NR 510 Week 1: Barriers to Practice

Chamberlain University NR 510 Week 1: Barriers to Practice– Step-By-Step Guide

This guide will demonstrate how to complete the Chamberlain University NR 510 Week 1: Barriers to Practice assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for NR 510 Week 1: Barriers to Practice

Whether one passes or fails an academic assignment such as the Chamberlain University NR 510 Week 1: Barriers to Practice depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for NR 510 Week 1: Barriers to Practice

The introduction for the Chamberlain University NR 510 Week 1: Barriers to Practice is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for NR 510 Week 1: Barriers to Practice

After the introduction, move into the main part of the NR 510 Week 1: Barriers to Practice assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for NR 510 Week 1: Barriers to Practice

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for NR 510 Week 1: Barriers to Practice

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer for NR 510 Week 1: Barriers to Practice

The barriers to APN practice that were identified in the article are state practice and licensure, physician related issues, job satisfaction, payer policies and not being allowed to follow patients who are admitted to acute care facilities (Hain &Fleck, 2014).

These barriers to me mean that APN are restricted in their practice. They do not get to practice to the best of their education. I do feel that in the beginning there does need to be some guidance from a physician. The barriers can cause dissatisfaction with the job because of the amount of control taken from the APN regarding their decisions with their patients. This should be done in the first five years or so of practice. This would give the ANP the guidance needed while caring for patients. These barriers also mean the ANP does not get the same compensation as does a physician and payers will not pay at the same rate as they would for a patient being seen by a physician.

These barriers are not new to me nor do they come as a surprise. I have spoken with a few FNPs who have mentioned the fact that they are restricted to a certain extent. When working in the emergency room a lot of times the APNs would only be allowed to work on the lower acuity patients. In the event that there was someone who ended up being a higher acuity the APN would have to go to the physician for their opinion. This I did not see as a bad thing. It is always good to have the extra resource which can provide an additional set of eyes and knowledge for a situation. These restrictions do not concern me currently. I feel my motivation is seeing how certain physicians welcome the APN and are willing to work with them. Many I have seen give the APN more room to do their thing once they gain confidence in the APN.

These barriers do represent restraint of trade. They do not allow the APN to see patients and prescribe medications without restrictions. They have rules and regulations that restrict them and only allow them to practice in certain ways.

Nurses can influence these barriers by forming organizati0ons to appeal to their states about the way they are allowed to practice. To do this they will need to research and provide data stating the care they give, and the care given by physicians. They will need evidence about practices to be able to change the minds and get regulations changed. This will not be an overnight process, so they will also need to be willing to commit to making a change over years.

Reference

Hain, D., & Fleck, L. (2014, May). Barriers to Nurse Practitioner Practice that Impact Healthcare Redesign. OJIN: The Online Journal of Issues in Nursing, Vol. 19, No. 2, Manuscript 2, doi: 10.3912/OJIN.Vol19No02Man02

Sample Answer 2 for NR 510 Week 1: Barriers to Practice

The barriers identified in the articles include state practice licensure issues, physician related issues, payer policy issues, and prescriptive issues (Hain, Fleck, 2014). These issues do not come as a surprise as physicians have dominated the medical field for a very long time. It is the same concept to the work field with male dominance and women fighting for equality. We have been living in a world that aims to maintain dominance, we are seeing it today in the financial world with the United States and their protectionist views by implementing trade tariffs. If we go all the way back in time, there has been wars and attempted genocides to ensure one’s beliefs dominate the world. So, for physician dominance to occur in the medical field is not a surprise to me. On the positive note, we do have organizations that fight for nurse practitioner equality in the medical field such as the American Association of Nurse Practitioner (Hain, 2014).

I believe these barriers are occurring naturally in a world that aims to maintain dominance. But we live in a time where change needs to occur, because the fact is we are short in primary care physicians in an aging population and a work force that will be reduced with baby boomers retiring, which will only add to the shortage in primary care physicians in a world where people are requiring more medical attention. The healthcare cost is also increasing at such a fast rate, where it will not be sustainable in the future. I believe these restraints will be resolved. The main driver of this resolution will be cost.

