NR 506 Week 1 Barriers to Practice Discussion
Chamberlain University NR 506 Week 1 Barriers to Practice Discussion– Step-By-Step Guide
This guide will demonstrate how to complete the Chamberlain University NR 506 Week 1 Barriers to Practice Discussion assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.
How to Research and Prepare for NR 506 Week 1 Barriers to Practice Discussion
Whether one passes or fails an academic assignment such as the Chamberlain University NR 506 Week 1 Barriers to Practice Discussion depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.
After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.
How to Write the Introduction for NR 506 Week 1 Barriers to Practice Discussion
The introduction for the Chamberlain University NR 506 Week 1 Barriers to Practice Discussion is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.
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How to Write the Body for NR 506 Week 1 Barriers to Practice Discussion
After the introduction, move into the main part of the NR 506 Week 1 Barriers to Practice Discussion assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.
Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.
How to Write the Conclusion for NR 506 Week 1 Barriers to Practice Discussion
After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.
How to Format the References List for NR 506 Week 1 Barriers to Practice Discussion
The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.
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Sample Answer for NR 506 Week 1 Barriers to Practice Discussion
Identify and describe practice barriers for all four APNs’ roles in your state and discuss these barriers on a state and national level. The four roles include the nurse midwife, nurse anesthetist, nurse practitioner, and clinical nurse specialist.
In the state of New Jersey there are a few practice barriers for all the four APN roles. In NJ we have a reduced practice in which all APNs must have a collaborative agreement with a practicing physician to prescribe or practice. This is a reduction of NP ability to engage in participation of NP practice without the agreement in accordance with the NJ law (AANP, 2023). The 4 roles of APN practice are governed by the Board of nursing but on a national level in some states, the Board of Midwifery will govern over nurse-midwives. Clinical Nurse specialists may be governed in the same way that Registered Nurses, sharing the same scope of practice, are regulated, and may not be recognized by the Nurse Practice Act; this is the same with CRNAs (AMA, 2022). According to the NCSBN (2022) in the state of NJ, CRNAs are supervised by a physician, while CNM, CNS, and CNP must have a collaborative agreement prior to practicing. Regarding defining APN practice, scope of practice is defined by laws and regulations of the board of nursing. Some states such as Louisiana, New York, Ohio, and Oregon have their own state-specific resources for scope of practice definition (NCSBN, 2022). To summarize it, APNs in all 4 roles are not allowed to practice to the full extent of their education in the state of NJ. On a national level, there are many states that prevent APNs from practicing with full authority and require either supervision, or a collaboration agreement. According to NCSBN (2022) NJ is not an independent state and a written agreement is necessary to specify scope of practice and allowance of medical acts with or without a general supervision by an MD, DO, DDS, Podiatrist, or APRN. Direct supervision is required in the presence of an MD, DO, DDS, Podiatrist or APRN with or without a written agreement with some specialties such as CRNA (NCSBN, 2022). As an APN you need the collaborative agreement in order to prescribe medications and although you have the right to assess, diagnose, order diagnostics, and sign POLST forms, an APN can not declare death in NJ (NJ Division of Consumer Affairs, 2023). Failure to secure such an agreement with a practicing physician will greatly impact the APNs ability to deliver nursing care at the level of their education. There are 24 states that allow for full NP practice authority and do not restrict care (AANP, 2023). CNS is limited in many states because they are not always recognized as APRNs. Only six states allow for prescribing authority for the CNS role. CRNA can order medications preoperatively, intraoperatively, and post operatively and it is not considered prescribing under federal law, so they don’t have to register with the DEA. 24 states allow CRNAs to practice without physician oversight. Nurse Midwives are identified as one of the four APN roles and their practice may require delegation or supervision of a physician and in some states requiring no oversight or written agreement. 12 states allow for full practice authority for CMAs (Goudreau & Smolenski, 2023). APNs are allowed to prescribe schedule LL through V controlled substances in Nj once they complete the Controlled Dangerous Substance registration (CDS) once a 6-hour course is completed, then they must register with the DEA to obtain a Federal DEA number (AANP, 2023). Another obstacle is the NJ APN licensure which was adopted to allow multi licensure for APNs to practice in other states. It has only been accepted in Delaware, Utah, and North Dakota thus far and will require 7 states to accept prior to it taking effect (NCSBN, 2023). This restricts portability of APN licensure.
Identify forms of competition on the state and national level that interfere with APNs’ ability to practice independently.
