Clearly describe an issue facing advanced practice nurses related to scope of practice.
After describing the issue, please answer the following questions. Discussion questions
(links to objective #1).
As the position of the nurse practitioner continues to evolve, autonomy concerning nurse's
function and scope of practice becomes a growing concern. Having practice autonomy allows
nurses to take charge of their practice by making decisions based on their work experience
and knowledge. According to Ganz, Toren, and Fadlon, (2016) prescriptive authority
constraints and lower reimbursement rates are examples of loss of nursing autonomy.
However, a number of issues, including organizational constraints, teamwork, and the support
of other healthcare professionals, hampers a nurse practitioner’s autonomy.
What ethical impact does the issue have on direct patient care?
The more autonomy a nurse practitioner has, the more likely they are to be aggressive while
gaining increased collaboration and support from their colleagues, resulting in nurse
practitioner empowerment and, in turn, improved patient outcomes. Furthermore, in reference
to Keeling, (2015) increasing autonomy for the nurse practitioner profession permits the nurse
practitioner's function and scope of practice to expand and progress. Nurse practitioners who
have more autonomy have higher job satisfaction, which has been linked to a reduction in
ethical issues and increased professionalism.
Describe any law or legal issue surrounding this policy issue.
According to the Arizona Board of Nursing, nurse practitioners must only practice in their
field of qualification and should not exceed the limits of their advanced practice specialty
area. For two years, NPs must work under a physician's collaborative practice agreement or
protocol. Keeling, (2015) states that this does not imply autonomous practice. A protocol
agreement necessitates general monitoring and delegation. The protocol agreement must
include a provision for prompt consultation between the NP and the delegating physician. It
must be between an NP and a physician who practices in similar specialist areas.
Decide how this policy would affect your specific role as an advanced practice nurse.
Autonomy gives a nurse practitioner the freedom to practice and make judgments based on their
knowledge base. However, when one's autonomy is restricted, nurses’ ability to execute to the
full extent of one's area of practice is also restricted (Hartigan, 2016). This results in not only
underutilization of the nurse practitioner but also in less effective patient outcomes. Quality,
safety, and treatment affordability would improve if nurse practitioners were allowed to practice
fully of their license (Hartigan, 2016).
Describe any changes you would make to your selected health policy issue. Please
provide rationale for each cited change.
If I had the chance, I would ensure that nurse practitioners have the practice autonomy they
require. Autonomy is vital in improving the quality of patient care by making prompt
decisions at the bedside, lowering stress and increasing job satisfaction. Furthermore, one of
the benefits of autonomy is that it promotes professional socializing. Patients can benefit from
improved nursing services if they are autonomous (Ganz, Toren, & Fadlon, 2016). On the
other hand, all registered nurses have a responsibility to comprehend the nursing practice act
in the state where they work, follow the laws and regulations, and ensure that they are fully
qualified and competent in their function as registered nurses (Hartigan, 2016).
How do nurse practice acts provide for consumer protection and for nursing
advancement?
Arizona Nurse Practice Acts are designed to limit patient injury risk and safeguard patients by
guaranteeing the most significant degree of competence. According to Hartigan, (2016) the
Nurse Practice Act is intended to guarantee high quality patient care and ensuring patient safety.
The BON has the jurisdiction and capacity to regulate nursing practice. The BON is also
responsible for protecting the health, safety, and welfare of patients against inadequate
nursing care.
References
Brous E. (2012). Common misconceptions about professional licensure.7The American journal of
nursing,7112(10), 55–59. https://doi.org/10.1097/01.NAJ.0000421027.92789.9
Ganz, F. D., Toren, O., & Fadlon, Y. (2016). Factors associated with full implementation of
scope of practice. Journal of Nursing Scholarship, 48(3), 285-293. doi:
10.1111/jnu.12203
Griffith R. (2020). The elements of negligence liability in nursing.7British journal of nursing
(Mark Allen Publishing),729(3), 176–177. https://doi.org/10.12968/bjon.2020.29.3.176
Hartigan C. (2016). Scope of Practice.7Critical care nurse,736(5), 70–72.
https://doi.org/10.4037/ccn2016325
Kaplan L. (2020). NP licensure and the discipline process.7The Nurse practitioner,745(3), 14–15.
https://doi.org/10.1097/01.NPR.0000653976.42290.01
Keeling, A. W. (2015). Historical perspectives on an expanded role for nursing. Online Journal
of Issues in Nursing, 20(2). doi:10.3912/OJIN.Vol20No02Man02
