lack of trust, lack of health care education and discrimination. Nursing is a trusted profession that provides education and care that no other health care professional

Bahadori and Fitzpatrick conducted a study regarding the actual level of autonomy of the APRNs in primary care settings. They compared clinical outcomes for patients assigned to either APRNs or physicians and found there was no significant differences in reported health status between patients treated by NPs or by the physicians. Also Bahadori and Fitzpatrick (2009) stated within their report although the APRNs had more restrictions regarding their professional authority and struggle with maximal autonomy they recommend APRNs have more autonomy and decision-making authority to allow them to work as competent professionals, and improve patient care outcomes.

The role of nurse practitioner is valuable when discussing collaborative care. There are so many levels of care, so many health entities, and so many insurer criteria involved that it is instrumental to have a role that can work towards help bring all aspects together. In addition to diagnosing, treating, and managing care, the role of the nurse practitioner is to manage simple and episodic acute health issues along with chronic disease (Sangster-Gormley, Martin-Misener, & Burge, 2013). It is important to note that although this is a function of this role, nurse practitioners also practice from a holistic point of view which allows them to help manage patient conditions or wellness in a more complete fashion. This includes helping patients have access to care beyond primary and secondary care settings. This encourages nurse practitioners to work alongside other health care and allied health professions, and families to create an individualized plan for every patient (van

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.

When there are Nurse Practitioners that are filling in for doctors, this can improve quality. The way that this takes place is to have these individuals work with select amounts of patients. This creates smaller teams and more personalized attention in providing these services. This is when mistakes will decrease with health care professionals doing more for everyone. Once this happens, is when the underlying quality of care will rise. (“Scope of Practice,” 2010)

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.

As a practitioner or a population health coach, both APNs considered other nurses at any level, and physicians within the same discipline, as her peers. Over the course of their professional careers, increased confidence, trust, and knowledge were the commonalities with evolving roles. The confidence and trust originates with oneself, then, includes that of her co-workers and physicians, but mostly from her patients. Maturing from the novice RN to an expert APN, the confidence and knowledge base has developed, building an individual practice and supporting patients and communities towards optimal health. Each considered autonomy the greatest privilege guaranteed them as APN.

“All health care disciplines share a common and primary commitment to serving the patient and working toward the ideal of health for all.” (American Association of Colleges of Nursing, 2014, p. 1) There are many different professional members in the healthcare system. Each of them, have a specific specialty and responsibility to the patient and play an important role in the patient’s overall plan of care. “The scope of health care mandates that health professionals work collaboratively and with other related disciplines. Collaboration emanates from an understanding and appreciation of the roles and contributions that each discipline brings to the care delivery experience.” (American Association of Colleges of

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).

Many examples of innovative professional practice have been highlighted throughout recent literature; which suggest that the needs of a patient are best met by an interprofessional team. (Caldwell & Atwal, 2003) Benefits from effective interprofessional practice include improved health outcomes, interprofessional team effectiveness and efficiency, job satisfaction among interprofessional team members, cost efficiency and respect for the roles of other health professionals and colleagues. (McNair, Brown, Stone & Sims, 2001) Interprofessional practice is critical to the provision of effective and efficient health care; given the complexity of patient's healthcare needs and the range of health providers and organisations. (Reeves et al.,

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

Nursing is an all encompassing profession in which practitioners are not only proficient in technical medical functionality, they also have the obligation to remain compassionate and respectful of patients and as such are expected to adhere to pre established codes of ethics. Of these ethics, autonomy is of extreme importance as it offers patients a sense of personal authority during a time where they may feel as if their lives, or at the very least their health, is no longer under their control. Autonomy in the context of nursing allocates the patient and often their family with the final word on the course of treatment. The concept of patient autonomy is a highly variable subject in all fields of health care. It is a universal concept that varies widely in its meaning and interpretation. Autonomy in its simplest form can be defined as a state of independence or self governing (Atkins, 2006). Patient autonomy can also be defined as the ability to make once own decisions, based on one’s sound judgment. It is defined by the American Nurses Association (ANA, 2011) as the "agreement to respect another 's right to self determine a course of action; support of independent decision making." This seemingly straight forward ethical concept is rife with difficulties when one considers potential disagreements that may arise even when informed consent is provided, particularly among children or vulnerable people. Relevant research and

According to American Nurses Association (2010) Scope and Standards of Nursing Practice, collaboration is defined as, “a professional healthcare partnership grounded in a reciprocal and respectful recognition and acceptance of: each partner’s unique expertise, power, and sphere of influence and responsibilities; commonality of goals; the mutual safeguarding of the legitimate interest of each party; and the advantages of such a relationship”.(p. 64). Collaboration amongst health care providers is very crucial in providing quality care to patients. Integration of disciplinary teams, improves communication, coordination, and most importantly, the safety and quality of patient care. It provides interaction between team members allowing

The role that nurse practitioner (NP) plays within the increasing complex health care system is a constant changing role with the Consensus Model and the introduction of the Affordable Care Act in 2010. The scope of the nurse practitioner (NP) includes the care of the young, the old, the sick and the well. The educational needs of a nurse practitioner vary greatly from that of a Registered Nurse (RN), in the amount of education as well as the focus of the education. NPs provide coordinated primary care with the use of comprehensive health histories and physical examinations, diagnosing and treating acute and chronic illnesses, the management of medications and therapies, ordering and interpreting tests results, and educating and