Discussion Response – The Role of Healthcare Policy and Advocacy in Advancing APRN Practice

Discussion Response – The Role of Healthcare Policy and Advocacy in Advancing APRN Practice

Responding to Laura

Hello,

Thank you for your insightful post on how healthcare policy impacts the APRN profession and the importance of advocacy in the nurse practitioner’s role. Your discussion on the restrictions placed on nurse practitioners in states like New Jersey highlights APRNs’ ongoing challenges in achieving full practice authority. The example from your experience in the Cardiac Stepdown unit effectively illustrates the real-world implications of these legislative barriers, especially regarding the ethical and professional conflicts that arise when collaboration with other healthcare providers is required.

To expand further, it is imperative to acknowledge that though the existing laws and regulations may hamper the level of APRN independence, they also comprise one of the essential voices for the profession’s advancement. This call for legislative change, for example, full practice authority, is not just for practitioners’ autonomy but also for access and patients’ benefit. Studies conducted in states where NP practice independently reveal that healthcare accessibility has improved, especially in poorly served areas (Chiu et al., 2021). This underscores the fact that these policies have far-reaching ramifications for public health.

Furthermore, when contemplating advocacy, examining how nurse practitioners can advocate for change as authorities in the nursing field becomes crucial. This is why NPs are apt to advocate not only for their professional interests but also for these comprehensive health reforms (Malik & Shankar, 2023). Examples of advocacy can entail lobbying political policymakers, involvement in professional bodies, and creating awareness of the importance of care led by NPs. Altogether, these actions can help establish the legislative measures that are required for deconstructing some practice limitations and developing the NP role. Further, it is worth noting that transformational leadership is an area in which I concur with your evaluation of how it impacts policy changes. However, it is also equally important to remember that change must be made by the leaders of transformation, and they must be ready to accept it, incorporate it with feedback and embody the characteristics of volunteerism across multi-disciplinary projects.

References

Chiu, P., Cummings, G. G., Thorne, S., & Makaroff, K. S. (2021). Policy advocacy and nursing organizations: A scoping review. Policy, Politics, & Nursing Practice, 22(4), 276–296. https://doi.org/10.1177/15271544211050611

Malik, E., & Shankar, S. (2023). Empowering nurses: Exploring self-managed organizations in Indian healthcare. BMC Nursing, 22(1). https://doi.org/10.1186/s12912-023-01647-5

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Explanation of how healthcare policy can impact the advanced practice nurse profession
Healthcare policy has a very big influence on the APRN practice in healthcare organizations. The highlight of week 6 was how state legislation and healthcare policy determined if states are restriction or have full practice authority in the healthcare setting as an NP. Whether or not the nurse practitioner has restrictions on their practice determines the impact on their practice In New Jersey, having to collaborate NP practice with a licensed provider who can prescribe limits autonomy and binds them ethically, legally, economically, and politically. Not having independence, does not allow you to practice freely. I have observed this in the Cardiac Stepdown I work in as a bedside nurse and as an educator. Many nurse practitioners must agree to disagree if they want to prescribe in their practice in an acute care center. Ethically practitioners may not always agree especially when there is collaborating teams of specialists. Legally, you must practice based on the political factors that are determined by the state legislation. Although legislation may have barriers on the NP practices, they also have a positive impact by passing legislation in some states allowing for NP independence to practices as well as Patient Affordable Care Act (Barnett et al., 2022).

The Role of Healthcare Policy and Advocacy in Advancing APRN Practice

Explanation of why advocacy is considered an essential component of the advance practice nurse’s role
For the professional development and growth to continue of the Nurse Practitioner there must be advocacy to continue to advance and move forward to gain the independence the profession deserves. As we advocate for our patients we must also advocate for our profession. Nursing is the only profession that is adjacent to another profession which takes away the autonomy and credibility. NP practice should be defined by the advanced education, clinical experience, and judgement, without restrictions or collaborations with other healthcare providers (Peacock and Hernandez, 2020). Fostering policy will lead to changes in the healthcare delivery system and provide safer outcomes for patients and independence for nurse practitioners (Ryder et al., 2020).

Discuss the four pillars of Transformational leadership and the effect they may have on influencing policy change
Transformational leadership focuses on building of relationships, empowering team members, and emphasizing common visions and values (Ystaas et al., 2023). There are four behavioral components of transformational leadership, Idealized influence (II) which is the power to inspire a vision, the second being Inspirinitional motivation (IM) where transformational leaders inspire and motivate their followers, Intellectual stimulation (IS) where leaders stimulate their followers, and Individualized consideration (IC) where leaders are compassionate (Gonfa, 2019). The Transformational leader may influence policy change because they are opened to discussion with other individuals. These leaders open minded to have discussion about change, they are motivated and have a vision and inspire the people around them to be inspired. This leadership style wins staffs trust and confidence in others, allowing for staff to be committed, share deeper visions for their futures and encourages them to perform better and make collaborate efforts to be a team and seek change in policy. Change comes in numbers and in volume, if nurse practitioners are committed to the same changes, it may influence policy makers to make changes in favor of healthcare practitioners, opening up door to independent practice globally for NPs.

References

Barnett, M., Balkissoon, C., & Sandhu, J. (2022). The level of quality care nurse practitioners provide compared with their physician colleagues in the primary care setting: A systematic review. Journal of the American Association of Nurse Practitioners, 34(3), 457-464.

Gonfa, B. D. (2019). Review on components of transformational leadership. Arabian Journal of Business and Management Review, 9(3), 1-5.

Peacock, M., & Hernandez, S. (2020). A concept analysis of nurse practitioner autonomy. Journal of the American Association of Nurse Practitioners, 32(2), 113-119.

Ryder, M., Jacob, E., & Hendricks, J. (2020). An integrative review to identify evidence of nurse practitioner‐led changes to health‐care delivery and the outcomes of such changes. International Journal of Nursing Practice, 26(6), e12901.

Ystaas, L. M. K., Nikitara, M., Ghobrial, S., Latzourakis, E., Polychronis, G., & Constantinou, C. S. (2023). The impact of transformational leadership in the nursing work environment and patients’ outcomes: a systematic review. Nursing Reports, 13(3), 1271-1290.