Introduction
Nurse-Managed Health Centers (NMHCs) are organizations that could become a significant part of the solution to the problem of restricted access to health care. According to the Centers for Disease Control and Prevention, the shortage of primary care practitioners will reach 44,000 by 2025 (as cited in Esperat, Hanson-Turton, Richardson, Tyree-Debisette, & Rupinta, 2012). Taking into consideration the existence of the looming gap in the provision of care services, it is safe to assume that the NMHC model of health care organization can serve as a viable option for expanding the scope of practice of nurse practitioners (NP). This paper will explore NMHC as a type of organization in which I would like to work as an NP.
Basic Model of NMHC
The majority of NMHCs could be classified as community-based health centers. Around 112 NMHCs are registered as independent nonprofit organizations (Esperat et al., 2012). Some NHHCs are categorized as academic-based health centers and have an affiliation with university-based nursing schools. The NMHC model is a continuation of the desire of educational institutions to reverse the decline of NPs’ numbers in primary care and “fulfill the mission of community outreach” (Esperat et al., 2012, p. 26).
The establishment of NMHCs has made possible the implementation of numerous organizing models that promoted the provision of diverse experiences for APNs. Moreover, the nature of the NMHC setting allows to organize the delivery of clinical services by community needs and ensuring that the provided care is directed by an APN (Esperat et al., 2012). Furthermore, the positive impact of this health care model on underserved populations could be illustrated by the data provided by the Nursing Education, Practice, and Retention Grant Program, which reveals that 85,000 uninsured patients received medical services from NMHCs in 2009 (Esperat et al., 2012).
The Role of NP in NMHC
American Association of Nurse Practitioners (AANP) identifies nurse practitioners as licensed and autonomous clinicians that are responsible for managing people’s health outcomes and disease prevention by bringing “comprehensive perspective to health care” (2016). All NPs have to hold a master’s or doctoral degrees and have sufficient clinical training that goes beyond their preparation program for professional registered nurses (AANP, 2016).
Advanced education and licensure of nurses are guided by recognized accreditation agencies as well as national certification associations such as boards of medicine, nursing, and pharmacy among others (Poghosyan, Boyd, & Knutson, 2014). Due to the vast array of organizations regulating NPs’ training and educational preparedness, there is significant diversity in the scope of practice (SOP) across states. The restriction in SOP laws results in variations of NPs’ level of autonomy when it comes to delivering health care services to patients (Poghosyan et al., 2014). For example, some states allow NPs to work without the involvement of physicians.
On the other hand, some states require the presence and direct supervision of physicians during the care delivery process (Poghosyan et al., 2014). Therefore, it could be argued that the regulatory environment of the state in which health care organization is located plays a key role in determining the limits of independent practice and legal capacity of NPs to provide the delivery of some health care services.
The State of Florida is known for its numerous restrictions and licensures that prevent NPs from having full practice authority. Moreover, a recent study suggests that even though a shortage of nurses significantly affects both workforce and the ability to provide care services to patients, primary care physicians are reluctant to support the expansion of SOP (Hain & Fleck, 2014). Therefore, it is only safe to assume that NMHC is a model of health care delivery that will facilitate the creation of a safety net for the underserved population while simultaneously addressing the problem of nurse shortages by lifting some of the restrictions on their SOP.
Moreover, one of the goals of NMHCs is to eliminate some boundaries between the roles of the advanced practice nurse, the educator, and the scholar thereby promoting the learning possibilities that are sometimes absent from the conventional clinical settings (Esperat et al., 2012). Furthermore, the structure of the NMHC model creates a unique environment for developing leadership skills of NP that allows a nurse leader to acquire the experiential qualification in supervision as well as development and implementation of plans for a wide variety of clinical areas of responsibility (Esperat et al., 2012).
It is also worth noting that Nursing Practice Act issued by Florida Board of Nursing will support the role of NP in NMHCs and confirm that this particular type of health care organization promotes wellness, maintenance of patients’ health as well as prevention of disease (Florida Department of Health, 2011).
Conclusion
Nurse-Managed Health Center is a type of health care organization that will help an NP to provide medical services for underserved populations of the nation thereby significantly contributing to the emergence of community-based care. Furthermore, by eliminating boundaries between the roles of the advanced practice nurse, the educator, and the scholar it could provide the practitioner with learning possibilities that are sometimes absent from the conventional clinical settings.
References
AANP. (2016). What’s an NP? Web.
Esperat, M., Hanson-Turton, T., Richardson, M., Tyree-Debisette, A., & Rupinta, C. (2012). Nurse-managed health centers: safety-net care through advanced nursing practice. Journal of The American Academy of Nurse Practitioners, 24(1), 24-31.
Florida Department of Health. (2011). Florida Board of Nursing. Web.
Hain, D., & Fleck, L. (2014). Barriers to nurse practitioner practice that impact healthcare redesign. OJIN: The Online Journal of Issues in Nursing, 19(2), 21-44.
Poghosyan, L., Boyd, D., & Knutson, A. (2014). Nurse practitioner role, independent practice, and teamwork in primary care. The Journal for Nurse Practitioners, 10(7), 472-479.