Advanced Practice Regulation Comparison
There are four areas that nurses act in in an advanced practice role. Those roles include clinical nurse specialists, nurse practitioners, certified nurse midwives, and certified registered nurse anesthetist (Bosse, et al, 2017). There are regulatory boards that regulate nursing practice on a state and federal level. If regulatory boards do not allow APRNâ€™s to practice to the full scope of their abilities, it affects healthcare for all (Bosse, et al, 2017). Each US State has a regulatory board that guides nursing practice for that state. The two states that I will compare for the sake of this discussion are Alabama and Massachusetts. The reason that I picked these two are because I have been licensed in both states individually prior to the development of the Nursing Licensure Compact (NLC).
The state of Massachusetts does not require you to take a test or prove any knowledge of regulations regarding Nursing practice prior to issuing you a license via endorsement. I just had to apply and pay a fee. The use of APRNs could assist physicians in having lighter patient loads and improve access to primary care for some patients (Bosse, et al, 2017). One of the abilities that would be needed in aiding APRNs to practice at full capacity is the ability to prescribe medications. In the state of Massachusetts, â€œCRNAs, CNPs, or PNMHCSs with a minimum of two years of supervised practice may engage in prescriptive practice without supervision upon submission of an attestation to the Board that the CRNA, CNP, or PNMHCS has completed a minimum of two years of supervised practice by a Qualified Healthcare Professionalâ€ (Commonwealth of Massachusetts, 2023). With that said, you would not be able to prescribe medications during your first two years of practice. I have witnessed recent graduate CNPs (certified nurse practitioners) unable to work in their specialty due to not having prescribing capabilities. The frustration comes in that they wonder how they are supposed to get the experience they need if no one wants to hire them without those privileges. In the State of Alabama, â€œNurse practitioners practicing in Alabama have limited authority to prescribe. They are allowed to do so only with physician collaboration. The name, practice site address and phone number of the collaborating physician must be present on each prescription written by the NPâ€ (ThriveAP, n.d.). NPs must be in practice for at least a year in Alabama before being considered for prescribing capabilities.
Primary Care Provider
The second regulation that I wanted to examine is the ability of the APRN to be a primary care provider. Neither Alabama nor Massachusetts recognize APRNs to be primary care providers. It is the hope of those in practice that legislation will loosen its grip to allow for APRNs to be recognized as Primary care providers (ThriveAP, n.d.). In states where APRNs have full practice abilities, there have been documented benefits to the healthcare system and over health of the population served. There has been a significant decrease in ER visits, decreased admissions to the hospital, and lower cost of care provided by the physicians (Bosse, 2017). It is unclear right now what changes legislation will decide to make in regard to APRNs having more autonomy in the field. As the healthcare staffing shortage continues to increase, the increase in duties that are able to be delegated to APRNâ€™s will likely increase.