Scope of Practice for Nurses in Primary Care

The Limitations in Florida and the Other States

Most states consider APRNs to be nurse practitioners with undergraduate nursing education, graduate nursing degree, and some experience in nursing practices. They are expected to provide such services as medical assistance, diagnosis and treatment of different kinds of illnesses, monitoring the patients after operations, supervising rehabilitation periods of the patients, and more. According to the reports, there are currently almost 250 000 APRNs who have their medical degree and who have successfully passed the national certification exams in the U.S. (Federal Trade Commission, 2014, p. 7). Usually, most APRNs are work in primary care (this is characteristic of every state) and are licensed and prepared for this kind of practice more than for any other nursing activity. Here lies the limitation.

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Factors and Barriers

Practice laws set the majority of barriers for the NPS. scope-of-practice regulations put a lot of restrictions on NPs’ tasks, and it is the primary care branch that suffers the most. Moreover, in 2013, it was proved for a fact that nurse practitioners see more patients in the states where the Scope-of-practice laws are less intimidating and strict (Kuo et al. 2013). Physician supervision is also a problem as it imposes more boundaries on the NP’s activities.

Changes in the Scope of Practice

There are going to be some changes in educational requirements by 2017, which will include changes in the number of PDH required (one PDH in Laws and Rules, one PDH in ethics, and four PDH in the area of practice) (Florida Board of Professional Engineers, 2016).

Changes’ Effect

I believe these changes will lift some of the restrictions and will help the nurse practitioners function more effectively. The education is vital to a medical professional’s job, but acquiring PHDs takes time, and the more of them are required, the less is the possibility of supplying the medical care facilities with trained professionals in time. The training should be fast and thorough, which is still something we have to achieve yet. We also need more changes in the field of physician supervision. According to the Autonomous Full Scope Nurse Practitioner Practice video presentation, “states without physician supervision have increased access to care by 16%, reducing ER costs and sicker patients” (2014).

Why It Took So Long

To understand the drawbacks and inconveniences, we need a trial-and-error method, which takes some considerable time. Revealing inconsistencies and finding ways to even them out is a delicate job that demands care and precision. However, I believe we start noticing problems and come up with solutions more often now than before. We are evolving.

Limitations Left

As it was said before, the strictness of the Scope-of-practice laws and physician supervision are still big problems.

Addressing the Scope of Practice Issues

The NP practice restrictions worsen the quality of medical care and therefore should be addressed primarily. We also need to stop organizations from delegating responsibilities to NPs who are not qualified to perform certain activities and teaching them to pay more attention to nurses’ scopes (Poghosyan et al. 2016, p. 149).

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Pros/Cons of Unrestricted Scope and Authority without Mandated Physician Supervision

Pros: the nurses will be allowed to perform more activities (e.g., order appropriate tests, sign death certificates, provide insurance, etc.), receive direct pay for said activities, come up with their own medical care practices, and expand their services to the areas that have poor medical maintenance (Autonomous Full Scope Nurse Practitioner Practice, 2014).

Cons: the shift to new working conditions may take some time to adjust for everyone involved.


Iorillo, K. [Kathy_Iorillo]. (2014). Autonomous Full Scope Nurse Practitioner Practice, FLORIDA. Web.

Federal Trade Commission. (2014). Policy Perspectives: Competition and the Regulation of Advanced Practice Nurses. New York, NY: Author.

Florida Board of Professional Engineers. (2012). Florida: Continuing Professional Development (CPD) Requirements. Web.

Kuo, Y. F., Loresto, F. L., Jr., Rounds, L. R., & Goodwin, J. S. (2013). States with the Least Restrictive Regulations Experienced the Largest Increase in Patients Seen by Nurse Practitioners. Health Affairs, 32(7), 1236-1243.

Poghosyan, L., Boyd, D. & Clarke, S. (2016). Optimizing Full Scope of Practice for Nurse Practitioners in Primary Care: A Proposed Conceptual Model. Nursing Outlook, 64(2), 146-155.

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