Nurse Practitioner Roles

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

Poghosyan and Knutson conducted a survey of 278 APRNs to better understand their independence and role in New York State primary care settings. Forty two percent of the APRNs surveyed stated they have their own patient panel and do not share panel with physicians and two thirds are able to review the outcome measures of the care they deliver. The study found that despite the restrictions on APRNs they freely apply their clinical knowledge

Results indicated a 25% decline growth rate of NP’s was slower in the most restrictive states

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).

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.

I personally see a NP for my primary care visits and feel confident in the care I receive. I feel like the more autonomy NPs are given and the research being done that proves good patient outcomes will help further along more autonomy for NPs in the future.

Two types of data were collected through surveys, both before and after implementation of the combined approach (Sand-Jecklin and Sherman,2014). The first data was on nurses’ point of view with regards reporting process, and the second on patients view regrading nursing care. The baseline survey included 233 patients and 148 nurses, while the survey three months into the implementation period included 157 patients and 98 nurses. The final survey, 13 months into the impanation, was completed by 154 patients and 54 nurses. The patient survey also included responses from patient families. These were 70, 72, and 53 responses for baseline survey, three-month postimplementation surveys, and 13-month postimplementation surveys.

The institute of Medicine (IOM) has defined quality healthcare as safe, effective, timely, efficient and patient-centered care that is given to an individual regardless of their race, gender, financial status or health status (Wood & Haber, 2014). Quality initiatives are designed to help maximize efficiency; decrease poor work performance and resolve workforce problems through leadership, commitment and involvement (Abdallah, 2014). Abdallah (2013) also noted that trained physicians can help with the implementation of quality culture and employee morale, and it can help with the collaboration of ACNP and physician management. According to Chorostecki et al. (2015), interprofessional (IP) care includes shared decision-making, collaborative problem solving, respect in the work field, and equal contribution among all healthcare team members. Implementing effective interprofessional collaboration can help enhance quality care in hospital, acute, home or office settings (Chorostecki et al.,

According to Health Resources and Services Administration If the system for providing primary care in 2020 were to stay fundamentally the same as today, there will be an estimated shortage of 20,400 primary care physicians ("Projecting the Supply and Demand for Primary Care Practitioners Through 2020," n.d.). In addition this projection doesn’t include the decreasing number of people perusing the medical degree and the baby boomers retiring form this filed of science. In the hand we are experiencing a significant increase in NPs and PAs. Considering this projected shortage, which is actually a very frightening situation the increasing number of NPs and PAs, can effectively be integrated; we could reduce the number of physician shortage by over 69 percent in 2020.

The implementation of a more autonomous and collaborative approach are the foundation to improve health care outcomes. I believe that patients with limit access to health care or especial populations will benefit the most, if NPs are allow to practice with more autonomy, cooperating with other health care providers.

Legislation in our state makes it very difficult for Nurse Practitioners to practice fully. Although the need for NP’s are at an all-time high, especially in Family Practice setting. APN must get a license to practice and have to submit to the board, a written application on forms furnished to the applicant. The original application shall contain the applicant's statements showing the applicant's education and other such pertinent information as the board may require. The applicant shall at least have completed their high school course of study, or the equivalent as determined by the state board of education, and have successfully completed the basic professional curriculum in an accredited or approved school of nursing and earned a professional nursing degree or diploma.

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

This paper will address and evaluate the research problem itself, the design of the study, the sample, how the data is collected, its limitations, and its findings. Furthermore, how does this study impact the overall nursing process?

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

Teamwork is vital in healthcare.  When all participants are engaged in a program, goals are successfully achieved. Being able to communicate and work collectively as a team requires an appreciation for each other’s area of practice.  Every team member has an important role and being acknowledged provides a sense of responsibility and accountability. Essentially, inter-professional collaboration helps ensure that the patient is getting care that is not only accessible but also comprehensive.  The plan of a patients’ care includes active participation by all health care professionals working interdependently in accordance to the patient’s preferences, values and beliefs. The health care team accomplishes the goal of meeting the patient’s medical needs by delivering evidence-based practice.   To deliver quality care, the patient should always be involved.