Scope of Practice for Nurse Practitioners in Florida
Level of Independence
Florida belongs to the list of U.S. states with a restricted state practice environment. Until a relatively recent change in state legislation, nurse practitioners (NPs) were not allowed to deliver primary care without an attending physician’s supervision (Gancarski, 2020). According to the bill HB 607, autonomous advanced practice registered nurses (APRNs) were granted the right to provide such primary care services as family medicine, general pediatrics, and general internal medicine (Gancarski, 2020).
Prescribing Authority and Limitations of Practice
Regarding prescribing authority, the Barbara Lumpkin Prescribing Act, an addition to the Nurse Practice Act, allowed ARPNs to prescribe any drugs. However, an ARPN must have a master’s or doctoral degree in a clinical nursing specialty area to ascend to this level of authority (Online Sunshine, 2022). Besides these relaxations, NPs in Florida are still under strict control from physicians and the Board of Nursing.
Licensure Process, Certification and Education Requirements
In particular, an NP must pass through several licensing stages before becoming eligible for autonomous practice. Firstly, a candidate has to obtain a Registered Nurse (RN) status. The Board grants RN licensures in two ways: examination for applicants from Florida and endorsement for applicants with an RN license (Florida Board of Nursing, n.d.a). After that, an RN must complete the requirements for a master’s degree or a post-master’s degree certification to become a licensed APRN (Florida Board of Nursing, n.d.b).
Finally, an APRN becomes eligible for an autonomous status by working at least 3,000 clinical hours under the physician’s supervision and completing extra education in pharmacology and differential diagnosis (Florida Board of Nursing, n.d.c). Completing this path is the only way to autonomous primary care practice for NPs in Florida.
Impact of Restricted Practice on Patient Care in the Local Community
The restrictions on the scope of nursing practice in Florida have resulted in the state population’s overuse of emergency departments (EDs). According to a report by the Office of the Assistant Secretary for Planning and Evaluation (ASPE, 2021), in 2018, Florida EDs had 1,208,463 non-mental health (MH)/substance use disorders (SUD) visits that ended in hospital admission. In addition, another 8,181,947 non-MH/SUD visits had a treat-and-release outcome (ASPE, 2021).
Florida led the ED visits ranking together with California and Texas, two states with restricted nursing practice environments (American Association of Nurse Practitioners [AANP], 2022). In that regard, one can see a pattern of patients overcrowding Floridian EDs with health issues that NPs could have treated had their scope of practice not been restricted by the state legislation.
The Role of Nurse Practitioners in Addressing Healthcare Disparities
Finally, access to primary care services provided by NPs should be considered one of the pathways to healthcare disparities mitigation. For instance, House Speaker Jose Oliva praised Governor Ron DeSantis for signing HB 607 because freeing Floridian APRNs from some bureaucratic ties improved access to quality care for all (Gancarski, 2020). According to Jose Castillo, the president of the Florida Association of Nurse Anesthetists, the amended legislation was a step toward ensuring that Floridians have full access to healthcare, especially in underserved rural areas (Gancarski, 2020).
Following that logic, increasing the scope of NPs’ practice facilitates access to primary care in regions and populations where it matters most. Residents of rural and lower-income communities can receive decent primary care from a local NP instead of traveling to an already overcrowded ED. Ultimately, independent nurse practice helps save time and money for people who cannot afford good healthcare services.
References
American Association of Nurse Practitioners. (2022). State practice environment. Web.
Florida Board of Nursing. (n.d.a). Licensing and registration. Web.
Florida Board of Nursing. (n.d.b). Advanced practice registered nurse. Web.
Florida Board of Nursing. (n.d.c). Autonomous advanced practice registered nurse. Web.
Gancarski, A. G. (2020). Ron DeSantis quickly signs scope of practice bills into law. Florida Politics. Web.
Office of the Assistant Secretary for Planning and Evaluation (2021). Trends in the utilization of Emergency Department services, 2009-2018. Web.
Online Sunshine. (2022). Chapter 464. Nursing. Web.