When discussing forms of competition on the state and national level interfering with APN independent practice, physicians are the first to come to mind. Many physicians still believe that if APNs were given the ability to practice independently without some sort of supervision quality of care and patient safety would be affected (Goudreau & Smolenski, 2023). Besides the opposition from physicians without proof that there is diminished care under unsupervised APNS, it is costly to obtain and maintain collaborative agreements. According to Goudreau & Smolenski (2023) costs for obtaining a written agreement range around $650 with a $500 per month charge to maintain such agreements with physicians. I was alarmed to find this out in NJ and many other states the cost is high, considering as an NP you are practicing off your own license, ability, and malpractice insurance. The collaboration seems like the physicians are getting all the benefits, while the APN is restricted and coming out of pocket to even practice at their level of education. APNs are not able to open practices independent of a physician and will need to secure a collaboration agreement prior to moving forward.
Identify the specific lawmakers by name at the state level (i.e., key members of the state’s legislative branch and executive branch of government)
APRN practice is defined by the Nurse Practice act and regulated by the Board of Nursing. In NJ the regulating body is the NJ Division of Consumer affairs. Certification is designated by the NJ Board of Nursing for APNs as per statue N.J.A.C. 13:37-7.1 (a). (NJ Division of Consumer Affairs, 2023). NJ certifies clinical nurse specialists, nurse practitioners, and certified registered nurse anesthetists as advanced practice nurses. The Midwifery Committee falling under the supervision of the State Board of Medical Examiners is responsible for licensure of CMAs (NJ Division of Consumer Affairs, 2023). Phill Murphy is the NJ current governor and Sheila Oliver is the lieutenant governor of NJ (New Jersey Legislature, 2023). The director of the NJ Board of Nursing is Cari Faris and the current Attorney General is Matthew J. Platkin (NJ Division of Consumer Affairs, 2023). These people are directly involved and responsible for NJ Nursing laws, APN practices in the state of NJ from an executive and legislative authority.
Discuss interest groups that exist at the state and national levels that influence APN policy.
Interest groups that exist in NJ and on national levels influencing APN policy included the American Association of Nurse Practitioners and the Advanced Practice Nurses of NJ. The AANP has worked toward changing laws and improving health policies for NPs of every state. Their purpose in regard to state policy is to back the expertise of the nurse practitioner5 and allow them to help guide health care policy. They are actively involved in removing barriers in NP practices to end health inequalities and improve access to care. This group acts on a national level to assist APNs in modernizing state licensure laws. (AANP, 2023). AANP works with states to update licensure laws providing patients with direct access to NPs. They are actively working to allow full practice authority to NPs in all states (AANP, 2023).
The APN of NJ is a grassroots advocacy coalition of APNs who work to improve healthcare in NU by removing scope of practice barriers. They have worked on passing the senate bill 1522 which will eliminate practice restrictions for APNs in NJ. This bill has passed out of the health committee as of December 15th, 2022. Their website links you to advocacy channels, brings awareness to the NJ legislative process, and helps you find your legislator to become more involved (Advanced Practice Nurses of New Jersey, 2023). This is a NJ state specific advocacy for nurse practitioners to assist in overcoming delays to patient care related to collaborative agreements and restrictions placed on NP practice authority in NJ.
Discuss methods used to influence change in policy in forms of competition, state legislative and executive branches of government, and interest groups.
Methods used to influence change in policy for APNs involve advocacy, involvement, and being part of the change. Groups like APN of NJ not only work actively towards making changes to policy but also help to bring awareness to those who don’t know where to start. Just looking at their website, I gain access to how the law works, who my legislator is, and some jobs for APNs in NJ (Advanced Practice Nurses of New Jersey, 2023). You can become involved in changing APN policies by participation in memberships like with the AANP which will provide educational opportunities, CEUs, opportunities to advance your career, and ways to get involved (AANP, 2023). These groups help to advocate for your rights as a nurse practitioner at a state and national level. Working in partnership with these advocacy groups can help to reduce competition in your state or others by removing barriers to scope of practice, changing the laws, and creating independence as an APN. Once the law is changed at a Legislative level, all other parts of state government will have to follow, including the nursing regulatory bodies.
References:
Advanced Practice Nurses of New Jersey. (2023) Advocating for Healthcare Quality and Access to Care for NJ Residents. Retrieved from https://www.apn-nj.org
American Nurses Association. (2022) Advanced Practice. Retrieved from https://www.nursingworld.org/advanced-practice/Links to an external site.
American Association of Nurse Practitioners. (2023) Practice Information. Retrieved from https://www.aanp.org/advocacy/new-jerseyLinks to an external site.
