NR 506 Week 1: Barriers to Practice
Purpose
Discuss barriers to practice as an APN in one’s state from both a state and national perspective. Research methods to influence policy change from various forms of competition, state legislative and executive branches of government and interest groups.
Activity Learning Outcomes
Through this discussion, the student will demonstrate the ability to:
- Discuss the history of policy development and policy making in nursing (CO1)
- Examine different types of policy and their relationships to healthcare policy (CO1)
- Explain current barriers to practice for advanced practice nurses (CO2)
- Discuss health policy and methods of lifting barriers to practice (CO2)
Due Date: Wednesday by 11:59pm MT of Week 1
Initial responses to the discussion topic must be posted by Wednesday 11:59pm MT. Two additional posts to peers and/or faculty are due by Sunday at 11:59pm MT. Students are expected to submit assignments by the time they are due.
A 10% late penalty will be imposed for discussions posted after the deadline on Wednesday of week 1 by 11:59PM MST, regardless of the number of days late. NOTHING will be accepted after 11:59pm MT on Sunday (i.e. student will receive an automatic 0). Week 8 discussion closes on Saturday at 11:59pm MT.
Total Points Possible: 100
Requirements:
Using the readings from this week as well as outside reliable resources to:
- Identify and describe practice barriers for all four APNs roles in your state and discuss these barriers on a state and national level. The four roles include the nurse midwife, nurse anesthetist, nurse practitioner and clinical nurse specialist.
- Identify forms of competition on the state and national level that interfere with APN’s ability to practice independently.
- Identify the specific lawmakers by name at the state level (i.e., key members of the state’s legislative branch and executive branch of government)
- Discuss interest groups that exist at the state and national levels that influence APN policy.
- Discuss methods used to influence change in policy in forms of competition, state legislative and executive branches of government and interest groups.
- A scholarly resource must be used for EACH discussion question each week.
Sample Discussion Post
As a master’s Prepared nurse, no matter what you do, you have your own set of skills and issues. As a NP, depending on your state, really regulates your autonomy as a provider, whether you need a physician to sign your notes, or if you can practice without them present. As in the state of PA, you must have a collaboration with a physician, however he/she doesn’t necessarily have to be with you while you are practicing. You can function in the state of PA as a Primary Care Provider. Nurse Anesthesia is the one where you have a lot of autonomy, however the schooling is far more intensive and you are literally putting people to sleep, intubating, and keeping them breathing during surgical procedures. I feel like CRNAs are very procedure based, and their skill set is wide. Nurse midwives are primarily only used in women’s health, they are a functioning OBGYN provider, their scope is just that, and there really isn’t flexibility between the roles. And a CNS, is more focused on education, than patient care. These providers are the heart of education programs for nursing, and leaders of the education departments in hospitals, however they are not licensed to act as a provider. (PANCP, 2020)
In ways of competition, I think for NPs the biggest competition would be PAs, this is because their model of learning is totally different, they’re very broad and can practice in many different aspects, however they also can switch it up between specialties. In the Nursing field, you pick a specialty and you’re kind of stuck there, you must practice only in that way, and it is hard to switch around, without more schooling. (MCPHS, 2018)
I live in Jamestown PA and also part of Greene Township. My legislator would be Parke Wentling. However, I went to high school with the daughter of one of the state senate members whose name is Michelle Brooks, who I could contact with any issue need be, and she has been very helpful with nurses in the area. (Pennsylvania General Assembly, 2021)
Of course, the big ones that affect my life as a nurse are the ANA (American Nurses Association) and the ENA (Emergency Nurses Association). These two national associations govern a lot of practice today. The ENA is primarily ER focused and is great with education and good with trying to get legislation passed that is good for all ER nurses. The ANA is for all types of nurses, no matter who you are. They are always trying to get legislation approved to help out nurses. (ANA, 2022) (ENA, 2022)
I think it is important to just join the committees, join the local branch of the ANA or ENA in your area, get to know the main issues facing nurses in your local hospitals. This is the way to know what is going on, what is working well, and what is not. Then you can take all of that energy and place it towards something else. You can also write your legislators, try and set up a meeting and get them on board. Today now than ever, nursing is sometimes very hard, everyone is tired, everyone is burned out. The only way things will get better is if we start standing up and using our voices.
Resources
ANA Enterprise | American Nurses Association. (2022). ANA. https://www.nursingworld.org (Links to an external site.)
Emergency Nurses Association (ENA). (2022). Enaorg. https://www.ena.org/
Find Your Legislator. (2021). The Official Website for the Pennsylvania General Assembly. https://www.legis.state.pa.us/cfdocs/legis/home/findyourlegislator/county_list.cfm?CNTYLIST=MERCER
pacnp.org. (2020). Pennsylvania Coalition of Nurse Practitioners. https://www.pacnp.org/page/ScopeofPractice
PA vs NP: What’s the Difference? | MCPHS University. (2018). MCPHS University. https://www.mcphs.edu/about-mcphs/news/difference-between-physician-assistant-and-nurse-practitioner
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