The shortage of the nursing staff is becoming more apparent with the growing population of aging people. Continuous cuts of state budgets and, as a result, hospitals’ budgets, makes people unable to access high-quality healthcare, especially when it comes to rural areas. The increased scope of nursing responsibilities is regarded as a possible solution to the problem (Dillon & Gary, 2017). Nurse Practitioner Full Practice Authority has been implemented in almost half of the US states while other areas are reluctant to embrace this change due to various reasons. This paper addresses some barriers to the successful implementation of Nurse Practitioner Full Practice Authority with the focus on Florida.
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Nurse Practitioner Full Authority, Reduced and Restricted Practice
Nurse Practitioner Full Practice Authority implies the provision of a significant degree of autonomy and authority to nursing professionals. The scope of nurses’ responsibilities includes patient evaluation, diagnosing, tests ordering, tests interpretation, treatment initiation, treatment management, medication prescriptions. This nursing environment has turned into a widely acclaimed policy that has been implemented in District of Columbia and 22 states. These states are Alaska, Arizona, Colorado, Connecticut, Hawaii, Idaho, Iowa, Maine, Maryland, Minnesota, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Dakota, Oregon, Rhode Island, South Dakota, Vermont, Washington, and Wyoming (Chesney & Duderstadt, 2017). Other states are characterized by the reduced practice, which implies certain limitations as compared to the full practice. Such reduced nursing practice exists in Alabama, Arkansas, Delaware, Illinois, Indiana, Kansas, Kentucky, Louisiana, Mississippi, New Jersey, New York, Ohio, Pennsylvania, Utah, West Virginia, and Wisconsin (Chesney & Duderstadt, 2017). This approach to nursing autonomy is characterized by certain authority when dealing with minor health issues and close collaboration and in some cases supervision of physicians.
There are also states that do not authorize to act nurses independently. This approach is referred to as the restricted practice. This practice environment is a utilized in California, Florida, Georgia, Massachusetts, Michigan, Missouri, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, and Virginia (Chesney & Duderstadt, 2017). This approach presupposes physicians’ close supervision of nurses’ activities. Nursing professionals have the lowest degree of autonomy as compared to other states.
Nursing Practice in Florida and Major Challenges
As has been mentioned above, Nurse Practitioner Full Practice Authority could help in addressing various issues in the healthcare system. However, many stakeholders including patients and even nursing professionals are reluctant to embrace the change and choose the full practice environment (Kung & Rudner Lugo, 2014). Chesney and Duderstadt (2017) point at five major arguments of the opponents of nurses full practice. It is stressed that physicians have more extensive formal education as well as training, which makes these healthcare professionals more prepared to address various health issues. Some people note that the modern health care is heading toward team-based practice, so the provision of more autonomy to nurses is unnecessary. Some even claim that public safety may be jeopardized if nurses will have more authority and autonomy. Another argument is related to the need to have a transition period that will enable nurses to acquire the necessary skills and experience. Finally, some opponents emphasize that nurses can contribute to the abuse of controlled substance if allowed to prescribe medication.
Although these fears and concerns are not evidence-based, they still prevail in the American society. Chesney and Duderstadt (2017) claim that different stakeholders have specific views and arguments against the full practice. For instance, some policy-makers are reluctant to change the status quo as they believe that it will lead to the tension between physicians and nurses. Such concerns are quite relevant as some physicians are against the use of this approach in many states including Florida. Importantly, many nurses of Florida are not ready to accept the change as they lack political activism and even knowledge on the matter (Kung & Rudner Lugo, 2014). However, the state has numerous issues associated with staffing especially in rural areas and underprivileged communities. Florida needs Nurse Practitioner Full Practice Authority as it can make high-quality care more accessible.
The Process of Change
When implementing the change, it is essential to ensure active participation of the major stakeholders in the process. The first step will be raising people’s awareness of the peculiarities of the nursing environment under analysis. Nurses and physicians are core stakeholders who need the most comprehensive information on the matter (Kung & Rudner Lugo, 2014). It is important to facilitate knowledge change and ensure the exchange of experiences among healthcare professionals. The focus should be on the collaboration between healthcare professionals working in the full practice nursing environment and those working within the scope of restricted or reduced practice. It is critical to make nurses and physicians see the benefits of the approach as well as ways to address possible issues. Training is also required as nurses should obtain skills necessary for being active political activists (Kung & Rudner Lugo, 2014). Nurses do not feel empowered as they are not aware of various strategies that can help them be agents of change.
Policymakers should also be involved in the process. They should seek more information on the matter. Communication and close collaboration with healthcare professionals can help them develop efficient policies that will ensure the development of the full authority nursing environment. The media are also key players in the process. It is necessary to raise people’s awareness of the benefits of the new system. It is essential to stress that modern nurses have extensive training and are able to perform numerous tasks.
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Being a nursing practitioner, I can contribute to the policy change. I believe that the transition to Nurse Practitioner Full Practice Authority will be beneficial for the people living in Florida. One of the steps to achieve this goal is the initiation of the debate on the matter. I can encourage physicians and nurses to discuss the benefits and challenges of the introduction of the new policy. This discussion should not be confined to a single healthcare facility as it is necessary to reach as many people as possible. The participation in conferences and various forums can be helpful.
On balance, Nurse Practitioner Full Practice Authority can help in addressing various health issues in Florida. It can ensure the increased access to high-quality healthcare in rural areas and underprivileged communities. There are many barriers to the implementation of change including insufficient awareness of key stakeholders. The collaboration of physicians, nurses, policymakers is important for the development of efficient policies that could improve the overall system of the US healthcare. The change can start with small steps undertaken by each stakeholder. For instance, nurses can start a discussion of the issue encouraging more and more people to participate.
Chesney, M., & Duderstadt, K. (2017). States’ progress toward nurse practitioner full practice authority: Contemporary challenges and strategies. Journal of Pediatric Health Care, 31(6), 724-728.
Dillon, D., & Gary, F. (2017). Full practice authority for nurse practitioners. Nursing Administration Quarterly, 41(1), 86-93.
Kung, Y., & Rudner Lugo, N. (2014). Political advocacy and practice barriers: A survey of Florida APRNs. Journal of the American Association of Nurse Practitioners, 27(3), 145-151.