Advancing the Scope of Practice- Exploring the Role of Advanced Registered Nurses in Shaping and Transforming the Healthcare Landscape

Advancing the Scope of Practice- Exploring the Role of Advanced Registered Nurses in Shaping and Transforming the Healthcare Landscape

In the United States, the scope of practice varies from state to state. However, there are general roles that apply to advanced nurse practitioners. The purpose of this paper is to discuss in depth the scope of practice of advanced registered nurses, including the accreditation, certification, and regulation of nursing practice. The paper will also include a description of the three most influential professional organizations and a further discussion of the most appealing organization among the three. Lastly, the paper will discuss the controversy and evolving issues that influence the scope of advanced nurse practice.

The Scope of Future Role as an Advanced Registered Nurse

Generally, an advanced registered nurse can be defined as a nurse who has undergone advanced training in a given specialty. Advanced education is a master’s or doctoral level in a given discipline. ARNs include clinical nurse specialists, nurse practitioners, certified nurse anesthetists, and certified nurse midwives, among others (Boehning & Punsalan, 2023). After training, the nurses must be certified by nationally recognized professional bodies or nursing organizations. For instance, in the United States, nurses get certified by organizations such as the Academy of Nurse Practitioners Certification Board (AANPCB) and the American Nurse Credentialing Center (ANCC). The certification enables the nurse’s practice and is, therefore, mandatory. The accreditation bodies, on the other hand, include the Accreditation Commission for Education in Nursing (ACEN) and the Commission of Collegiate Nursing Education (CCNE). The role of these accreditation bodies is to ensure the nursing training meets the set national standards (Chappell et al., 2021). In addition to the accreditation and certification bodies, there are also regulatory bodies that ensure the licensing of the nurses to practice. An example of a regulatory body in the United States is the National Council of States Boards of Nursing (NCSBN), which is responsible for the NCLEX-RN examination.

The role of advanced registered nurses varies depending on the state in which they are licensed to practice. As an advanced registered nurse in pediatrics, future roles will include, first, an autonomous practice that enables ARNs to work independently while assessing, making diagnoses, and treating patients (Clarke, 2023). This is, however, determined by the state of practice. The second future role concerns the prescription authority that enables ARNs to prescribe medications based on the diagnosis made. For instance, working in a pediatric department, I will be allowed to prescribe medications for pediatric patients I have assessed and diagnosed. Another role regards patient referral, where an ARN is allowed to refer patients to the appropriate physician or a health facility should further management be required. In the old days, all nurses, irrespective of their academic qualifications, were to strictly work under the supervision of physicians. However, with a widened scope of practice, the ARNs can independently carry out some duties, such as patient referral.

Three Influential Professional Nursing Organizations

Essentially, there are several professional nursing organizations nationally that play a crucial role in influencing the scope of advanced nursing. To begin with, the American Association of Nurse Practitioners is a body that represents all nurse practitioners in the United States. This organization mainly focuses on training nurse practitioners, leadership, and advocacy (American Association of Nurse Practitioners, 2023). The body also encourages the involvement of nurse practitioners in policymaking. The second organization is the American Nurses Association, which is a professional body for all registered nurses. The association has an important role in healthcare policy, promotion of nursing practice, and advocating for patients’ and nurses’ rights (American Nurses Credentialing Center, 2022). The association also has well-developed and defined ethics that guide the nursing practice nationally. Thirdly, the National Association of Clinical Nurse Specialists is also an influential nursing organization. Its main role is to promote quality, evidence-based nursing practice in addition to influencing healthcare policies.

The Most Appealing Professional Organization

Of all the three professional nursing organizations described, I would like to join the American Association of Nurse Practitioners (AANP). The mission and goals of AANPs are to empower nursing education, leadership, and advocacy. AANP’s mission and goals align with the worldview of patients’ and nurses’ right advocacy for effective healthcare service delivery (American Association of Nurse Practitioners, 2023). Besides, the organization focuses on the leadership role of nurses, and this resonates with my career as an assistant nurse manager in a pediatric emergency room. Joining this organization will help shape and improve my leadership skills and advocacy capability. The AANP membership will provide access to networking opportunities and resources for leadership and advocacy (Savin & Newberry, 2023). Furthermore, as a member, I will be constantly informed of new developments regarding nursing practice and will be free to engage in educational activities that promote their expertise.

Controversial or Evolving Issue Most Likely to Impact Scope of Practice or Role

An evolving and controversial issue that is most likely to impact the roles of advanced registered nurses or the scope of practice is the ongoing debate regarding full practice authority for advanced nurse practitioners. Full practice authority can be defined as the ability of nurses to utilize their expertise fully without necessarily working under the supervision of physicians. The full practice authority regulations vary from state to state. The scopes of practice are, therefore, classified into full practice, reduced practice, and restricted practice. Full practice is defined as the ability of advanced nurses to work independently without collaborating with physicians. States that allow full practice include Minnesota, Lowa, South Dakota, New Mexico, and Arizona, among others. Reduced practice, on the other hand, allows nurse practitioners to perform within some of the scope of practice without physician supervision. However, nurses are not allowed to order tests and diagnose independently (Clarke, 2023). Some states with reduced practice include Kentucky, West Virginia, Pennsylvania, and Ohio, among others. Other states have restricted practice where advanced nurse practitioners must operate under the supervision of physicians. States with restricted practice include Texas, California, and Oklahoma.

The controversy on whether or not to grant full practice authority revolves around different opinions on patient safety, resource distribution, and healthcare access. Those in support of full practice authority argue that granting practice autonomy to nurse practitioners will address the issue of physician staff shortage, mostly in the underprivileged arrears (Yang et al., 2021). As a result, there will be improved health access in remote areas. On the other hand, those against full practice argue that granting full practice to nurse practitioners will compromise the safety of patients during treatment as nurse practitioners have no similar competencies as physicians.

