Discuss your state NP community in terms of scope of practice. Include your state’s scope of practice for NPs, including:
Level of independence of practice **In California, NPs are required to practice under Standardized Procedure Guidelines. If CA is your intended practice state, please provide details on how Standardized Procedures Guidelines are developed in California and an example of a California SPG.
Prescribing authority
Any limitations of practice
Process for obtaining licensure in your state
Certification and education requirements for licensure.
If you live in a restricted or reduced practice state, how has patient care been impacted in your local community by these barriers? For instance, is the ED used for primary care? Are the EDs overcrowded with long wait times? Are there urgent care clinics readily available? Is there adequate access to primary care? If you live in a full practice, how has an independent practice of the APN resulted in improved patient access to healthcare?
I live in Florida, “NP SCOPE OF PRACTICE IN FLORIDA – (RESTRICTED PRACTICE) The nurse practitioner’s scope of practice in Florida is restricted practice. This indicates the patient must have a physician’s career-long supervision, delegation, or team management” (Nurse Practitioner Scope of Practice by State – 2024, n.d.)). In the current ED that I work in, since many patients do not have insurance, there will be a lot of admissions for basic health concerns, yet if they saw a primary healthcare physician regularly, then their health matters would be cared for more closely. For example, a patient that came in for a stroke diagnosis did not regularly see a primary physician and therefore was unaware that they had undiagnosed hypertension.
There are several urgent care and MD Now facilities around my community that see patients on a regular basis, and they will escalate patient care to the hospital if need be. One can be seen within a few minutes to a couple of hours as you wait for assistance at these clinics. Since some patients do not seek primary physician care regularly, they will turn to the ED which is one of the reasons it has become overcrowded. Nevertheless, when trying to book a regular annual visit to any primary care office, and trying to establish oneself in their office, the wait time can be weeks if not months out for their next opening, which is a great issue for the patients’ concerns, since concerns are not being addressed sooner, this may be due to inadequate access to a PCP. In the state I reside, Florida, is a Restricted Practice state which indicates limitations on how the residing NP can practice.
How does access to NPs impact any healthcare disparities?
According to Whitehurst, nurses are the most sought out professionals because of their honesty and trustworthiness in this healthcare field. And the United States suffers from a shortage of Primary Care Physicians on a practical level. Yet because NP’s have restrictions in their practice, they are unable to fulfill their patients’ needs to the fullest extent, hence “[NP’s] can be primary care providers who use their extensive skills without paying for costly collaboration contracts with physicians” (Whitehurst, 2023). She also points out that NP’s of the same cultural background are able to help those of the same culture since they will likely seek their medical expertise due to their similarities of culture. And the reason there will be a shortage of primary physicians is simply because there will be more that want a higher specialty paying job than a more rewarding job that covers more patient care. Therefore, the shortage of medical professionals is a great issue due to this. Having restrictions on how a Nurse Practitoner may practice due to thier medical experience and state they reside is an issue since the training of majority of nurses is the same all accross the board yet the state dictates their practice.
Since NP’s in Florida are restricted, they are limited in what they can prescribe, such as schedule 2 drugs and, unless one is a psychiatric NP with this concentration, a NP cannot prescribe those types of medications unless they take a special course / training successfully and wish to prescribe these drugs to a patient under the age of 18 (Nurse Practitioner Scope of Practice by State – 2024, n.d.). This is what impacts healthcare disparities in the nursing healthcare status.
References:
Nurse practitioner scope of practice by state – 2024. (n.d.). https://www.nursingprocess.org/nurse-practitioner-scope-of-practice-by-state.html#:~:text=NP%20SCOPE%20OF%20PRACTICE%20IN,%2C%20delegation%2C%20or%20team%20managementLinks to an external site.
Whitehurst, L. (2023, January 30). Nurse practitioner fpa reduces health disparities in underserved communities, study finds. Nurse.org. https://nurse.org/articles/nurse-practitioner-reduce-health-disparities-wvu/Links to an external site.
