Introduction
Florida is the state with the restricted practice of NP. Due to House Bill 607, starting from July 1, 2020, the restrictions will lessen for several categories of specialists. Initially, the full powers and the list of specialists to be allowed to have independent practice in HB 607 were much wider, but legislative processes made both the House and Senate apply some amendments to it. This paper aims to study the jurisdiction of NP in Florida and the potential changes in frames of HB 607.
NP Community in Terms of Scope of Practice
NP in Florida is obliged to obtain a written agreement of collaboration with a physician to have prescriptive authority. ARNP in Florida can operate strictly within the guidelines of a signed supervision protocol. If NPs are eager to have the authority of prescribing controlled substances, they have to complete the relevant three credit hours of American Medical Association PRA (Category 1) (“State Law Chart”, 2017). Starting from 2017, NPs are authorized by the AMA to prescribe drugs from schedules III-V. In terms of psychiatric medication, the situation is as follows: unlimited psychiatric controlled drugs are allowed to be prescribed by NPs with the 7-days limit only (“State Law Chart”, 2017). When it comes to children under 18, the prescription of psychiatric medication is allowed strictly to psychiatric NPs.
The licensing procedure for clinical nurses is different from the state credentialing of nurse anesthetists. The general initial requirement for ARNP credentialing is the license of a registered nurse in Florida. Today, for ARNP students, the completion of a master’s program is a must. The same rule also applies to the post-master program. Those who graduated before October 1998 are an exception to this rule – they are allowed to apply for a nurse anesthetist credentialing without a master’s degree. For ARPN, a 2-hours course in medical error prevention is also mandatory, as well as the liability insurance (“House Bill 607”, 2020). State credentialing varies depending on the specialty in Florida.
The Impact of Restricted Practice on Patients
The states with full practice authority of nurse practitioners demonstrate the absence of a decline in care. In Florida, being now one of the states with limitations of practice authority for NP, on the contrary, people face the situations in which their health care providers are booked for several months ahead. Luckily, about 630 cities of the state have at least one urgent care clinic. Moreover, studies in 2015 showed that “current primary care production rates will be unable to meet demand, resulting in a shortage of over 33,000 primary care physicians” (Petterson et al., 2015, p.107). Thus, today, in the era of rapidly changing technologies, the physicians will be significantly unloaded and will be able to provide their care where needed most.
The Impact of Access to NP on Healthcare Disparities
According to many pieces of research, it is obvious that the less the restrictions of ARPN’s practice regulations are, the higher are the utilization and access to healthcare. Compared to the full practice states, the restricted practice states, the indicators of geographic accessibility to primary care specialists (including NPs) are about 65% and 35%, respectively. Moreover, “ARNPs’ practice and prescriptive independence had a positive impact on physician referral, health education and counseling services, and the number of medications taken by patients” (Ortiz et al., 2018, p. 65). This fact confirms the earlier researches, stating that NPs can provide the population with minor injuries appropriate care, sometimes performing even better than some physicians in frames of recording the medical histories and scheduling the follow-up care for their patients.
Conclusion
Hopefully, the changes in the law, expected to take place in summer, 2020, will finally take place without further amendments. Nevertheless, there would still be several nuances like the obligation to renew the independent practice license and the standard state ARPN license every two years (“House Bill 607”, 2020). Moreover, the independent practice license for NPs will cover only primary practice. This law will positively affect the state NP Community in Florida.
References
House bill 607 (2020). Web.
Ortiz, J., Hofler, R., Bushy, A., Lin, Y., Khanijahani, A., & Bitney, A. (2018). Impact of nurse practitioner practice regulations on rural population health outcomes. Healthcare, 6(2), 65. Web.
Petterson, S. M., Liaw, W. R., Tran, C., & Bazemore, A. W. (2015). Estimating the residency expansion required to avoid projected primary care physician shortages by 2035. Annals of Family Medicine, 13(2), 107-114. Web.
State law chart: Nurse practitioner prescriptive authority (2017). Web.