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You should respond to at least two of your peers


You should respond to at least two of your peers

 You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points  

150 word each respond

Discussion 1

Advanced nursing practitioners play an imperative role in promoting positive health outcomes in patients across the globe as the health care system continues to evolve. Advanced nursing practitioners should have the opportunity to practice their skills to the optimum level without any limitations since they have undergone proper training and education (Spacey et al, 2021). Nevertheless, there are barriers that hinder advanced nursing practitioners from fully practicing their acquired skills which call for the need to drive new change so that they can have the opportunity to practice without set restrictions. This essay intends to document the specific barriers as well as interventions that can be put in place to eradicate those barriers. 

The fact that various states in the United States have specific policies concerning state practice as well as licensing, causes barriers to advanced nursing practitioners (Markowitz & Adams, 2022). This is because many states have relegated advanced nursing practitioners by restricting them from fully practicing their nursing skills. For example, the full training and advanced education nurses go through equip them with skills to competently diagnose, assess patients, provide medication as well as effectively interpret diagnostic lab tests. However, nurses are limited to just undertaking one of two elements stated above. 

In addition, high trust in physicians is another barrier that limits advanced nursing practice. Bates and Martin-Misener (2021) postulate that healthcare institutions have the perception that physicians are superior to advanced nursing practitioners with regard to the skills and experience they possess. This is because they are believed to have undergone thorough training, and advanced education and that they have many years of experience compared to nursing practitioners. As such, this assumption drives the conclusion that nurses lack the capabilities to offer quality care and promote patient safety.  

Thirdly, state payer policies hinder advanced nursing practitioners from practicing to their full extent. Due to the limited scope of practice, stringent payer policies apply which in turn limit advanced nursing practitioners from practicing to full extents (Peterson, 2017). This is because they force nurses to be under physicians and they are disregarded as the primary care providers meaning that they are not directly paid for their services and they receive lower reimbursement rates. 

Concerning state practice as well as licensing, organizations such as the American Nurse Association should step in and allow advanced nursing practitioners to practice to their full extent considering that they are unaware of the skills nurses possess as primary care providers (Bates & Martin-Misener, 2021). For example, in my state Florida, local organizations like Florida Health Care Association (FHCA) can collaborate with organizations such as American Nurse Association to drive policy changes that allow the free practice of nurses in accordance with the set best practices. 

Also with regards to physicians being considered more skilled, as long as the nurses have undergone the appropriate training and education, the healthcare sector should allow nurses to practice independently without the supervision of the physicians considering that in my state Florida, nurses are restricted from assessing patients because it is considered the role of the physicians. Lastly, variances in reimbursement rates should be eliminated in order to promote advanced nursing practitioners’ freedom of practice as they are the primary care providers compared to physicians (Peterson, 2017).

It is worth noting that existing barriers such as state licensure/scope of practice, physicians’ superiority/supervision, and varying reimbursement rates hinder advanced nurse practitioners from freely practicing to their full extent. Therefore, all these factors should be eliminated to ensure that they can practice to their full potential as primary caregivers.  

Discussion 2

Barriers in Advanced Nursing Practice and strategies to overcome them

As the medical field continues to advance each day so does the role of a nurse practitioner (NP). Although, faced with countless barriers they have become a health partner of choice that serve a diverse population across many healthcare settings. A nurse practitioner is considered an advanced-registered nurse qualified to provide a wide variety of health care services such as diagnosing diseases, writing prescriptions, constructing a treatment plan as well as executing bone marrow biopsy and lumbar punctures (Medline Plus, 2020). Furthermore, NPs also have the leisure of working in different specialties for example, Women’s health, Pediatric or Neonatology to name a few (Medline Plus, 2020). For years, demand has been high for the nursing profession, but it wasn’t until 2020 during the COVID-19 pandemic when we saw a drastic increase in nursing shortage as it became one of the healthcare system frontline workers. The first barrier that slowed down the progress of advanced practice nursing are the physician related issues when differentiating the medical roles (The Online Journal of Issues in Nursing, 2021).

Physician organizations strongly believe that due to the rigorous training they acquire, nurse practitioners are by no means conveying the same nature of patient care as they are. Thus, a study established that although many physicians understood the importance of a nurse practitioner and agreed with allowing them to perform at their highest level of scope of practice, many disagreed and deviated from the idea (The Online Journal of Issues in Nursing, 2021). A nurse practitioner providing skills like those of a doctor or even attaining equal pay when doing so was insupportable. Sadly, the perspective of physicians providing better patient care compared to a nurse practitioner is dishonest and misleading. Nurses are patient centered, empathetic and knowledgeable. Therefore, when continuing our education to better serve our patients, it should be recognized and respected among our peers. The second barrier I believe a nurse practitioner encounter is the lack of power they hold when the patients they treat is admitted to an acute care facility (The Online Journal of Issues in Nursing, 2021).

Once a patient is admitted the nurse practitioner no longer can continue care which can cause major issues. The lack of privilege can result in a patient decline and an immense risk of complications (The Online Journal of Issues in Nursing, 2021). Lastly, the third and final barrier is minimal comprehension other healthcare workers have when it comes to the scope of practice of a nurse practitioner (NCBI, 2017). Due to this setback, finalizing patient care can be postponed and delayed. Ultimately, we all advocate for our patients however, if an NPs scope of practice is unbeknownst then orders may be delayed, and patient care will deteriorate (NCBI, 2017). Hence, to overcome these barriers the medical team should address the situation and formulate a positive outcome that will eventually benefit the care given to the patient. Educating others and collectively demonstrating the ability of teamwork will benefit the end results of a positive patient outcome.

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