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Introduction
At present, local laws regarding advanced practice nurses (APNs) vary widely between different states and countries. As a consequence, specialists with the same degrees of knowledge, experience, and competence would receive different treatment depending on the state, including restrictions on the scope of their activities. The introduction of a standardized nationwide regulation model for APNs would be a significant contribution to the solution of this issue.
Current Issues
Currently, APNs are not held to a single standard across the United States. According to Hamric, Hanson, Tracy, and OGrady (2014), there are many names and different certifications for the role, and this confuses the policymakers, leading to varying perceptions of APNs and resulting in laws that grant or deny them necessary privileges. Furthermore, the authors state that when an APNs practices in the hospital, they sometimes cannot get essential privileges since most of the criteria are written exclusively for medical practitioners.
Another issue that Hamric et al. (2014) highlight is the lack of recognition for APNs. A physician is assumed to be competent immediately upon assuming the position, but an APN has to prove their ability and knowledge, although their certification is no less credible. Furthermore, newer APNs usually have to abide by more restricting collaborative agreements, as they are not trusted to carry out evidence-based practice competently.
APN Regulations in Florida
APN activity is significantly restricted in Florida, as the practitioners do not have free access to vital authorities. According to the Florida Senate (2018), they cannot practice independently and require the supervision of a physician to be able to work and prescribe substances. Furthermore, APNs are restricted in their ability to perform their work by their supervisors, and their ability to prescribe controlled substances is limited by a committee that determines the quantity and purpose of controlled substance use.
Floridas approach to APNs can be considered to be among the most restrictive in the United States. The limits placed on APN activity in the state prevent them from adequately following the principles described by Hamric et al. (2014). An introduction of a unified model would benefit the profession greatly, as such a model would most likely incorporate the ability to practice and prescribe independently, allowing APNs to carry out their practice to its fullest extent.
The Consensus Model for APRN Regulation
The NSCBN has proposed a consensus model for APRN regulation and aimed to convince all states to implement it. The document submitted by the APRN Joint Dialogue Group (2008) defines advanced practice registered nurse, sets education and certification requirements, and describes the privileges and recognition an APN would receive after being licensed. The ideas proposed are significantly more lax than those defined by the Florida Senate (2018).
The model incorporates a detailed description of education that would be considered sufficient for an APN. According to the APRN Joint Dialogue Group (2008), the degree would have to be granted by an accredited institution, prepare the graduate for one of the four defined APRN roles, and teach them a general core of competence as well as advanced skills related to one or more of the six population foci discussed in the document. The standard is clearly defined, and it would be helpful in answering the questions about the competence of a new APN.
The document also permits APRNs practice independently without regulatory requirements for collaboration, direction, or supervision. Furthermore, the model allows for mutual recognition of APRN between states and adds a grandfathering clause that removes the need for existing APNs to undergo certification again. These propositions would considerably enhance the quality of life for APNs, allowing them to be acknowledged as full specialists and have fewer difficulties in relocating their practice.
The Benefits of Implementing the Model
The consensus model proposed by the APRN Joint Dialogue Group (2008) will allow Floridas APNs to practice and prescribe independently, which is significantly different from the current situation. This change will allow more freedom to newly certified specialists, who would previously be constrained by restrictive collaborative agreements, and benefit established APNs as well. Furthermore, implementing a national standard of education and certification will improve the public awareness and image of the profession.
The freedom to practice and prescribe will allow APNs to address the needs of their patients better. Furthermore, the removal of the restrictions will make the profession more attractive to newcomers, increasing the size of the medical force and therefore the coverage it provides. Overall, the implementation of the model will improve the outcomes for both APNs and their patients through access to better care provided by a higher number of specialists.
Conclusion
Floridas policymakers view the APN profession negatively, and the laws reflect that attitude by establishing severe restrictions to APN practice. The consensus model proposed by the NSCBN may be beneficial in resolving many concerns related to advance practice nursing and granting them more independence. The changes would benefit both APNs and their patients, as the members of the profession would be able to administer better care, and the line of work would attract more newcomers.
References
APRN Joint Dialogue Group. (2008). Consensus model for APRN regulation: Licensure, accreditation, certification & education. Web.
Hamric, A. B., Hanson, C. M., Tracy, M. F., & OGrady, E. T. (2014). Advanced practice nursing: An integrative approach (5th ed.). St. Louis, MO: Elsevier Saunders.
The Florida Senate. (2018). Chapter 464: Nursing.
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