The Evolution of the Role of the NP
Order Instructions:
This assignment is in 2 sections and each section need to have a minimum of 4 references at the end of that section, meaning the writer will have to provide 2 reference list one each at the end of the section. I have also included the document that is needed to complete section B. The writer must pay attention to details and respond t all questions in detail.
The Evolution of the Role of the NP
SECTION A (2 pages minimum)
The Evolving Role of the NP
The role of the NP has evolved dramatically over the course of the last 50 years. The evolution of the role is impacted by changes in legislation affecting licensure, credentialing, scope of practice, and educational requirements. Choose a legislative issue related to the role of the NP and describe this for your colleagues. How does this issue impact the scope of practice for NPs? What changes might this issue catalyze? Describe the implications of the DNP credential in regard your selected issue.
Include a minimum of 4 reference at the end of this section.
SECTION B (2 pages minimum)
The Consensus Model/LACE
The Consensus Model was developed with the idea of uniform regulation of NPs across the United States. Review the document Consensus Model for APRN Regulation: Licensure, Accreditation, Certification and Education (NCSBN, 2008). The document will be uploaded in the file section for the writer.
Evaluate the proposed model. What are the strengths and weaknesses of the Consensus Model? Consider the implications, as well. How might this model impact competition and/or collaboration between NPs and physicians in the U.S. health care system?
Include a minimum of 4 reference at the end of this section.
Resources
Textbooks, read the following:
Advanced Practice Nursing: Emphasizing Common Roles
• Chapters 1, 6
Please review the following web resources:
• Are Nurse Practitioners the Solution to Shortage of Primary-Care Doctors? (PBS, 2011)
• Nurse Practitioner World News: The 5 NP Political Issues and the One Solution (O’Grady, 2009).
• Consensus Model for APRN Regulation: Licensure, Accreditation, Certification and Education (APRN Consensus Work Group & the
• National Council of State Boards of Nursing APRN Advisory Committee, 2008)
• American Association of Colleges of Nursing (AACN) Resources and information on Doctor of Nursing Practice (AACN, 2011)
SAMPLE ANSWER
The Evolution of the Role of the NP
SECTION A: The evolving role of the NP
The chosen legislative issue is the expansion of the scope of practice of the Nurse Practitioners (NP). The scope of NPs should be expanded and NPs actually qualify for independent practice – they should be allowed to practice independently without being supervised or directed by a physician. NPs are registered nurses with a postgraduate degree in nursing – commonly a master’s degree. In many states, scope-of-practice laws give Nurse Practitioners the ability to carry out various primary care services which might be delivered whenever people make an initial approach to a nurse or physician for treatment and continuing care for chronic illnesses (Cassidy et al., 2014).
With an envisaged shortage of primary care as the population continues to increase and as millions of Americans become newly insured beginning the year 2014, it is imperative to expand the role of NPs in a lot more areas and to permit them to deliver a broader range of acute as well as preventive healthcare services (Vestal, 2013). Some groups of physicians are against the expansion of NPs’ scope of practice because of concerns over safety of patients. This controversy mostly plays out in state capitals, in which legislators and medical boards determine scope of practice for professionals who are not physicians, such as NPs. In addition, there are concerns and worries at the national level that bear on the ability of NPs to be reimbursed for the care they deliver (Cassidy et al., 2014).
NPs are essentially prepared in master’s degree programs and they are typically team-trained together with medical students and they share similar course work, patient rounds, in addition to other on-site clinical experiences. Studies have indicated over and over again that NPs, within their level of training, provide cost-efficient, quality treatment of common diseases as well as management of minor chronic disorders. Studies have also shown that NPs are as competent as doctors in carrying out a common endoscopic screening test for cancer of the colon (Yee et al., 2013).
The chosen issue impacts the scope of practice for Nurse Practitioners in that it advocates for the expansion of the scope of practice for NPs. The change that this issue may catalyze is allowing nurse practitioners to practice independently to the full scope of their capabilities without being under supervision of physicians. In essence, the critical shortage of primary care providers might actually make the appointment of a physician hard to come by (American Association of Colleges of Nursing, 2014). Some states are attempting to fill the shortage of doctors in primary care with nursing staffs that have advanced degrees in family medicine. This calls for relaxing of old medical licensing limits, understood as scope of practice laws, which are preventing these NPs from playing the lead role in the delivery of basic health services. They should be allowed to work without a supervising doctor (Vestal, 2013).
A Doctor of Nursing Practice (DNP) is basically designed for nursing staffs who are seeking a terminal degree in nursing practice. DNP-prepared nurses are properly equipped to execute fully the science developed by nurse researchers. For the selected issue, the implication of the DNP credential is that DNPs will help in designing and providing care for diverse populations. This is necessitated by the quick expansion of knowledge underpinning practice, countrywide concerns regarding patient safety and the quality of care; the complexity of patient care; as well as shortages of faculty and personnel (Yee et al., 2013).
