Description
Maria Bates
APRN’s must follow their state and national level policies/rules. Legislation must pass laws that are discussed with other professionals, which makes it important for APRNs to attend these meetings. The presence of APRNs can provide knowledge, experience, and concerns regarding laws and regulations that are in place or new laws and regulations that are being discussed. “Regulation is used to describe scope of practice, the level of education, prescriptive authority, and the level of physician involvement” (Blair, 2018, p. 188). Scope of practice refers to who can prescribe, who can practice as an APRN, and who can receive reimbursement. Licensure refers to authority to practice and “credentialing is the process of assessing and confirming the license or certification, education, training, and other qualifications of the licensed or certified healthcare practitioner” (Blair, 2018, p. 188). Various states have different laws and regulations.
One of the issues for APRNs is having full prescriptive authority. There are 14 states that allow APRNs to practice without physician supervision and have full prescriptive authority. “The states that allow APRNs to have full prescriptive authority include AK, AZ, DC, HI, IA, ID, MT, ND, NH, NM, OR, RI, WA, and WY” (Blair, 2018, p. 188). There are 11 states in which APRNs have independent practice with full prescriptive authority after a period of being under supervision. And there are 26 states in which APRNs have limited practice and prescriptive authority under supervision by a physician (Blair, 2018, p. 188). Having limited prescriptive authority can delay care for the patient as the APRN would need to consult with the physician. “The United States still faces a growing and aging population, and NPs can provide a cost effective and quality source of care” (Brom et al, 2018). APRN can provide care to those who are unable to receive services in a cost-effective manner. This can result in quality care for their patients.
Aman Patel
Identify the issue you think is most important regarding APRN credentialing and licensure.
When it comes to APRN credentialing and licensure, the most critical issue is the confusion that is associated with the process. Blair (2018) states that frequent changes in the credentials and various terms used for advanced practice nurses confuse others. This process must be clarified because each state has its process for obtaining credentials and licensure. Since each state has different regulations, the APRN may need to learn what is acceptable as there is no clear delineation of their role (Blair, 2018). Therefore, their credentialing and licensure should be streamlined. State regulatory officials should unite and make it unified across all the states. This would allow one APRN to go to another state and practice without obtaining further certifications.
What barriers or challenges have slowed the progress of advanced practice registered nursing?
Blair (2018) mentions that practice issues regarding APRNs include safety, legal, and ethical implications. An APRN may be less trusted than a doctor when providing medical care. APRNs must maintain their status by reassuring patients they have received the education to care for them properly and safely. Another challenge that has slowed the progress of APRNs is the issue of billing and reimbursement—Blair (2018) and this week’s presentation mention that APRNs get less reimbursement than doctors. Therefore, doctors will bill and get reimbursed under their name rather than the APRN’s name. Regarding finances, the APRN may be paid less than the medical doctor, which means they may bring in less money to the hospital or practice.
Identify a current legislative policy on the local, state, or national level that will influence policies APRN practice.
In September of 2020, Governor Newson of California signed Assembly Bill 890. This bill allows current Nurse Practitioners to apply to become 104 NPs, which allows the nurse practitioner to practice independently without physician supervision among the population they are nationally certified in. (California BRN, 2022). Furthermore, the Nurse Practitioner must be in good standing for three years before applying for the 104 NP status (California BRN, 2022). This means the BRN will not be able to certify 104 NPs until 2026.
With this bill’s passing, there will be some pushback from medical doctors. In a 2016 article by Dr. Samer Cabbabe, he concluded that physicians are the most educated and trained to lead the healthcare system. Dr. Cabbabe also states that people should not confuse the accessibility of healthcare with the quality the patient will receive without physician supervision (Cabbabe, 2016). While the passing of the bill will create a policy for NPs in California to practice independently, there will always be a stigma that NPs need to have the proper education to treat a patient. However, that is why the policy states that the NP should have at least three years of experience with national certification. The clinical experience that the NP cultivates makes them proficient in what they do. With the passing of this bill, this is one advancement for APRNs.