Certainly, these controversies have an impact on the scope of practice of nurse practitioners. Should all states approve full practice authority to nurse practitioners, there will be improved health access, especially in places with limited physicians, job satisfaction, and professional autonomy (Stucky et al., 2021). In contrast, if all states stick to the restricted practice regulation, the healthcare needs of the population may not be met, and issues of health inequity will persist.

Other than influencing the profession, healthcare stakeholders such as patients, physicians, and the healthcare system will also be influenced. With full practice authority, patient access to healthcare will be enhanced, and this will generally improve the overall health of the population, especially in rural areas (Htay & Whitehead, 2021). Furthermore, the healthcare services will also be affordable. Secondly, the full practice authority will enhance the relationship between the physicians and the nurse practitioners, enhancing interprofessional collaboration, and nurses and physicians will be working towards one goal. In the health system, full practice will impact the deployment of the workforce as the healthcare organization will mandated to adopt a staffing model allowing nurse practitioners to work independently.

The outcome of the issue of full practice will significantly play a role in the job satisfaction, professional autonomy, and roles of advanced nurse practitioners. As stated previously, full practice will enable nurses to fully utilize their expertise when providing care. This will lead to increased job satisfaction and better patient outcomes (Waltz et al., 2020). On the other hand, restricted practice will limit the nurse practitioners’ ability to practice fully, and this may lead to demotivation and job dissatisfaction. This matters since all healthcare professionals look forward to job satisfaction as the motivation factor to work effectively (Yasin et al., 2020). Besides, full practice will enhance healthcare access, and the healthcare providers collectively look forward to affordable and accessible healthcare for a healthy population. Lastly, since nurse practitioners would be able to make independent decisions without having to depend on the physicians, there will be enhanced patient-provider relationships and, hence, patient-centered care.

Conclusion

In conclusion, the evolving landscape of advanced nursing practice is marked by critical issues such as full practice authority for nurse practitioners. This debate underscores the tension between the need for increased autonomy to address healthcare gaps and concerns about patient safety. The outcome will significantly impact the professional scope of advanced registered nurses, influencing their role, autonomy, and contribution to patient care. As these discussions unfold, advanced registered nurses must stay informed, engage in advocacy efforts, and actively shape the future of their profession.

References

American Association of Nurse Practitioners. (2023, December 1). AANP | The American Association of Nurse Practitioners. https://www.aanp.org/

American Nurses Credentialing Center. (2022, November 16). Nursing certifications: Our Certifications | ANCC. ANA. https://www.nursingworld.org/our-certifications/

Boehning, A. P., & Punsalan, L. D. (2023). Advanced practice registered nurse roles. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK589698/

Chappell, K. B., Howard, M. S., Lundmark, V., & Ivory, C. (2021). Credentialing and certification: overview, science, and impact on policy, regulation, and practice. International Nursing Review, 68(4), 551-556. https://doi.org/10.1111/inr.12721

Clarke, E. M. (2023, November 10). Nurse practitioner practice authority: A state-by-state guide | NurseJournal.org. NurseJournal. https://nursejournal.org/nurse-practitioner/np-practice-authority-by-state/

Htay, M., & Whitehead, D. (2021). The effectiveness of the role of advanced nurse practitioners compared to physician-led or usual care: A systematic review. International Journal of Nursing Studies Advances, 3, 100034. https://doi.org/10.1016/j.ijnsa.2021.100034

Savin, M. K., & Newberry, D. M. (2023). Education standards, accreditation, certification, and regulation of nurse practitioner practice. Journal of the American Association of Nurse Practitioners, 35(11), 725-730. DOI: 10.1097/JXX.0000000000000873

Stucky, C. H., Brown, W. J., & Stucky, M. G. (2021, January). COVID-19: An unprecedented opportunity for nurse practitioners to reform healthcare and advocate for permanent full practice authority. In Nursing Forum (Vol. 56, No. 1, pp. 222-227). https://doi.org/10.1111/nuf.12515

Waltz, L. A., Munoz, L., Weber Johnson, H., & Rodriguez, T. (2020). Exploring job satisfaction and workplace engagement in millennial nurses. Journal of Nursing Management, 28(3), 673-681. https://doi.org/10.1111/jan.14293

Yang, B. K., Johantgen, M. E., Trinkoff, A. M., Idzik, S. R., Wince, J., & Tomlinson, C. (2021). State nurse practitioner practice regulations and US health care delivery outcomes: a systematic review. Medical Care Research and Review, 78(3), 183-196. https://doi.org/10.1177/1077558719901216

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For this assignment, you will conduct research on the current scope of practice for your specialty efforts that are being made to expand that scope and the role of the advanced registered nurse in positively influencing the health care system. Write a 1,250-1,500-word paper that includes the following:

A discussion of the scope of your future role as an advanced registered nurse, including any regulatory, certification, or accreditation agencies that define that scope.

A discussion of three professional nursing organizations that you think are most influential in advancing the scope and influence of advanced nursing. Of these organizations, evaluate the one that you would most like to join. How do its goals and mission fit in with your worldview and philosophy of care? How might membership in this organization improve your practice?
A discussion of a controversial or evolving issue that is most likely to affect your scope of practice or role in the next few years. How do you think this issue could influence the profession and other stakeholders, and why does it matter to the advanced registered nurse?
You are required to cite five to 10 sources to complete this assignment. Sources must be published within the past 5 years and appropriate for the assignment criteria and nursing content.