Goudreau, & Smolenski, M. C. (2023). Health policy and advanced practice nursing: impact and implications (Goudreau & M. C. Smolenski, Eds.; Third edition.). Springer Publishing.
NCSBN. (2022). APRN Consensus Model by State. Retrieved from https://www.ncsbn.org/public-files/aprn_consensus_model_by_state.pdfLinks to an external site.
NJ Division of Consumer Affairs. (2023) Advanced Practice Nurse FACTS. Retrieved from https://www.njconsumeraffairs.gov/nur/Pages/APN-Certification.aspx.
New Jersey Legislature (2023). Retrieved from https://www.njleg.state.nj.us/our-legislatureLinks to an external site.
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Sample Answer 2 for NR 506 Week 1 Barriers to Practice Discussion
Great clip and thank you for sharing this. This really got me thinking about the licensing, education, and experience that makes a MD and an APN. Let me start by saying that I stand indecisive on this at the moment.
Observing this from the sidelines, my thoughts are that part of what the reporter and the ER doctor said make valid points. I didn’t watch this clip and become upset or defensive. I stayed objective to their perspective and opinion. At the end of the day, it is just their opinion. We don’t have to agree or like it.
It is difficult to compare the training, experience, and years of education. Doctors and Nurses/APNs learn different things because their scope of practice and specialty may be different. The average number of years to accomplish medical school is roughly 10-14 years. APN schooling as we know can be 6-8 years, assuming traditional 4-year BSN, then MSN etc.
Personally, I would not feel after becoming an NP that I could perform surgery or pop a hop back in place without the training and experience.
If primary care is the focus, the perspective of both MD and NP isn’t as far off as we may think. Physicians consistently indicated that NPs were great for primary care and that their ability to provide a routine with ease and use their unique nursing approach to patient care was desirable (Kraus & DuBois, 2017). Many physicians were very happy to have NPs function autonomously and the only caveat was that they know their limits. Many physicians stated that knowing their own boundaries was key. That a NP can be very good at what they do and they know when they come across something they shouldn’t be dealing with to refer or ask for help (Kraus & DuBois, 2017).
When it comes to critical care/ER or a specialty field, there is a difference between opinions. Given the rapid expansion of NPs in the workplace, clinical activities provide by both the MD and NPs have some level of interprofessional conflict (Kraus & DuBois, 2017). Does experience supersede education? Does education supersede experience?
Kraus, E., & DuBois, J. M. (2017). Knowing Your Limits: A Qualitative Study of Physician and Nurse Practitioner Perspectives on NP Independence in Primary Care. Journal of General Internal Medicine, 32(3), 284–290. https://doi.org/10.1007/s11606-016-3896-7
Sample Answer 3 for NR 506 Week 1 Barriers to Practice Discussion
This is an informative post. Indeed, one of the major practice barriers for APNs in all 4 roles in the state of New Jersey is denying them authority to practice to the full extent of their education. This barrier is also manifested on a national level where many states prevent APNs from practicing with full authority and require either supervision or a collaboration agreement (Hudspeth & Klein, 2019). The US healthcare system is currently changing and the patient population keeps becoming more diverse, which warrants fundamental changes in the healthcare delivery system to keep up with these changes. Today, there is a shortage of healthcare providers in the United States due to the expansion of insurance coverage under the ACA. As such, it is important to grant APNs authority to practice to the full scope of their education and training to help in developing needed healthcare workforce to help in attaining the primary health care need of the US.
Various methods can be used by APNs to influence policy change. The first method is to build a relationship with legislators. APNs should consider developing an effective relationship with lawmakers with interests in healthcare bills to help in advancing healthcare policy change at the legislative level (Wichaikhum et al., 2020). APNs can also influence policy change by participating on national boards. APNs can seek appointments or invitations to participate on federal or state boards that influence policy. This provides a better opportunity to influence policy formulation and the future of nursing. The other method is to collaborate with lobbyists. It is recommended that nurses need to consider becoming lobbyists to champion policy changes. However, they can also consider partnering with lobbyists and giving them evidence-based data to convince lawmakers to advance policy changes to help in enhancing the healthcare system.
