Nurse-Practitioner Role Model

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.

In 2008, the coalition of members from the Alliance for Advanced Practice Credentialing and the National Council of State Boards of Nursing (NCSBN) created the Consensus Model for Advanced Practicing Registered Nurses (APRN’s). This model creates a framework for APRN’s in licensing, accreditation, certification, and education in the United States (Alleman & Houle, 2013). The establishment of this Consensus Model has developed a bases for the ARNP’s comprehensive knowledge base, ability for clinical reasoning, cultural, and ethical competencies, establishing a model of practice for ARNPs in which to follow. These concepts will be further discussed in this paper.

Consensus Model for APRN Regulation has 4 components: Licensure, Accreditation, Certification, and Education It supports goals of the ANCC APRN certification process and will align the inter-relationships among licensure, accreditation, certification, and education to create a more uniform practice across the country. Its aim is to improve consistency and clarity and take APRNs to the next level and also enhance patient care (“American Nurses Credentialing Center," 2015)

The Full Practice Authority for APRNs (HB 1415/ SB 681) deals with the legislation which will permit Nurse Practitioners (NPs) to practice to the complete magnitude of their education and training. It will also eliminate expensive and difficult regulatory requirements like having contracted delegation arrangements with physicians, and will place NPs under the select supervisory authority of the Texas Board of Nursing (BON). Bill HB 1415 was filed on 02/01/2017 and was “Left pending in committee” as of 04/25/2017. Bill HB 681 was filed on 01/31/2017 and was “Referred to Health and Human Services” as of

In recent years, APRNs have been very vocal through many nursing coalitions and associations. The voices of all ARNPs seeking full practice authority has been heard with the proposed bills. The Florida Panhandle Nurse Practitioner Coalition (FRNPC), has given information to all ARNPs to keep ahead in legislative issues. A white paper published by the American College of Physicians have been shared to all Floridian ARNPs through the

Role is a function played by an individual or particular group of individual in a particular situation. It includes connected obligations, behaviors, rights, beliefs, and norms as theorized by people in a social state. The role of a nurse practitioner (NP) started to manifest in the mid-1960s. This came as a response to the nationwide physicians’ shortage. The NPs were then classified under the advanced practice registered nurse (APRN) umbrella. The origin of the NP role in the United States came through the effort of Loretta Ford (RN) and Henry Silver a pediatrician who had insight for the nurses to be developed and be more effectively used to improve the health care. The demand for primary healthcare was increasing as physician were moving to areas of specialty because of the associated income, lifestyle incentives and status. The nurses were to fill the gap. To realize this, education was essential. The nurses where then equipped with skills of performing developmental tests, history taking, doing evaluative procedures, some laboratory procedures and physical examination and referral for medical care that traditionally had been a medicine domain (O’Brien, 2003).

Under this model, the licensure enables the APRN to legally provide care to the public, with the required education and training, they are allowed to practice within the scope of practice depending of the States where they want to practice. The education

An Advanced Practice Registered Nurse is a nurse who has obtained at least a Master’s Degree in Nursing. Further specialization within in the APRN category includes Nurse Practitioners, as well as Certified Nurse Midwives, Certified Registered Nurse Anesthetists, and Clinical Nurse Specialists. APRNs have the education, training, and skills to perform many of the primary-care

The APRN is uniquely skilled and trained to meet this growing need, and policy should focus on expanding the role and autonomy of APRNs, and increasing funding, and possibly diminishing the reimbursement gap in order to attract and sustain a greater number of providers in underserved areas and provide them with the financial resources to remain viable, independent providers. Nurse Practitioners are more likely to work in primary care and in rural areas, particularly, remote rural areas,which are characteristically similar to underserved areas, than are

Hamric explains, advanced practice nursing as patient centered and skillful activities provided to improve population outcomes. Hamric focuses on educational and clinical practice, criteria and competencies. The baseline criteria include graduate education, certification and patient/family focused. The education of an APN is graduate level with specialized knowledge of an advanced practice role and supervised practice. Professional certification is required for advanced practice with a focus on a certain population. The competencies include: direct clinical practice, holistic perspective, therapeutic partnerships, expert clinical performance, reflective practice, use of evidence, and diverse approaches to health (Hamric et al., 2014, p. 76).

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.

APRNs are structured by the Consensus Model for APRN Regulation. The model was created by the APRN Consensus Work Group and the National Council of State Boards of Nursing (NCSBN) APRN Advisory Committee. This was developed to provide consistency so that the standards and scope of practice of APRNs will be the same (APRN, 2008).

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 specialty area selected by this author among the Advanced Practice Registered Nurse (APRN) roles was that of the Family Nurse Practitioner (FNP). High among the list of reasons for choosing the FNP specialty track was the ability to care for patients who lack healthcare insurance, are of limited financial resources, or are stigmatized. The type of organization that would allow me to provide high-quality, patient-centered care in a manner consistent with my professional aspirations would be a Primary Care Organization (PCO). Being part of a PCO would allow me to implement clinical skills that are distinctive of the care provided by the FNP, such as to educate patients regarding management of chronic conditions as well as counseling on disease prevention and health promotion strategies. These skills would be provided in addition to the well-established responsibilities shared with other healthcare providers; such as performing examinations, making diagnoses, prescribing medications

Advanced practice nurses in the United States are governed by the state boards of nursing of the state in which they practice. There are no uniform rules governing autonomy and prescriptive authority throughout the country. Therefore, there is a disconnect among practitioners who are certified by national credentialing but practice under differing regulations from state to state. This paper will examine support for changes to existing regulations regarding the APRN’s prescriptive authority.