NR 506 DISCUSSION QUESTIONS Week 1 - 8
WK 1:
Hello to all classmates and Professor,
1. Identify and describe practice barriers for APNs in your state and
discuss these barriers on a state and national level.
In today's society, Advanced Practice Nurses play an imperative role in healthcare.
According to the American Nurses Association, APN's "provide primary, acute, and
specialty health care across the lifespan through assessment, diagnosis, and treatment
of illnesses and injuries in different healthcare settings." (ANA, n.d.). As of 2015,
Maryland passed the nurse practitioner full practice authority law, expanding patient
access to quality healthcare across the entire state, making it more accessible to its
citizens. (NPAM, 2015). According to the Scope of Practice Policy, After the first 18-
months of licensing and practicing under a full authority physician or nurse practitioner,
Nurse Practitioners are allowed to practice independently by law. They are recognized
to be primary care providers in the state of Maryland. (SOPP, 2020). This allows the
nurse practitioner to diagnose illnesses, order further testing, prescribe, treat, refer, and
advise patients regarding health issues.
I consider myself fortunate to live in a state where APN's have full practice authority.
There are many barriers from state to state that limit practice and action is needed at
both the state and national levels. APN's can have either full authority practice, reduced
practice or restricted practice depending on the state and their scope of practice laws.
There are many states in the fight for full practice as many believe it should be granted
nationwide. It is vital to achieve full practice authority nation wide in order to keep
healthcare cost down, provide effective healthcare services services, and most
importantly to help meet the growing demands for providers, especially those needs of
rural communities. According to Peterson (2017), only 44% of states allow full authority
practice to APNs and identifies restrictive scope-of-practice regulation of APNs as one
of the most serious barriers to accessible care. (para 5). As the aging population and
the need for providers increases, it is clear that APN can help fill in the gaps and are
valued members of the healthcare team. Moreover, the fight for universal healthcare in
the United States has been on the spotlight and more accessible healthcare continuous
to be a right to all Americans. If in the near future healthcare becomes available for
more individuals, the need for providers will only continue to increase. This will impact
the nation as a whole and will impact access to care due to a lack of providers
available. If NPs have full practice authority nationwide, the concern of lack of providers
will be greatly relieved.
2. Identify forms of competition on the state and national level that interfere
with APN’s ability to practice independently.
One example of a form of competition that interfere with APN’s ability to practice
, independently is push back from some physician professional organizations, such as
the American Medical Association. These organizations believe that physicians have
more extensive and specialized training than NPs and therefore NPs lack the ability to
provide quality care that is safe like physicians can. (Hain and Fleck, 2014).
Additionally, Hain et al. (2014) further identified the lack of knowledge physicians have
of the scope of practice of APNs as a barrier for successful collaboration of APNs with
physicians.
The traditional medical hierarchal model of practice fails to cultivate effective teamwork
between APNs and physicians and a more collaborative model should be implemented.
(Hain et al., 2014). As long as physicians believe APNs to lack competence, the
collaboration between members of the healthcare team will not be successful and the
barrier to accessible healthcare and lack of primary providers will continue to exists.
3. Identify the lawmakers at the state level (i.e., key members of the state’s
legislative branch and executive branch of government)
In the state of Maryland where I reside and plan to practice, there are three branches of
government. The executive branch implements and enforces laws and it is overseen by
the chief executive officer which is our Governor Larry Hogan. The legislative branch
consist of the senate and house of delegates who pass laws to be signed by the
governor who signs them into law. Finally there is the judicial branch that consist of
judges who resolve all matters regarding civil and criminal law. The lawmakers in the
legislative branch are elected by the people of the state of Maryland which has 47
senators 141 representatives. (Maryland Manual on-line, 2020). It is vital for NPs to
participate in the process of lawmaking by advocating for their proposed laws or against
unreasonable laws that may affect NP practice. It is our duty to be in touch with
legislators in our states to advocate for our right to practice and be the voice needed to
make changes.
4. Discuss interest groups that exist at the state and national levels that
influence APN policy.
Some interest groups making a difference in the sate of Maryland are the Nurse
Practitioner Association of Maryland, The Maryland Academy of Advanced Practice
Clinicians, and The American Association of Nurse Practitioners Region 3. All of these
organization were involved in the fight for APNs full practice authority law implemented
in 2015.
5. Discuss methods used to influence change in policy in forms of
competition, state legislative and executive branches of government and interest
groups.
One method that can be used to influence change in policy is through evidence and
research. In order to get involved in policy, one must follow policy debates, gain
knowledge of current issues and get involved by getting to know the policy makers.
