Healthcare Issue Identified
One of the issues affecting Nurse Practitioners (NP’s) nationwide is being able to work fully with accordance to their training and education also referred to as full practice authority (FPA) (Dillon and Gary, 2017). Across various states in America, the ability of NP’s to provide services with accordance to their certification and training levels is not equally guaranteed. In California, which has the highest number of people, NP’s are kept under restricted practice authority where they are required to have agreements with supervising physicians in order for them to offer essential services like prescribing medicines or interpreting diagnostic tests. Such environments hinder the abilities of the NP’s to provide healthcare services as they lead to unnecessary bureaucracy as well as patient confusion with regard to the nurse practitioners roles. Such restrictions in practice only worsen the situation for the millions of California residents where the numbers of healthcare personnel has been found to be significantly short of the federal recommendations. Reports show that in California, primary doctors’ range from 35 to 49 in every 100,000 patients enrolled in Medicare (Yee et al., 2013).
Change Needed in Health Care Policy
The future of nursing report by the IOM points out that the changing healthcare landscape as well as the changing profile of the American population needs fundamental changes in the system of healthcare delivery. It places emphasis on the issue of primary care shortages especially after expanded coverage brought by the ACA and advocates for NP’s to be allowed to provide care to the full extents of their training and education (Salsberg, 2015). This would enable the healthcare system to acquire the workforce needed in meeting the primary care needs of the citizens and will allow the NP’s to contribute their skills in delivering community-based, patient-centered care. Despite the extensive training of the NP’s which enables them to provide different services, various barriers such as federal policies and state laws prevent them from doing so. The change needed is for NP’s to have full practice authority that can allow them to diagnose, examine, and prescribe medication without oversight or supervision from physicians. In particular, change is needed in the California Nursing Practice Act which points out that NP’s need the approval of the doctor when managing care, prescribing pharmaceuticals, certifying disability or ordering basic medical tests. Extensive research has shown that NP’s are capable of providing high-quality care with outcomes that are better or similar to physician-provided care (Altman et al., 2016). Such a change of easing up restrictions to NP’s practice scope will not only strengthen the capacity of primary care but will also increase access for patients and free up physicians to manage cases that are more complex.
Future as an NP and Legacy
My future aspiration as a nurse practitioner is to one day run my own independent practice and be considered a primary care provider through the provision of my unique skills which combine nursing care with medicine. I aspire to understand and develop my contributions in a healthcare team while autonomously performing my role and giving recognition to other team members’ roles through collaboration. My legacy is to advocate for change in policies that are bureaucratic and unnecessary in my practice as a nurse practitioner such as the restrictive scope of practice policies which acts a barrier preventing NPs from practicing to the full extent of our training and education. Such a change will aid the community by making it possible for NP’s to provide safe, affordable and quality healthcare thus aiding in social change.
References
Altman, S. H., Butler, A. S., &Shern, L. (Eds.). (2016). Assessing progress on the Institute of Medicine Report The Future of Nursing. National Academies Press.
Dillon, D., & Gary, F. (2017). Full practice authority for nurse practitioners. Nursing administration quarterly, 41(1), 86-93.
Salsberg, E. S. (2015). Is the physician shortage real? Implications for the recommendations of the institute of medicine committee on the governance and financing of graduate medical education. Academic medicine, 90(9), 1210-1214.
Yee, T., Boukus, E., Cross, D., & Samuel, D. (2013). Primary care workforce shortages: Nurse practitioner scope-of-practice laws and payment policies. National Institute for Health Care Reform Research Brief, 13, 1-7.
