NU 502 Assignment 8: Removing Barriers to Nurse Practitioners’ Practice
Nurse practitioners play an essential role in the delivery of high quality, safe and efficient care to the populations they serve. Nurse practitioners work in collaboration with other healthcare providers to optimize the outcomes of care for their patients. Changes in the dynamics of patient population have been shown to have a significant impact on the role of nurse practitioners over the next decade. For example, the aging population in America is expected to increase, leading to physician shortage. Nurse practitioners are therefore expected to address this shortage by providing the advanced care to the population. However, this might not be the case if the current restrictions and limitations on the roles of nurse practitioners are not addressed (Poghosyan, 2018). Therefore, the purpose of this paper is to examine the need for the removal of practice barriers for nurse practitioners.
Contextualization
Nurse practitioners are professionals who have been trained on their roles to provide advanced care to their patients and significant others. Nurse practitioners have advanced knowledge and skills in assessing, planning, diagnosing, ordering and interpreting diagnostic results, initiating and managing treatments, and prescribing medications according to the regulations of their state boards of nursing (Andrilla et al., 2019). Despite the above, the ability of nurses to practice fully to their training and education has been restricted or limited in most of the states in America. The limitations or restrictions hinder the ability of the advanced registered nurses to provide care in full extent of their training and education, hence, limiting provider autonomy. According to the Institute of Medicine, limitations and restrictions on the roles and practice of nurse practitioners should be removed to enhance provider autonomy, population’s access to and utilization of high quality and affordable care (Dillon & Gary, 2017).
Historical Development
The history of nurse practitioner roles can be traced to 1965 when the training of nurse practitioners was initiated.
The training of nurse practitioners was due to the increased need for primary care providers in the US. The supply of physicians during this time was inadequate to meet the care needs of the American population (Brennan, 2020). Despite the introduction of the training for nurse practitioners, policies and regulations that expanded their roles were not implemented. For example, the recommendations by Medicaid and Medicare documents implemented in the early years of nurse practitioners’ roles considered physicians as the main drivers of the American healthcare system. In addition, the revisions of the acts adopted in the US have failed to recognized the role of nurse practitioners in directing care in health institutions (Dillon & Gary, 2017). Consequently, the history developments and perceptions of the society towards nurse practitioners affected the implementation of acts that expand the roles of nurse practitioners.
Socio-Political Influences
The restriction or limiting of the roles of nurse practitioners in America is also attributed to socio-political factors. One of the factors is the inter-professional barriers in healthcare. For example, physicians are always against the provision of full practice authority for the nurse practitioners. In 2012, the American Academy of Family Physicians cautioned the creation of a two-tier healthcare system led by the physicians and less-qualified healthcare professionals, which comprised of nurses (Dillon & Gary, 2017). The insurers also act as a source of socio-political forces that contribute to the barriers for practice for nurse practitioners. For example, some of the commercial insurers in the US do not recognize nurse practitioners as primary care providers. The regulations adopted by the federal and state governments also contribute to the barriers. For example, the Social Security Act does not recognize the vital role of nurse practitioners in American healthcare system (Barnes et al., 2018). Cumulatively, the above factors act as socio-political influences of nurse practitioners’ role in the American healthcare system.
Literature Review and Analysis
The adoption of the Patient Protection and Affordable Care Act increased the health coverage for millions of American citizens. The increase translates into the high demand of healthcare that the current number of physicians cannot address in the state. The implication is that the role of nurse practitioners should be expanded to meet the care needs of the American population (Poghosyan & Carthon, 2017). There is also the evidence that the aging population in America will rise significantly in the next decade. This implies that the care needs of the elderly population will rise significantly in a manner that is not proportion to the supply of primary care providers in America. As a result, there is an increased need to expand the roles of nurse practitioners to improve patient accessibility as well as reduce waiting times by the patients. In addition, full practice authority for nurse practitioners will ensure consistency, equitability, and patient-centeredness in the provision of evidence-based care to the patients (Barnes et al., 2018). Therefore, the realization of optimum care outcomes in healthcare settings in America is largely dependent on the implementation of policies that expand the roles of nurse practitioners in the American healthcare system.
Recommendations
One of the recommendations that should be considered is American states implementing policies that enable full practice authority for nurse practitioners. States with limited or restricted practice for nurse practitioners should persuaded using evidence-based data on the importance of increasing the autonomy of nurse practitioners. The second recommendation is the fact that nurse practitioners should play the roles of advocating the recognition of the need for full practice authority in their practice. Nurse practitioners should lead advocacy interventions and use of best practices in healthcare to raise their importance in primary care. The implications of the above recommendations on APRN role is that they have to advocate the recognition of their role in primary care as well as consistent use of evidence-based interventions in providing their care to diverse populations.
Conclusion
Barriers to nurse practitioner roles should be removed in America. Nurse practitioners play a vital role in providing high quality, safe and efficient care to patients in America. Nurse practitioners also provide a solution to the issue of physician shortage in the state. Therefore, states should enact policies that increase the autonomy of nurse practitioners in their roles as well as enhancing the need for advocacy for expanded roles for nurse practitioners.
References
Andrilla, C. H. A., Moore, T. E., & Patterson, D. G. (2019). Overcoming Barriers to Prescribing Buprenorphine for the Treatment of Opioid Use Disorder: Recommendations from Rural Physicians. The Journal of Rural Health, 35(1), 113–121. https://doi.org/10.1111/jrh.12328
Barnes, H., Richards, M. R., McHugh, M. D., & Martsolf, G. (2018). Rural And Nonrural Primary Care Physician Practices Increasingly Rely On Nurse Practitioners. Health Affairs, 37(6), 908–914. https://doi.org/10.1377/hlthaff.2017.1158
Brennan, C. (2020). Tracing the History of the Nurse Practitioner Profession in 2020, the Year of the Nurse. Journal of Pediatric Health Care, 34(2), 83–84. https://doi.org/10.1016/j.pedhc.2019.12.005
Dillon, D., & Gary, F. (2017). Full Practice Authority for Nurse Practitioners. Nursing Administration Quarterly, 41(1), 86–93. https://doi.org/10.1097/NAQ.0000000000000210
Poghosyan, L. (2018). Federal, State, and Organizational Barriers Affecting Nurse Practitioner Workforce and Practice. Nursing Economics, 36(1), 43–46.
Poghosyan, L., & Carthon, J. M. B. (2017). The Untapped Potential of the Nurse Practitioner Workforce in Reducing Health Disparities. Policy, Politics, & Nursing Practice, 18(2), 84–94. https://doi.org/10.1177/1527154417721189