NR 506 NP Week 1 Discussion Exam (elaborations) NR506
NR 506 NP Week 1 Discussion Exam (elaborations) NR506
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. 1. Identify and describe practice barriers for in your state and discuss these barriers on a state and national level. 2. Identify forms of competition on the state and national levels that interfere with the APN’s ability to practice independently. 3. Identify the lawmakers at the state level (i.e., key members of the state’s legislative branch and the executive branch of government) 4. Discuss interest groups that exist at the state and national levels that influence APN policy. 5. Discuss methods used to influence change in policy in forms of competition, state legislative and executive branches of government and interest groups. Dr. Sibel and fellow classmates, There have always been barriers for advanced practice nurses (APN) on the state and national level. Family nurse practitioners (FNP) are faced with challenges involving licensure, prescription privileges, and payment from insurance companies. Each state varies when it comes to practicing guidelines and prescribing privileges. In my home state of Kentucky, FNPs can practice fully but must have an agreement with an overseeing physician before being able to prescribe narcotics (Kentucky Board of Nursing, 2020). From what I gather from fellow nurses from different states, a few other states are not so lax. On the state level and nationally, family nurse practitioners also get reimbursed less by insurance companies than that of a doctor. In fact, nurse practitioners receive an average of 29% less reimbursement than that of a doctor for the same exact procedure when reimbursed by Medicare (Perloff, DesRoches, & Buerhaus, 2016). Within the state and national level, nurse practitioners must compete with doctors and physician assistants. Despite millions in need of healthcare, there seems to be a misconception that doctors provide better care than that of an FNP. Because of this public belief, some healthcare offices only hire doctors and do not rely on mid-levels to see patients. Nurse practitioners must also compete against physician assistants who apply for many of the same mid-level positions available to APNs. My whole life I have heard people say that they would rather see a doctor or physician assistant over an FNP. While I never understood this, it became apparent to me that may have a harder time finding employment and locating providers to oversee them in order to have privileges to write narcotics. While FNPs may practice independently, in Kentucky I have noticed that many chose to work in offices with large client bases that also have a doctor on staff because many patients prefer to go to a practice where a physician is available. Wyoming received backlash for introducing emergency nurse practitioner certification in 2017 due to individual’s perceptions that FNPs are not properly educated to work in the emergency care setting (Davis, 2019). Davis (2019) states that instead of defending the nurse practitioners and educating the public on the roles of APNs, some hospitals simply replaced emergency care nurse practitioners with physician assistants and physicians. Instead of promoting the use of FNPs, many complied with the suggestions of the public and reinforced the misconception that physicians and physician assistants provide better care than nurse practitioners, making it hard for FNPs to practice independently. Lawmakers in Kentucky that play key roles in healthcare legislation include the legislative and executive branches of government. According to the Commonwealth of Kentucky (2020), Kentucky’s executive branch is led by our governor Andy Beshear and under this branch, the Cabinet for Health and Family Services falls. They ensure that Kentucky families have access to human services and healthcare programs and advocate for low-income families. The legislative branch has a non-partisan group responsible for Kentucky Medicaid and are liable for making the state’s laws and determining the duties and services of government (Commonwealth of Kentucky, 2020). These lawmakers all help influence healthcare in Kentucky and ensure that its residents have access to healthcare. There are interest groups within the state and national level that influence APN policy. In Kentucky, one of the largest is the Kentucky Nurses Association. The Kentucky Nurses Association has representatives at the state capitol during hearings and advocates for nurses and nurse practitioners within the state. Not only do they push for safe working conditions, they also advocate for laws giving nurse practitioners the ability to practice with autonomy. Nationally, the American Association of (AANP) aids in influencing APN policy. They also have an influence on the state level. The AANP has legislative teams that represent FNPs and their patients. In recent years, they have aided in bills passed on full practice authority, signature recognition and other essential NP/patient care issues (Kopanos, 2020). Methods used to influence change in policy involve advocacy and education. Showing support for healthcare change can encourage others to learn about the issue at hand. Educating the public about healthcare concerns can not only help gain the support of fellow clinicians but can also encourage the community to support FNPs and favor improved legislation as well. Community support can aid in showing state legislative and executive branches that changes need to be made and show potential competition that APNs are competent when providing patient care. With the help of interest groups at the state and national level, family nurse practitioners can show the positive impact of FNPs in medicine and continue to demonstrate how beneficial APNs are to the healthcare system.
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 group.