Restrictions on Nurse Practitioners

Restrictions on Nurse Practitioners

Restrictions on Nurse Practitioners


Discussion: Organizational Policies and Practices to Support Healthcare Issues

Quite often, nurse leaders are faced with ethical dilemmas, such as those associated with choices between competing needs and limited resources. Resources are finite, and competition for those resources occurs daily in all organizations.

For example, the use of 12-hour shifts has been a strategy to retain nurses. However, evidence suggests that as nurses work more hours in a shift, they commit more errors. How do effective leaders find a balance between the needs of the organization and the needs of ensuring quality, effective, and safe patient care?

In this Discussion, you will reflect on a national healthcare issue and examine how competing needs may impact the development of polices to address that issue.

To Prepare: 

  • Review the Resources and think about the national healthcare issue/stressor you previously selected for study in Module 1.
  • Reflect on the competing needs in healthcare delivery as they pertain to the national healthcare issue/stressor you previously examined.

By Day 3 of Week 3

Post an explanation of how competing needs, such as the needs of the workforce, resources, and patients, may impact the development of policy. Then, describe any specific competing needs that may impact the national healthcare issue/stressor you selected. What are the impacts, and how might policy address these competing needs? Be specific and provide examples. Restrictions on Nurse Practitioners

By Day 6 of Week 3

Respond to at least two of your colleagues on two different days by providing additional thoughts about competing needs that may impact your colleagues’ selected issues, or additional ideas for applying policy to address the impacts described. Restrictions on Nurse Practitioners

Submission and Grading Information

Grading Criteria Restrictions on Nurse Practitioners

To access your rubric:

Week 3 Discussion Rubric

Post by Day 3 and Respond by Day 6 of Week 3

To participate in this Discussion:

Week 3 Discussion

America Health Workforce

Despite its position as a leader in global economics the United States continue to lag behind on issues of health disparities. This mainly due to ability to pay for health care, which has been addressed largely by the Obama care, resulting in additional over 30 million Americans with health insurance and secondly is the inadequate access to primary health care due to a huge health care professionals deficit (Sonenberg & Knepper, 2017).

With increasing demand for medical services over the years and amplified by the Covid-19 pandemic and increasing rate of chronic illnesses such as kidney disease, heart diseases and diabetes, there is an urgent need to reorganize the health care work force of the united states at the federal level to meet this health care system needs (Ricketts & Fraher, 2013). Restrictions on Nurse Practitioners

Auerbach et al, (2018) while contributing to the body of knowledge on clinician workforce opined that there will continue to be a yearly slow growth of physician supply, at the rate of 0.5%/year between 2016 and 2030 mostly as a result of long training times and the few residency accredited positions. Whilst, other health professionals such as, the Nurse Practitioners and Physician Assistances will grow rapidly at the rate of 6.8% and 4.3% annually respectively. Thus, by 2030 it is estimated that NP’s and PA’s would add 67.3% (two third), of health care practitioners to the work force. Restrictions on Nurse Practitioners

Therefore with this projection and proper work force planning we should be able to provide effective and efficient patient care and improved outcome at the primary health care level, in the rural communities, which makes up 40% of the American population, the aged and mental health individuals (Ricketts & Fraher, 2013). However, the NP’s ability to care for patient has been limited by the scope of practice of some states Board of Nursing (BON). In the United States only 22 states and the District of Colombia allow for NP’s full practice authority (FPA) as at 2017 (Poghosyan,  Norful & Laugesen, 2018). Restrictions on Nurse Practitioners

There is satisfactory scientific evidence that the primary care provided by NP’s and PA’s is similar to that of physicians and even at a reduced cost. Therefore, although NP SOP is a state level regulation, the federal authority needs to encourage the lifting of this restriction in all 52 states so that there is even distribution of physicians, nurse practitioners and physician assistance who currently provide the bulk of primary care so as to meet the challenges of the aging population, rural communities, minorities and insurance coverage expansion (Auerbach et al, 2018). Restrictions on Nurse Practitioners

In the center where I practice in New York due to the inability to properly implement the Nurse Practitioners Modernization Act, 2015, which abrogated the experienced NP’s and physician written practice aggrement, giving Full practice authority to NP’s, occasionally results in provider role and skill confusion amongst physician, NP and the patients and it often lead to practices that tend to undermined the education and training of the NP and thus its efficiency and productivity (Poghosyan,  Norful & Laugesen, 2018).

Finally, there is no indication that there will by sudden rapid growth of physician supply, therefore the changing workforce composition, especially in provision of primary healthcare, is a reality and Physicians, NP’s and PA’s should be trained to prepare them for the challenges and opportunities that will come with it (Auerbach et al, 2018). Restrictions on Nurse Practitioners


Sonenberg, A. And Knepper, J. H. (2017). Considering Disparity: How do nurse practitioner

regulatory policies, access to care and health outcomes vary across four states.

Nurs  outlook. 65(2017) 143-153. Retrieved from https//:www.nursing

Ricketts, C.T. and Fraher, P. E. (2013). Reconfiguring Health Workforce Policy so that

Education, Training and actual delivery of Care are closely connected. Health Affairs.

32(11) 1874-1880. DOI:10.1377/hlthaff.2013.0531.

Auerbach, I. D., Staiger, O. D., and Buerhaus, I. P. (2018). Growing Ranks of Advanced

Practice Clinicians- Implication for the Physician Workforce. The New England Journal

of Medicine; Boston. 378(25): 2358-2360. DOI: 10.1056/NEJMp1801869.

Poghosyan, L.,  Norful, A. A., and Laugesen, J. M. (2018). Removing restrictions on nurse

practitioners’ scope of practice in New York State: Physicians and Nurse Practitioners

perspectives. Journal of the American Association of Nurse Practitioners. 30(6) p354-360.