Select an advanced professional or advanced practice nursing specialty. How has past and current regulation/legislation affected the role and scope of this nursing role? What, if any, discussions are currently underway relative to the scope and role of this specialty? What resources are available to assist nurses in advocating for these roles?
The advanced professional or advanced practice nursing specialty that will be discussed in this paper is the role of nurse practitioners (NPs) in primary care. Nurse practitioners are advanced practice registered nurses (APRNs) who possess advanced education and clinical training beyond their initial RN preparation, allowing them to provide a wide range of healthcare services to patients of all ages. The role and scope of nurse practitioners have been greatly influenced by past and current regulation/legislation, and ongoing discussions continue to shape their practice.
Past regulation/legislation, such as the Nurse Training Act of 1964 and the Nurse Practitioner Education Program of 1971, contributed to the development and recognition of nurse practitioners as a distinct and advanced nursing role. These acts provided federal funding for nursing education, including the establishment of nurse practitioner programs. This helped to expand the role of nurse practitioners and increase access to primary care services, particularly in underserved areas.
In recent years, various regulations and legislation have further impacted the role of nurse practitioners. One significant development is the expansion of full practice authority (FPA) for nurse practitioners in certain states. FPA allows nurse practitioners to practice independently, without physician oversight, and have full authority to prescribe medications and order diagnostic tests. This loosening of restrictions has greatly expanded the role of nurse practitioners in providing primary care services, especially in areas with limited access to physicians.
However, the scope of practice for nurse practitioners still varies across states, with some states still requiring physician collaboration or supervision. This variability is due to differing state regulations and legislation, as well as the influence of medical professional organizations advocating for physician-led care models. These factors have hindered the full realization of the nurse practitioner role in primary care.
Current discussions and debates are underway to further advocate for the expansion of the nurse practitioner role. Many professional nursing organizations, such as the American Association of Nurse Practitioners (AANP), are actively lobbying for legislation that would grant FPA to nurse practitioners nationwide. The goal is to eliminate unnecessary barriers that restrict nurse practitioners from practicing to the full extent of their education and training. These discussions involve various stakeholders, including nursing organizations, medical associations, policymakers, and the public.
Furthermore, several recent studies have demonstrated the high quality and cost-effectiveness of nurse practitioner-led primary care. These findings provide evidence to support the argument for expanding the role and scope of nurse practitioners. The ongoing discussions aim to address the concerns and misconceptions surrounding nurse practitioner practice, such as patient safety, quality of care, and provider collaboration.
Nurse practitioners seeking to advocate for their roles and advance their practice have numerous resources available to them. Professional nursing organizations, such as the AANP and the National Association of Pediatric Nurse Practitioners (NAPNAP), offer resources and support for nurse practitioners in advocating for FPA and promoting their specialty. These organizations provide legislative toolkits, practice guidelines, and educational resources to help nurse practitioners stay informed, engaged, and empowered in their practice.
Additionally, the Nursing Community Coalition (NCC), a collaboration of national nursing organizations, works to advance the nursing profession through advocacy and policy efforts. The NCC provides a unified voice for nursing and works to influence legislation and regulations that affect the nursing profession, including advanced practice nursing roles.
In conclusion, nurse practitioners in primary care have experienced significant impacts from past and current regulation/legislation. While progress has been made in expanding the role and scope of nurse practitioners, variability still exists across states. Ongoing discussions and debates seek to further advance the nurse practitioner role, with calls for national full practice authority. Nurse practitioners have resources available to them, including professional nursing organizations and coalitions, to support their advocacy efforts and promote their specialty. Through continued dialogue and advocacy, the role of nurse practitioners in primary care can be further strengthened and recognized.