IUON Nurse Practitioner Independence and Support Discussion Replies – Description
Need a discussion post in reply to both posts below
Length: A minimum of 150 words each post, not including references
Citations: At least one high-level scholarly reference in APA 7th edition from within the last 5 years
Post #1
The main idea behind creating a board of regulations and guidelines is to protect patients and providers. Integrating guidelines within each state helps regulate healthcare providers, who first have to meet criteria, then follow their state rules to practice as healthcare providers. The term appropriate practitioner refers to a person who has been trained and has the skills to treat patients at an academic level. In Arizona, to have a license as an advanced nurse practitioner, you have further education than the master’s level and successfully pass your board exam. According to the Nurse Practice Act, rule R4-19-508, Arizona nurse practitioners do not have to work under a physician’s license and can work independently (Advanced Practice FAQ – AZ Board of Nursing, 2020). A nurse practitioner also has to apply to prescribe medication to patients through the Controlled Substance Prescription Monitoring Program (CSPMP) application and register with the Drug Enforcement Agency (DEA) before prescribing medications to patients (Arizona Board of Nursing).
Nurse practitioners have been exposed to barriers including reduced support from identities like hospital administration, which is where many feel they need appropriate support. Another barrier nurse practitioners can experience is regulations of insurance to pay for limited services, which prevents providers from being able to provide the best care to patients (Kleinpell et al., 2023). Arizona does not require a residency after completing a program and passing the state board exam. However, a residency program for new nurse practitioners is essential because it provides mentorship and support to make the transition to professional practice much smoother. It is also crucial for these nurse practitioners to be appropriately compensated while doing these residencies, because the amount of money and time these practitioners spend on education can put immense pressure on their personal lives. Residencies can be an excellent resource for new professionals to network and share experiences with other professionals in the same areas of interest. This collective effort of support and guidance will allow new nurse practitioners to succeed in whatever field they practice.
Post #2
North Dakota is one of the few Full Practice states. APRNs in North Dakota can practice independently; however, organizational by-laws can vary throughout the state concerning hospitalized patients. Such practice can be seen predominantly in tertiary hospitals. On the other hand, APRNs in critical access hospitals and the rural areas of North Dakota are mostly independent. Aside from prescribing to oneself, children, and spouse and prescribing without a patient-provider relationship, there are only a few restrictions to APRN practice in North Dakota. North Dakota used to require APRNs to have a collaborative agreement with a physician where a collaborating physician gives oversight and direction. However, the ND Administrative Code’s Section 54-05-03.1-12 governing physician collaboration was repealed as of October 1, 2011. In addition, the State of North Dakota does not require Nurse Practitioners to obtain residency hours with a physician or NP before they can practice independently. (Advanced Practice FAQ – ND Board of Nursing, 2019).
I do not support the residency hours requirement with a physician or NP for a conspicuous reason. Mandatory residency hours with a physician or an NP should be on a case-to-case basis or through organizational by-laws. In the state of North Dakota, where the primary focus of NPs is primary care and rural health care services, mandatory residency hours are unnecessary. Nevertheless, this is an excellent point to conduct study and research on compulsory residency hours’ practicality, effectiveness, and efficiency. I prefer the idea of mentorship for the first employment of newly licensed or certified nurse practitioners. Mentorship for the freshly certified NPs should be done with a physician or an experienced NP within the first 3-6 months of employment. The freshly employed, newly certified NP can work independently but must be supervised and coached by the mentor. In this manner, a beginner NP will build confidence in the practice while keeping the public safe. (American Psychological Association, 2021).
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