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Reference:

Hain, D., & Fleck, L. M. (2014). Barriers to NP Practice that Impact Healthcare Redesign. Online Journal Of

Issues In Nursing, 19(2), 5. doi:10.3912/OJIN.Vol19No02Man02

Sample Answer 3 for NR 510 Week 1: Barriers to Practice

I am aware of patient barriers. My father had an MI a few years back and he was following up with a cardiac NP for his routine follow up appointments. At first he was skeptical of his treatment plans and knowledge in medicine. I had to educate him and inform him that NPs are knowledgeable and are fully educated with medicine as much as doctors. They might even be more compassionate with patients, which can greatly improve their care. I provided him examples and had him rethink some of his past experiences with doctors on how some of them lack compassion. After this he was able to compare the difference and he did mention how the NP actually talks to him like a regular person and explains things in ways where he can understand.

I believe educating the population is extremely important to break these barriers. The population is not informed of the education NPs have to achieve in order to become providers. One way to do this is to inform the population with research in how effective NPs can be in treating common and chronic illnesses. Throughout this NP program, I have come across many scholarly articles that proved NPs are more effective in managing chronic illnesses compared to MDs, such as diabetes mellitus type 2. Therefore, we must do a better job in educating the population in the role of NPs and the extensive education and training they go through to become providers.

The purpose of this essay is to look at various obstacles APNs encounter both within New Jersey and nationwide and why it is necessary to tackle them. Advanced Practice Nurses (APNs) are highly educated healthcare professionals with advanced degrees and specialized nursing experience who provide quality healthcare to underserved areas in the US (Brom et al., 2018). APNs play an invaluable role in delivering this vital service. However, despite their significant contribution, APNs in New Jersey and across the nation often face numerous barriers to practice ranging from legal constraints and limited scope of practice to insufficient reimbursement of services provided and limited resources and technology access. Addressing APN challenges through policy and advocacy efforts is imperative to ensure they can effectively contribute to improving access to quality healthcare for all patients.

Practice Barriers

Nurse midwives must work under physician supervision, which delays care delivery and adds unnecessary costs. Nurse anesthetists face restrictions in providing anesthesia independently, while nurse practitioners may be restricted in prescribing certain drugs and must enter collaborative practice agreements (Schorn et al., 2022). Clinical nurse specialists may be limited in their ability to deliver certain services and have limited job prospects, creating delays in care, higher healthcare costs, and reduced patient access to services. It is essential to address these obstacles so they can provide high-quality patient care.

Competition

APNs face several forms of competition that impede their ability to practice independently, particularly from physicians and physician assistants. Physicians tend to be seen as leaders within healthcare, possessing more resources and influence than APNs themselves (Schorn et al., 2022). Furthermore, some may view APNs practicing independently as an attack on their authority within healthcare systems and might resist APNs being independent providers altogether.

Interest Groups

Numerous interest groups influence APN policy at both state and national levels. These include professional nursing organizations, consumer advocacy groups, and healthcare organizations. Professional nursing organizations like the American Association of Nurse Practitioners and the National Association of Clinical Nurse Specialists advocate for policies to promote Advanced Practice Nurse (APN) practice while removing practice barriers posed by APNs. Furthermore, these organizations aim to raise awareness regarding its significance and expand its scope. Consumer advocacy groups such as the American Consumer Institute and AARP also play an integral role in shaping APN policy. These organizations lobby for policies that ensure access to high-quality healthcare at an affordable cost, including practices like APNs. Their advocacy helps ensure patients receive the care they require regardless of location or financial circumstance. Healthcare organizations such as hospitals and insurance companies also play an integral role in APN policy development. These entities may support policies that expand APN practice to increase access and decrease healthcare costs; conversely, they could oppose expansion due to concerns regarding quality, liability, or financial considerations.

Lawmakers and Interest Groups

Lawmakers play an integral part in shaping APN policy at both the state and national levels. Key figures within New Jersey’s legislative and executive branches that shape policy for APNs include Governor Phil Murphy, Senate President Edward Durr, and Assembly Speaker Craig Coughlin.