References
Hudspeth, R. S., & Klein, T. A. (2019). Understanding nurse practitioner scope of practice: regulatory, practice, and employment perspectives now and for the future. Journal of the American Association of Nurse Practitioners, 31(8), 468-473. DOI:10.1097/JXX.0000000000000268
Wichaikhum, O., Abhicharttibutra, K., Nantsupawat, A., Kowitlawakul, Y., & Kunaviktikul, W. (2020). Developing a strategic model of participation in policy development for nurses. International nursing review, 67(1), 11-18. https://doi.org/10.1111/inr.12571
Sample Answer 4 for NR 506 Week 1 Barriers to Practice Discussion
I got very intrigued by your post the Medicare reimbursement. To be honest, I didn’t realize that it is 85% percent so it made me research deeper this issue.
Incentivizing offices to bill nursing practitioners under the Physician’s program undoubtedly influences the NPs’ quality of care reporting. The differentiation of APNs in different states leads to unequal treatment for health practitioners with the same education level.
As a future nurse practitioner in New Jersey, I feel NPs receive little pay than ANPs, yet they work in more demanding healthcare sectors. According to Bischof and Greenberg (2021), NPs receive 85% reimbursement, which is lower than other physicians who receive 100%. Therefore, the reimbursement policy should be reviewed to increase NP’s reimbursement to 100%. An example that shows NPs engage in a more demanding healthcare sector includes their engagement during the COVID-19 pandemic following a lift on the restrictions that denied NP to have full practice to improve patients’ access to quality care (Bischof & Greenberg, 2021).
In addition, allowing states to formulate different practice regulations promotes inequality among NPs working in different states. Yet, they acquire the same healthcare skills and competencies under the same education program. Therefore, nursing practitioners should be allocated to a uniform scope of practice regardless of their state (Hudspeth & Klein, 2019). NP should have a clear scope of practice to offer optimum health care and promote mobility from one state to another. In addition, developing a uniform scope of practice in all states increases the validity of NP licensure, which is currently affected by their population foci.
The differentiation between the services an NP can offer in different states causes inequality regarding Medicare reimbursement. There should be a change in the policy regarding their reimbursement because they are equally trained and capacitated to offer quality care. In addition, defining and making the scope of practice uniform across all states can increase the NPs’ opportunity to work in any state without being discriminated against.
Great post! I appreciate that it made me “dig deeper” and learn something new.
References
Bischof, A., & Greenberg, S. (2021). Post COVID-19 reimbursement parity for nurse practitioners. OJIN: The Online Journal of Issues in Nursing, 26(2). https://doi.org/10.3912/ojin.vol26no02man03Links to an external site.
Hudspeth, R. S., & Klein, T. A. (2019). Understanding nurse practitioner scope of practice: Regulatory, practice and employment perspectives now and for the future general. Journal of the American Association of Nurse Practitioners, 31(8), 474-475.
Sample Answer 5 for NR 506 Week 1 Barriers to Practice Discussion
This is an informative post. Indeed, one of the major practice barriers for APNs in all 4 roles in the state of New Jersey is denying them authority to practice to the full extent of their education. This barrier is also manifested on a national level where many states prevent APNs from practicing with full authority and require either supervision or a collaboration agreement (Hudspeth & Klein, 2019). The US healthcare system is currently changing and the patient population keeps becoming more diverse, which warrants fundamental changes in the healthcare delivery system to keep up with these changes. Today, there is a shortage of healthcare providers in the United States due to the expansion of insurance coverage under the ACA. As such, it is important to grant APNs authority to practice to the full scope of their education and training to help in developing needed healthcare workforce to help in attaining the primary health care need of the US.
Various methods can be used by APNs to influence policy change. The first method is to build a relationship with legislators. APNs should consider developing an effective relationship with lawmakers with interests in healthcare bills to help in advancing healthcare policy change at the legislative level (Wichaikhum et al., 2020). APNs can also influence policy change by participating on national boards. APNs can seek appointments or invitations to participate on federal or state boards that influence policy. This provides a better opportunity to influence policy formulation and the future of nursing. The other method is to collaborate with lobbyists. It is recommended that nurses need to consider becoming lobbyists to champion policy changes. However, they can also consider partnering with lobbyists and giving them evidence-based data to convince lawmakers to advance policy changes to help in enhancing the healthcare system.
References
Hudspeth, R. S., & Klein, T. A. (2019). Understanding nurse practitioner scope of practice: regulatory, practice, and employment perspectives now and for the future. Journal of the American Association of Nurse Practitioners, 31(8), 468-473. DOI:10.1097/JXX.0000000000000268
Wichaikhum, O., Abhicharttibutra, K., Nantsupawat, A., Kowitlawakul, Y., & Kunaviktikul, W. (2020). Developing a strategic model of participation in policy development for nurses. International nursing review, 67(1), 11-18. https://doi.org/10.1111/inr.12571