Lizandra

Now days, Nurse practitioners are able to practice in nearly all care settings from clinics to hospitals. The practice of an NP continues to grow, and it is not limited to managing the patient’s care like physicians. Coordinating the care and educating the patient is part of care that Nps are able to provide. Nps are also able to independently collaborate with other health care professionals in order to better provide care. A Nurse Practitioner is able to provide care not worrying so much about the setting but instead focusing on the patient’s need.

The education of an NP consists of an RN who obtains graduate education to receive a national board certification. The national standards make sure that NPs are able to provide safe and high-quality care. Nurse practitioners are to remain accountable to the patients, the nursing profession, and the state board. Therefore, Nps are to practice in an ethical way as per the code of conduct. 

Eduardo

Among the challenges encountered by advanced nurse practitioners (ANP) in their practice, as suggested by Mark and Patel (2019), is the increased workload, which is often accompanied by a certain level of pressure and stress. The rising demand for primary care means that ANPs have to deal with not just straightforward health cases, but also complex health cases, and they have to perform activities that are traditionally carried out by doctors in a bid to meet the primary care demands. These stretched responsibilities put ANPs at risk of work-related stress and burnout, and they have to struggle navigating through their demanding workloads without compromising the quality of care they render to patients. The second challenge as revealed through this article is irregular working hours, stemming from the uniqueness of the ANPs sphere of responsibility.

 It is correct to say that the ANPs responsibilities are diverse since ANPs have to attend to different patient groups. These inconsistent working hours also arise from the shortage of primary care professionals amidst the exhausting pace of patients. ANPs often encounter varied shift lengths. Prolonged shifts beyond their scheduled working hours are a norm in order to provide increasing patient care and satisfy practice expectations, as agreed by Steinke et al (2018). The third challenge identified is the limited ability to practice independently, and this stems from certain policies and regulations that restrict ANPs from practicing to the full extent of their nursing education and training. These scope-of-practice restrictions bring forth role ambiguity, and make it difficult for ANPs to contribute fully to positive outcomes in healthcare and to the optimal functioning of healthcare teams. This challenge also breeds a gradual loss of status amongst ANPs, which may affect their everyday productivity and performance.

Rosie

Nurse Practitioners (NPs) are advanced practice registered nurses (APRNs) who have pursued master’s or doctoral degrees and obtained certification from the federal government. NPs obtain special knowledge and clinical competency to offer safe, quality, and affordable care in different health settings during their studies. NPs are accountable to patients, the nursing profession, and the state nursing board (American Association of Nurse Practitioners (AANP), 2021). NPs are supposed to follow a strict ethical code of conduct in their practice, use evidence-based practice, and obtain national certificates. NPs are supposed to be flexible and move with the current trends in the healthcare sector. They are supposed to engage in continuous professional development, enroll in professional organizations and engage in policy advocacy in the local, state, and federal settings. 

The American Association of Nurse Practitioners (AANP) defines nurse practitioners’ scope of practice (NPs). NPs work in various healthcare settings such as clinics, hospitals, emergency rooms, nursing homes, colleges, and schools (American Association of Nurse Practitioners (AANP), 2019). NPs are engaged in assessing, ordering, supervising, performing, diagnosing, interpreting diagnostic findings, prescribing treatment interventions, counseling, coordinating care, and educating patients and community members. The state laws limit the NPs scope of practice and require them to collaborate with other healthcare providers in providing patient care.

Mercedez

Of the four key messages that the Institute of Medicine pointed out in their report recommendations, I feel recommendation 1 will be most beneficial to my future FNP practice. The IOM (2010) stated that the “advanced practice registered nurses should be able to practice to the full extent of their education and training”. The report points out what congress, state legislatures, and the federal trade commission can do; however, we as nurses need to remember that our voices and involvement are needed too. 

           Hooper (2011) made a great point when she recommended that the nurse should “…get involved”. By contacting our legislature and congressman we can inform them of our education and training. We may also find it helpful to send them a copy of the IOM recommendations. Nurses can attend rallies and stay informed to help educate others on how the NP can be a great asset to the healthcare system. 

           NPs can fill the gaps of the lacking healthcare system, with the right support and motivation, and by becoming involved with the recommendation of removing the scope-of-practice barriers. I, as a future NP, will not only be helping my community that does not have easy access to healthcare, I will also be helping myself in meeting a personal goal of providing quality care that is utilizing my full extent of knowledge and ability. 