Methods of Influencing Policy

APNs and their supporters can employ various means to sway policy change, such as lobbying lawmakers, organizing grassroots campaigns, advocating for reimbursement policy changes, or simply informing the public and lawmakers of their role in healthcare, benefits provided to patients by APNs, and need for policy modifications that remove obstacles to practice (Eden et al., 2021). By using these processes to initiate change, APNs can contribute to improving healthcare provision in the U.S.

Conclusion

Advanced practice nurses face numerous practice barriers that impede their independence both in New Jersey and across the US, such as restrictions on their scope of practice, educational and certification requirements, collaborative practice agreements, competition from other healthcare providers, and legislative advocacy. Through effective advocacy and education efforts, APNs and their supporters can work to remove these obstacles to increase access to high-quality health services for patients.

References

Brom, H. M., Salsberry, P. J., & Graham, M. C. (2018). Leveraging health care reform to accelerate nurse practitioner full practice authority. Journal of the American Association of Nurse Practitioners, 30(3), 120-130. https://doi.org/10.1097/jxx.0000000000000023

Eden, L. M., Merrill, H., & Luthy, K. E. (2021). Empowering nurse practitioners to make health policy CHANGE: Steps to successful passage of legislation in Utah. Journal of the American Association of Nurse Practitioners, 33(12), 1254-1260. https://doi.org/10.1097/jxx.0000000000000561

Schorn, M. N., Myers, C., Barroso, J., Hande, K., Hudson, T., Kim, J., & Kleinpell, R. (2022). Results of a national survey: Ongoing barriers to APRN practice in the United States. Policy, Politics, & Nursing Practice, 23(2), 118-129. https://doi.org/10.1177/15271544221076524

Sample Answer 4 for NR 510 Week 1: Barriers to Practice

Thank you for your detailed discussion. I was particularly interested in Bill 1522 that you mention. I did some research of my own to see if I could find any additional updates or information. I located Bill 1522 (also known as Bill A2286) on the State of New Jersey Legislature website (2022). This bill was introduced last February and was referred to the Assembly Health Committee during that time (State of New Jersey, 2022). In December of 2022 the Senate Committee voted in favor of passing it with an overwhelming seven votes for yes and zero votes for no (State of New Jersey, 2022). While this has passed through the Senate, it seems that this Bill has not crossed over to the House for approval yet. It can be frustrating waiting for these Bills to pass. I am eager to follow this one and hope that it will be passed into law soon.

One other interesting concept I learned from reviewing the New Jersey nurse practice act regards the current set up for physician collaboration agreements. I learned that the collaborating physician does not have to work within proximity to the APRN and does not have to focus on the same specialty as the APRN they are overseeing (State of New Jersey, 2022). This means that potentially a women’s health focused physician could “oversee” an emergency care APRN. While medical doctors carry vast knowledge, this seems like it could potentially present problems such as lack of knowledge and disruptions to patient safety. Ideally, you would have a physician collaboration with a similarly focused specialty but since it is not required, it likely does not always work out that way.

Reference:

State of New Jersey. (2022). Assembly, No. 2286. State of New Jersey: 220^th Legislature. https://pub.njleg.state.nj.us/Bills/2022/A2500/2286_I1.PDF

Sample Answer 5 for NR 510 Week 1: Barriers to Practice

I believe that PA’s viewed as a greater asset to a practice over a NP is a barrier to practice. A PAs scope of practice is similar of that of an NP. Both practitioners are required to obtain higher levels of education and training, and have similar scopes of practice, especially in states that require NPs to work under the supervision of a physician. Lovink, Persoon, Koopmans, Van Vught, Shoonhoven, and Laurant (2017) state “NPs, PAs or nurses working as a substitute provide the same services as the physicians, while those working as supplemental caregivers provide additional services which complement or extend those provided by the physician” (p.2085), concluding in their research of these providers that substituting them for primary care improved outcomes of over half of the patients studied. I had a conversation yesterday with an ortho surgeon and he asked me a similar question. I love being a nurse and I want to continue to be a nurse. I want to improve my practice and advance my career, but I do not want to go into administration. I decided to become a nurse practitioner to have the ability to improve the lives of more people. I can continue to practice as a nurse while providing care to more people. I feel that nurses are different in their thinking and actions than physicians and PAs. Evidence shows that implementing NPs into primary care improves patient outcomes, I want to be part of that.

