NURSING VALUES AND PROFESSIONAL ETHICS

Olivia Infante

Dec 10 10:25pm| Last reply Dec 11 9:26am

Reply from Olivia Infante

Values and ethics

In West Texas, both mental health and primary care services are in short supply. Existing providers are overwhelmed, resulting in appointment with times of several weeks or even months.  Expanding access to care is a critical advocacy priority, and one effective solution is to grant nurse practitioners full practice authority in Texas.

Provision 4 of the Code of Ethics for Nurses states, “the nurse has authority, accountability, and responsibility for nursing practice; makes decisions; and takes action consistent with the obligation to provide optimal care” (Haddad & Geiger, 2023). The code does not require the use of a supervising collaborator to deliver patient care. Provision 8 states, “the nurse collaborates with other health professionals and the public to protect human rights, promote health diplomacy, and reduce health disparities” (Haddad & Geiger, 2023). Ensuring fair and equal treatment aligns with the ethical principle of justice, which includes providing rural patients the same access to healthcare as those in urban areas (Haddad & Geiger, 2023). Allowing nurse practitioners to practice independently would enable them to open clinics in underserved rural communities, alleviating provider shortages and reducing the need for patients to travel long distances for care.  Removing the requirement for physician oversight would empower nurse practitioners to diagnose, treat, and prescribe autonomously, addressing access barriers and supporting ethical, high-quality care for all Texans.  

Agenda

In the United States, nurse practitioner practice authority varies significantly by state.  Currently,11 states require nurse practitioners to practice under the supervision of a physician, while 30 states grant nurse practitioners full practice authority, allowing them to provide care independently.  As a result, more than half of the country permits nurse practitioners to deliver care across diverse clinical settings without physician oversight.  

A study by Dunbar-Jacob and Rohay (2024) found that states with full practice authority for nurse practitioners achieve better population health outcomes than those with more restrictive regulations.  Nurse practitioners are recognized for providing extensive patient education and counseling, rooted in their background in bedside care and patient-centered interactions.  Advancing independent practice authority for nurse practitioners in all 50 states should remain a national priority until legislative barriers are removed, ensuring that nurse practitioners can practice to the full extent of their education and training.  

Law

In Texas, restrictions on nurse practitioner practice are the result of legislative decisions.  Most recently, Senate Bill 1700- which would have granted independent practice authority to nurse practitioners and certified registered nurse anesthetists- was rejected during the latest legislative session (Zarefsky, 2024). Currently, supervising physicians receive additional compensation for overseeing nurse practitioners, and removing these supervisory requirements could impact this income stream.  This dynamic raises questions about whether provider opposition is driven by concerns for patient care or financial interests (Feeney, 2025). As a DNP-prepared student, advocating for reduced practice restrictions and supporting legislation can help expand access to both mental health and primary care services, particularly in underserved communities.

References

Dunbar-Jacob, J., & Rohay, J. M. (2024). State health and the level of practice authority for nurse practitioners.  Nursing Outlook,  73(1), 102319.  https://doi.org/10.1016/j.outlook.2024.102319Links to an external site.

Feeney, A. (2025, July 9).  Nurse Practitioner Practice Authority: A State-by-State Guide. Nurse Journal.  https://nursejournal.orgLinks to an external site.

Haddad, L. M., & Geiger, R. A. (2023a, August 14).  Nursing ethical considerations. StatPearls - NCBI Bookshelf.  https://www.ncbi.nlm.nih.gov/books/NBK526054/Links to an external site.

Zarefsky, M. (2024, July 26). Texas rejects whopping 140 scope of practice bills.  American Medical Association.  https://www.ama-assn.org/practice-management/scope-practice/texas-rejects-whopping-140-scope-practice-billsLinks to an external site.