Lauren

The newly granted privilege to prescribe medication gives nurses the ability to practice to their full knowledge and skills. APRNs are well educated and with such a privilege; they can help transform the delivery of healthcare services. Different states have different laws that define the roles and responsibilities of nurses. In Florida, Nurses can practice independently, but they are required to enter into a collaborative agreement with the physicians, which defines the roles and responsibilities to be performed by each party. The written protocol outlines the duties the nurse is allowed to perform and the level of physician supervision for the different actions on the part of the ARNP. When it comes to the issue of prescription of controlled substances, ARNPs are allowed to prescribe controlled substances in Schedule II, Schedule III, or Schedule IV (Florida Board of Nursing, 2016). This only applies to nurses who have graduated with a master’s or a doctoral degree.

APRNs scope of practice is governed by state nurse practice acts and regulated by the board of nursing. States that do not grant APRNs the privilege to full practice limit one or more elements of the advanced nursing practice, such as providing emergency medical services, ordering certain diagnostic tests, dispensing certain medication, initiating treatments or medical referral. Though Nurse Practice acts are specific and may vary in each state, there are common elements outlined in collaborative agreements between physicians and APRNs, prescriptive authority, protocols and procedures for APRN practice.

Yedy

Nurses being allowed to prescribe a class of drugs is one of the important legislative updates in the state of Florida. Advanced Registered Nurse Practitioners can now prescribe controlled substances listed in schedule II and III or schedule IV since 2017 (Florida Board of Nursing, 2016). Under this new law, APRNs who undertake the responsibility of prescribing controlled substances listed in schedule II are limited to seven-day supply and does not include the prescription of psychotropic medications to patients under the age of 18 years (Florida Board of Nursing, 2016). This applies to APRNs who graduated with a master’s or doctoral in nursing specialty areas that, with training on some important practitioners, kills. The law further provides that APRNs need to consider themselves as controlled substance prescribers if they need to undertake the responsibility of prescribing to treat chronic malignant pain (Florida Board of Nursing, 2016). In this case, ARNPS will need to meet the same standards as physicians.

           In their practice, APRN seeking employment are always required to enter into a practice agreement which will define their roles and establish a working relationship with the physician. This is done to provide a mechanism of legal protection to the nurse and also clearly defines the rights and responsibilities of the parties involved. It is important to understand the current laws governing the prescription of drugs and how nurses need to approach their responsibilities. Laws change, and healthcare providers need to understand the current law because they cannot claim obtuseness in case a problem arises.

Yanet

A nurse practitioner’s scope of practice describes the privileges allowed by their license. The American Nurses Association defines the scope of practice as the “who, what, when where, and why and how of nursing practice.” State boards of nursing determine the scope of practice and refer to the actions, procedures, or processes permitted by a professional in their profession by the law. 

The scope of practice that law allows is essentially based on the educational qualifications and experience in the particular field. APNs can work as primary care providers in autonomous practice settings. APNs are also allowed to prescribe medications and offer physical therapy independent of physician collaboration, delegation, or supervision. APNs can sign death certificates, issue handicap parking permits, and oversee worker compensation claims. 

A nurse practitioner’s standards of scope of practice describe the clinical practice patient care and health education and promotion, patient advocacy, quality assurance, and collective responsibilities (Nurse Practitioner Scope of Practice, n.d.). 

Natalye

ARNPs have a wide range of practice. The health care providers focus on women’s health, family, and others as adult-geriatrics. In the state of Florida, ARNPs have more privilege because they can prescribe controlled drugs. However, the ARNPs must fulfill particular requirements before enjoying the privilege.

Schedule II and schedule III consists of a list of controlled substances. The ARNPs can use the lists to prescribe controlled substances within the state of Florida. Schedule IV has more of the list of the controlled drugs (Kellams & Maye, 2017). ARNPs must obtain a license before undergoing a three-hour training (DCD, n.d.). Simultaneously, the ARNPs must apply for a DEA license that is valid for three years (Kellams & Maye, 2017). ARNPs have no freedom to prescribe controlled substances in the state of Florida without having an agreement with supervising physician (AANP, 2019). The two parties must concur on the prescription of controlled drugs.

ARNPs must indicate on their practitioner profile that they can prescribe controlled substances. The reason for offering the information is to ensure ARNPs can treat chronic nonmalignant complications (AANP, n.d.). In the case the ARNPs can prescribe controlled drugs in treating chronic nonmalignant disorders, they must fulfill similar practice standards as physicians. For instance, the ARNPs must have a master’s or doctorate in clinical nursing (Kellams & Maye, 2017). In this way, the nurses can only rely on evidence-based practices (USDJDEA, n.d.). The ARNPs focus on identifying the needs of clients and meeting them.

Prescribing controlled drugs in Florida requires acquisitions of licenses. Also, ARNPs require some training before starting practicing. The ARNPs need to have a legal agreement with supervising physicians for successful therapies