Resource:

Lovink, M., Persoon, A., Koopmans, R., Van Vught, A., Schoonhoven, & Laurant, M. (2017). Effects of substituting nurse practitioners, physician assistants or nurses for physicians concerning healthcare for the ageing population: a systemic literature review. Journal of Advanced Nursing, 2084-2102.

Sample Answer 6 for NR 510 Week 1: Barriers to Practice

The article by Hain and Fleck (2014) describe multiple barriers to APN practice. State practice and licensure is identified as a challenge as each state has its own guidelines that outline an NPs scope of practice (Hain & Fleck, 2014). This does not allow for a general standard of care expected for NPs to evaluate and diagnose patients, order diagnostic tests or initiate and manage treatment plans. Approximately 20 states grant NPs full practice authority licensure, which allows NPs to practice independently of a physician or hospital. Most states reduce the NPs practice and licensure, which means NPs can either engage in at least one element of the NP practice through a collaborative agreement or with an outside health discipline or under supervision of a physician (Hain & Fleck, 2014). The next challenge the article mentions is physician related issues. The problem here is that physicians do not feel NPs have received enough training or education to administer the same type of treatment as a doctor. Physicians are also confused about the role of nurse practitioners in a collaborative environment (Hain & Fleck, 2014). Physicians may feel there is no need for the NP to advise the patient if the physician (especially if a medical specialist is present). Other barriers mentioned are payer policies, job satisfaction, and restrictions in admitting and prescriptive privileges. Since nursing services have traditionally been tied into the institutional room fee or other professional fees on a patient’s billing statement, nursing services are not considered “billable” (Hain & Fleck, 2014). Nurses often cite having little autonomy over practice and limited career advancement opportunities as reasons for leaving the profession (Hain & Fleck, 2014).

I am not surprised about the barriers presented in the article. I believe the majority of concerns center on accountability and skill level. The article by Hain and Fleck (2014), states NPs can help reduce the primary care provider gap but that allowing NPs full practice authority may cause patients to choose between being seen by a physician or NP. I understand this point of view, but I believe patients are astute enough to know when to see a specialist for a condition versus opting for services provided by an NP. I also see a great deal of disrespect displayed by doctors toward nurses simply because physicians have more medical training than NPs. The lack of collaboration may stem from a lack of trust or mutual respect (Schadewaldt, McInnes, Hiller, & Gardner, 2013). A number of factors influence the functioning or failure of collaboration between NPs and MPs, such as funding issues, traditional role allocation, legislation, personal attitudes toward collaboration, and organizational structures (Schadewaldt et al., 2013). NPs must hold a four-year degree, have years of practice experience, obtain a graduate degree, pass multiple certification exams, and pursue further specialization. While new roles for NPs present opportunities, NPs are unsatisfied with their work roles because they lack autonomy and respect (Schadewaldt et al., 2013).

These barriers represent restraint of trade because NPs are not allowed in over 29 states to practice without restrictions imposed by state nursing licensing boards. Since NPs must go through rigorous training to become just as qualified as a physician to administer medical services, they should be allowed to practice. However, one of the reasons Hain and Fleck (2014) state NPs are not allowed this professional courtesy is physicians may feel some sort of competition toward them. Physicians do not want to lose revenue.Nurses can influence these barriers by joining powerful nursing organizations that promote and advocate the rights of NPs. Nursing practitioners can also become more involved in the legislative process. NPs can also become influential members of state nursing licensing boards and lead the vote to change current standards.

References:

Hain, D., & Fleck, L. (2014, May). Barriers to nurse practitioner practice that impact healthcare redesign. OJIN: The Online Journal of Issues in Nursing, 19, 2. Manuscript 2. Retrieved from doi: 10.3912/OJIN.Vol19No02Man02

Schadewaldt, V., McInnes, E., Hiller, J. E., & Gardner, A. (2013). Views and experiences of nurse practitioners and medical practitioners with collaborative practice in primary health care – an integrative review. BMC Family Practice, 14, 132. Retrieved from http://doi.org/10.1186/1471-2296-14-132