Exercising your right to vote as an American is another way to influence policy as you
can vote for legislators who care about the issues you want to see reform and move
forward. In order to create change one must know the issues at hand, the goals for
WK 1:
Hello to all classmates and Professor,
1. Identify and describe practice barriers for APNs in your state and
discuss these barriers on a state and national level.
In today's society, Advanced Practice Nurses play an imperative role in healthcare.
According to the American Nurses Association, APN's "provide primary, acute, and
specialty health care across the lifespan through assessment, diagnosis, and treatment
of illnesses and injuries in different healthcare settings." (ANA, n.d.). As of 2015,
Maryland passed the nurse practitioner full practice authority law, expanding patient
access to quality healthcare across the entire state, making it more accessible to its
citizens. (NPAM, 2015). According to the Scope of Practice Policy, After the first 18-
months of licensing and practicing under a full authority physician or nurse practitioner,
Nurse Practitioners are allowed to practice independently by law. They are recognized
to be primary care providers in the state of Maryland. (SOPP, 2020). This allows the
nurse practitioner to diagnose illnesses, order further testing, prescribe, treat, refer, and
advise patients regarding health issues.
I consider myself fortunate to live in a state where APN's have full practice authority.
There are many barriers from state to state that limit practice and action is needed at
both the state and national levels. APN's can have either full authority practice, reduced
practice or restricted practice depending on the state and their scope of practice laws.
There are many states in the fight for full practice as many believe it should be granted
nationwide. It is vital to achieve full practice authority nation wide in order to keep
healthcare cost down, provide effective healthcare services services, and most
importantly to help meet the growing demands for providers, especially those needs of
rural communities. According to Peterson (2017), only 44% of states allow full authority
practice to APNs and identifies restrictive scope-of-practice regulation of APNs as one
of the most serious barriers to accessible care. (para 5). As the aging population and
the need for providers increases, it is clear that APN can help fill in the gaps and are
valued members of the healthcare team. Moreover, the fight for universal healthcare in
the United States has been on the spotlight and more accessible healthcare continuous
to be a right to all Americans. If in the near future healthcare becomes available for
more individuals, the need for providers will only continue to increase. This will impact
the nation as a whole and will impact access to care due to a lack of providers
available. If NPs have full practice authority nationwide, the concern of lack of providers
will be greatly relieved.
2. Identify forms of competition on the state and national level that interfere
with APN’s ability to practice independently.
One example of a form of competition that interfere with APN’s ability to practice
, independently is push back from some physician professional organizations, such as
the American Medical Association. These organizations believe that physicians have
more extensive and specialized training than NPs and therefore NPs lack the ability to
provide quality care that is safe like physicians can. (Hain and Fleck, 2014).
Additionally, Hain et al. (2014) further identified the lack of knowledge physicians have
of the scope of practice of APNs as a barrier for successful collaboration of APNs with
physicians.
The traditional medical hierarchal model of practice fails to cultivate effective teamwork
between APNs and physicians and a more collaborative model should be implemented.
(Hain et al., 2014). As long as physicians believe APNs to lack competence, the
collaboration between members of the healthcare team will not be successful and the
barrier to accessible healthcare and lack of primary providers will continue to exists.
3. Identify the lawmakers at the state level (i.e., key members of the state’s
legislative branch and executive branch of government)
In the state of Maryland where I reside and plan to practice, there are three branches of
government. The executive branch implements and enforces laws and it is overseen by
the chief executive officer which is our Governor Larry Hogan. The legislative branch
consist of the senate and house of delegates who pass laws to be signed by the
governor who signs them into law. Finally there is the judicial branch that consist of
judges who resolve all matters regarding civil and criminal law. The lawmakers in the
legislative branch are elected by the people of the state of Maryland which has 47
senators 141 representatives. (Maryland Manual on-line, 2020). It is vital for NPs to
participate in the process of lawmaking by advocating for their proposed laws or against
unreasonable laws that may affect NP practice. It is our duty to be in touch with
legislators in our states to advocate for our right to practice and be the voice needed to
make changes.
4. Discuss interest groups that exist at the state and national levels that
influence APN policy.
Some interest groups making a difference in the sate of Maryland are the Nurse
Practitioner Association of Maryland, The Maryland Academy of Advanced Practice
Clinicians, and The American Association of Nurse Practitioners Region 3. All of these
organization were involved in the fight for APNs full practice authority law implemented
in 2015.
5. Discuss methods used to influence change in policy in forms of
competition, state legislative and executive branches of government and interest
groups.
One method that can be used to influence change in policy is through evidence and
research. In order to get involved in policy, one must follow policy debates, gain
knowledge of current issues and get involved by getting to know the policy makers.
Exercising your right to vote as an American is another way to influence policy as you
can vote for legislators who care about the issues you want to see reform and move
forward. In order to create change one must know the issues at hand, the goals for