References
American Association of Colleges of Nursing. (2014). Expanded Roles for Advanced Practice Nurses. Available at http://www.aacn.nche.edu/media-relations/fact-sheets/apn-roles (Accessed November 22, 2014).
Cassidy, A., Aiken, L. H., Bodenheimer, T. S., Agres, T., Schwartz, A., & Dentzer, S. (2013). Health Policy Brief: Nurse Practitioners and Primary Care. Health Affairs.
Vestal, C. (2013). Nurse Practitioners Slowly Gain Autonomy. Kaiser Health News. Available at http://kaiserhealthnews.org/news/stateline-nurse-practitioners-scope-of-practice/ (Accessed November 22, 2014).
Yee, T., Boukus, E. R., Cross, D., Samuel, D. R. (2013). Primary Care Workforce Shortages: Nurse Practitioner Scope-of-Practice Laws and Payment Policies. National Institute for Health Care Reform, 13.
SECTION B: The Consensus Model – LACE
The Consensus Model for ARPN Regulation is essentially the product of considerable work carried out by the ARPN Consensus Work Group and the NCSBN APRN Advisory Committee. It is a consistent model of regulation for the future of advanced practice nursing and was actually designed for the purpose of aligning the interrelationships amongst licensure, accreditation, certification, as well as education (LACE). The 4 main roles of advanced practice registered nurse as specified in the Consensus Model document include the following: certified nurse-midwife; certified nurse practitioner; clinical nurse specialist; and certified registered nurse anesthetist (American Association of Colleges of Nursing, 2013).
Strengths and weaknesses of the Model: it is expected that the clarity and consistency resulting from this regulatory model would benefit individual nursing staff members and enhance patient care. The uniformity that is anticipated to be produced from this model may enable advanced practice registered nurses to practice to the full extent of their licensure and education (Summers, 2011). Additionally, the more consistent system would offer opportunities for nursing staffs through the likelihood of ease of mobility across state lines. As implementation of the Consensus Model is carried out in every state across the country, it would ensure that the advanced practice registered nurse profession keeps on growing and meeting the demands of changing healthcare (American Nurses Credentialing Center, 2014).
Moreover, the model also ensures the scope of practice of APRN is used to its fullest extent. Equally important, the Consensus Model will also ensure that accreditation, licensure, education, as well as certification are uniform throughout all states in America for advanced practice registered nurses (American Nurses Credentialing Center, 2014). The other benefits of the Conceptual Model are as follows: it ensures public safety; it increases access to healthcare; it advocates appropriate scope of practice; and it facilitates mobility of advanced practice nurses. The Model is basically designed to raise the responsibility of advanced practice registered nurses and increase satisfaction with work through opportunities to practice more autonomously (American College of Nurse-Midwives, 2014). Even though this Model consists of several highly positive recommendations and is believed that it would provide benefits to nurse practitioners and advanced practice registered nurses, it has actually created a very dynamic environment wherein there are opportunities for improvements and setbacks if misinterpreted.
The Consensus Model might impact competition and/or collaboration between physicians and NPs in America’s healthcare system considering that it provides APRNs with opportunities to practice independently with doctors. It impacts competition between physicians and APRNs since APRNs will also launch their own practice in an effort to address the problem of doctor shortage thereby competing with physicians for clients and patients. The Model establishes various standards which are aimed at protecting the public; improving access to quality, safe advanced practice registered nurse care; and improving mobility. American Nurses Credentialing Center (2014) pointed out that the Consensus Model emphasizes that advanced practice registered nurses should be licensed as autonomous practitioners. It also claims that APRNs do not have any regulatory requirement for direction, collaboration, or supervision. The Model impacts collaboration in that it does not foster the collaboration of a qualified physician with nurse practitioners. In essence, it stipulates that advanced practice registered nurses are not required by law to collaborate with physicians, and not to be supervised or directed by physicians (Summers, 2011).
References
American Association of Colleges of Nursing. (2013). APRN Consensus Process. AACN
American College of Nurse-Midwives. (2014). Consensus Model for ARPN Regulation: Licensure, certification, accreditation, and education. Available http://www.midwife.org/Consensus-Model-for-APRN-Regulation-Licensure-Accreditation-Certification-Education. (Accessed November 22, 2014).
American Nurses Credentialing Center. (2014). Consensus model for APRN regulation. ANCC
Summers, L. (2011). Taking stock of the consensus model. The American Nurse. American Nurse Association.
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