Barriers for a Nurse Practitioner to Practice in Long Term Care

There is a shortage of all health care professions throughout the United States. One shortage in particular that society should be very concerned about is the shortage of Registered Nurses. Registered Nurses make up the single largest healthcare profession in the United States. A registered nurse is a vital healthcare professional that has earned a two or four year degree and has the upper-most responsibility in providing direct patient care and staff management in a hospital or other treatment facilities (Registered Nurse (RN) Degree and Career Overview., 2009). This shortage issue is imperative because RN's affect everyone sometime in their lifetime. Nurses serve groups, families and individuals to foster

Healthcare workers in the United States work together to provide the best possible care for patients that come into their facility. Patients go through different waves of health care professionals before seeing an actual physician. Healthcare systems use a nurse practitioner, which is a registered nurse with more education and specialization, to help treat a patient in a timely manner. According to the American Academy of Nurse Practitioners, NPs have been providing care to patients for over 45 years. The year 2011 has seen 140,000 practicing nurse practitioners in the United States alone, with 9,000 more expected to enter the work force (American Academy of Nurse Practitioners a, 2010). With statistics demonstrating great expectations of

Registered nurses are an integral part of the healthcare system, and make up the largest number of healthcare professionals. According to the Bureau of Labor Statistics (2015) “The employment rate for registered nurses is expected to grow by 16% between 2014 and 2024”. This is more than double the average rate of growth for a profession. The rapid growth rate can be attributed in part to better management of chronic diseases and the baby boomer generation. The growth in the nursing profession is paramount, however the demographics of the nursing population does not mirror the demographics of the population served.

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

Budzi, Lurie, Singh, and Hooker (2010) state, “Nurse Practitioners’ (NP) interpersonal skills in patient teaching, counseling, and patient centered care contribute to positive health outcomes and patient satisfaction.” According to their research they encourage healthcare systems in the U.S. to hire more NPs to allow for better access affordable, and quality care (Denisco & Barker, 2016). With the demand for primary care providers, The NP role aids in delivering a solution to some of the healthcare issues that exist today. Organizations like the Institute of Medicine (IOM) and Centers for Medicare and Medicaid (CMS) all agree to allow nurses to practice to their full abilities to make healthcare more accessible and affordable, especially for the aging baby boomers and less accessible rural neighborhoods, and densely populated urban areas. Research has proven that NPs that provide primary care have similar health outcomes to primary care physicians (DeNisco et. al., 2016). NPs particularly take pride in their holistic approach, forming therapeutic relationships between other providers of the healthcare team, patients, and their families, aiding the informed decision making process, use of the evidence based practice approach in health management (Brown, 2005). Some of the other actions or qualities that

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.

Over the last several years, the majority of graduating medical students (90%) has been focused on careers in specialized care. (Pickert, 2009) This is because they will make more money in comparison with doctors that are working in a primary care environment. As a result, a shortage has developed with many health care providers turning to Nurse Practitioners. These are nurses with some kind of advanced degree in Nursing. Their job is to diagnose / treat patients and prescribe medication. To fully understand what is happening requires looking at how this trend is having an impact on accountability, quality, costs / health promotion and risk reduction. These different

Nurse practitioners have been practicing and providing care to patients for decades. They are often at the forefront of providing care alongside physicians. They are quickly becoming the primary provider choice for many patients in a world where there is a shortage of good and accessible primary care providers. As health care providers, they have prescriptive authority to diagnose, treat, and evaluate patients. Besides being health care providers, nurse practitioners are mentors, educators, administrators and

The success of NPs depends on practicing evidence-based care with competency in assessment, diagnosing, managing patients, and maintaining a caring practice. The nursing component of the NP role continues to be challenged from within nursing, as well as by large national physician organizations. NPs are extensions of nursing practice who are guided by nursing theory. The transformation from nurse to the advanced practice role of NP involves development of advanced knowledge and skills for listening, knowing, being with patients, connecting patients to their communities, promoting health,

The Robert Wood Johnson Foundation (RWJF) has just released a new study highlighting the steps 12 states are taking to prevent a looming crisis in nursing. Experts predict the United States could be short more than 260,000 nurses by 2025 and the study authors say state-level partnerships must take the lead in addressing the problem. The scarce supply and shortage of nursing staff has become a matter of sincere concern for healthcare organizations across the nation. The demand for healthcare services is increasing and requires healthcare organizations to employ qualified and well trained nursing staff.

Debra Hain and Laureen M. Fleck. ”Barriers to Nurse Practitioner Practice that Impact Healthcare Redesign" OJIN: The Online Journal of Issues in Nursing Vol. 19, No. 2, Manuscript 2. Web. 6 Apr. 2016.

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).

I would assume that all of us aspire to live a long healthy life, however, sometimes things don’t go as planned and some of us ultimately end up suffering from some type of ailment throughout our lives’. It would be disappointing if there wasn’t a nurse to care for you during your visit to a clinical facility. Unfortunately, this dilemma might come into existence due to a possible nursing shortage in the near future. That being said, all patients and their family members would be outraged if their loved one wasn’t receiving adequate care, understandably so. In addition, this scenario would also take a toll on physicians because I don’t believe they would be able to tack on all of the work that a nurse is specializes in.

The rapidly increasing sector of aging population and an implementation of the Affordable Care Act, which extends coverage to an additional 32 million of Americans, would culminate in the dire shortage of medical providers (Moote, Kleinpell, & Todd, 2011, p. 452). Predicted shortage of health care workforce intensifies the interest in and need to understand better NP utilization, productivity, and unique value (Moote, Kleinpell, & Todd, 2011, p. 453). Within the last decade growing shortage of physicians and the restriction on resident duty hours implemented by the Accreditation Council for Graduate Medical Education (ACGME) in 2003 presented wide employment opportunities for Acute Care Nurse Practitioners (ACNP) (Moote, Kleinpell, & Todd, 2011, p. 452). As nurse practitioners (NPs) assume an increasing role in providing care to hospitalized patients, evaluation of the quality of care provided by ACNPs is an important determinant of their impact on the patients’ outcomes (Kapu & Kleinpell, 2012, p. 1, Sidani & Doran, 2010, p. 31). While organizational constraints and variations in the scope of practice persist, in order to firmly establish the position of the ACNPs in acute care settings, it is imperative to determine to what extent NPs contribute to the quality, safety, and effectiveness of healthcare (Stanik-Hutt, et al., 2013, p. 492).

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