Inured Patients: A Case Study

The Bureau of Labor Statistics predicts a 22 percent overall growth rate in the number of registered nursing jobs. This growth will be driven by an increasing emphasis on preventive care; technological advances in patient care that allow a greater number of health problems to be treated; and an increasing older population, creating a larger pool of illnesses needing treatment. Among specific industries in the realm of health care, job growth is predicted to be highest at physician’s offices, followed by home health care services, nursing care facilities, employment services and hospitals. The job growth at hospitals is forecast to be in outpatient services such as day surgery, oncology and emergency. Nurse practitioners, who supply a lower-cost option for primary care, will be in high demand, especially in medically

Therefore, there is great need to have all stakeholders at both national and state levels to address these emerging challenges. This will help to achieve the triple objective of healthcare, which is to provide better care, ensuring better health, and reducing the costs of accessing healthcare (Hain, & Fleck, 2014). Among the barriers the authors point out include practice and licensure laws in various states, payer policies, and other physician related issues among others. Licensure and practice laws for the profession vary across the states. Nonetheless, the challenge lays in the way these laws and practices relate with the full practice authority governing practice and licensure (Hain, & Fleck, 2014). A big proportion of the country has only adopted certain parts of the legal requirements, creating a significant barrier for NP practice. The other challenge is the perception among some groups of physicians that NPs cannot provide quality and safe patient care at the same level as the physicians (Hain, & Fleck, 2014). This perception emanates from the notion that NPs do not receive a rigorous and longer training and education unlike other physicians. This hinders effective performance of nurse practitioners and greatly affects the work of professionals such as family nurse

These impose severe constrictions on the ability of the nurse to move forward or advance into the areas of practice where traditional nursing practices were not allowed {Institute of Medicine, 2010}. However with the increase in the number of nurses graduating with advance degrees in nursing; the situation is changing. These well educated nurses are leading the charge to confront the complex issues that the rapidly changing health care situation presents. Regulatory barriers must be lifted so that nurses can practice within their scope in order to be reimbursed by private insurance for the services they provide. These changes can be done through the federal and state legislators as well as supervisory agencies and bodies such as congress and licensing regulatory boards. The IOM also recommends that nurses will expand their scope of practice and increase their responsibility through teaching and counseling of patients. {Institute of Medicine,2010}. The use of Advance Practice Registered Nurses and Physician Assistant in providing primary care services will decrease wait time and increase patient satisfaction. The high turnover of nurses transitioning from school to practice also affects the quality of care. These nurses do not have enough experience to make decisions in patient care.{Institute of Medicine,2010}.The IOM and JCAHO{2012} report supports the recommendations for the introduction of nursing residency

Samantha stated that initially many people asked her if she chose to be a family nurse practitioner to be a “mini physician” (S. Hage De Reyes, personal communication, June 22, 2016). In her perspective, it has been an issue to show others in health care professions that nurses just want to expand their knowledge. She “fights battles every day” for her patients because of the holes in our health care system (S. Hage De Reyes, personal communication, June 22, 2016). In her experience, she has seen many individuals without insurance. She has learned that being a family nurse practitioner is being an advocate for the patient and helping them get the resources that they need. Family nurse practitioners help provide care in a more affordable way. In Samantha’s opinion, family nurse practitioners are the answer to creating access to care for the large uninsured population and those that are newly insured under the Affordable Care Act, and I could not agree

Like what was stated previously, the cost of having Nurse Practitioners in place of doctors is lower. This is because their salaries are much less and the cost structure is lower. Evidence of this can be seen with Medicare and Medicaid. These government sponsored programs will pay for 85% of these services in comparison with doctors. This is important, because it is showing how the lower cost structure is one reason why Nurse Practitioners are playing a major role inside a health care environment. (Pickert, 2009)

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

Nurse Practitioners (NPs) play a key role in long term health care by ensuring provision of holistic healthcare services particularly in remote areas and in those areas that have few physicians. Currently, there is a concern where there is a shortage of physicians in nursing homes and in other critical health care services questioning the care being provided (Colwill, Cultice, & Kruse, 2008). Due to population growth,

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.

According to the Pearson Report, there is a total of 147,295 Nurse Practitioners throughout the United States (Pearson, 2009). However, for NPs in some states the battle continues over some forms of prescriptive authority or physician involvement in NP prescribing, such as the state of Pennsylvania. State regulatory approaches to NP prescribing range from no authorization for prescribing (in Georgia, 2006 legislation passed which recognized NPs as prescribers, but the rules have not been approved at the time of this writing) to unencumbered prescriptive authority (Arizona, DC, Montana, Oregon, Washington, and Wyoming) (Lugo, O’Grady, Hodnicki & Hanson, 2007).

In the Texas, state law prohibits Advanced Practice Registered Nurses (APRNs) including nurse practitioners (NPs) from practicing to the full extent of their education and clinical ability. Currently, Texas law requires than an APRN receive approval from an individual physician prior to engaging in the practice of advanced nursing. This type of complex regulatory scheme is outdated and restricts patients’ access to care, creates geographic disparities in services, and unnecessarily increases health care costs. For example, current law requires APRNs to meet periodically face-to-face with a supervising physician; with few physicians choosing to practice in rural areas, many APRNs who are willing to work in rural areas are essentially forbidden from delivering care to these underserved areas.

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.

One state, Massachusetts, enacted the legislation guaranteeing universal health coverage, this overwhelmed the state’s primary care physicians by a wave of newly insured patients. This resulted in advanced practice nurses because they

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).

Primary care practice will be greatly impacted by health care reform. To provide better health care, the country will see a trend away from specialty to primary care and the avoidance of acute issues by delivering this care in the community setting. As a result, primary care physicians will be overwhelmed with the patient load as the number of the insured increases exponentially. The committee recognizes the scope of nursing practice that remains untapped and therefore the profession

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