The Nurse Practitioner’s Expanding Role
The Nurse Practitioner's Expanding Role
Increasingly, the Nurse Practitioner's role has been expanded to combat the effects of doctor shortages. Learn about the latest changes in several states.
Over the past several years, the role of the Nurse Practitioner has expanded a number of times to allow Nurses greater autonomy to make treatment decisions. In many states, discrepancies in Nurse training methods and certifications have caused lawmakers to limit the decision-making authority of all Advance Practice Registered Nurses despite their postgraduate-level training and advanced knowledge in a number of specialty areas. Recently, professional trade organizations, NGOs and legislators have pushed for changes in state regulatory laws to expand the role of Nurse Practitioners, Clinical Nurse Specialists, Nurse Midwives and Nurse Anesthetists to allow them to operate to the full extent of their training, including provisions for prescribing, insurance reimbursement, admitting and referral privileges. Below is a sampling of recent news about the expansion of the roles and responsibilities of Nurse Practitioners and other APRNs.
FLORIDA — Florida state Rep. Daphne Campbell recently filed a bill in the state's House of Representatives to expand the role of Nurse Practitioners to include the authority to involuntarily commit patients who are suicidal or homicidal. Currently, Advanced Practice Registered Nurses have no such authority in Florida. The expansion of authority is intended to expedite care for patients who are experiencing a mental health crisis and allow APRNs to operate at their 'full scope' as they do in 48 other states.
GEORGIA — On January 1, the state of Georgia expanded the definition of "Advanced Practice Registered Nurse" to include Clinical Nurse Specialists. Under the change, Clinical Nurse Specialists in the state will be able to apply for prescriptive authority and may receive increased reimbursement. This change reflects a desire for CNSs to make a full range of decisions according to their training, which in the state of Georgia includes requirements for knowledge of advanced pharmacology, adult pathophysiology and advanced mental health assessment.
MISSOURI — Due to a shortage of primary care Physicians in the state, particularly in rural areas, the authority to write prescriptions in Missouri was recently expanded to include controlled substances. Proponents at the Missouri Nurses Association cite the aforementioned shortages, as well as the advanced training of Nurse Practitioners, as ample reason to extend prescriptive authority to Nurse Practitioners in the state.
VIRGINIA — Doctor and Nurse Practitioner groups in Virginia plan to propose changes to the law that requires a Physician to supervise a Nurse Practitioner. In the proposed changes, Nurse Practitioners will work in teams lead by Physicians and would allow for collaboration between Doctors and Nurses to occur electronically. The intent of the change is to give Nurse Practitioners more flexibility to treat patients, providing patients with better access to treatment in areas where coverage shortages exist, including rural areas.
