NUR 512 Module 4 Discussion Practices in other states
Sample Answer for NUR 512 Module 4 Discussion Practices in other states
Patients visit healthcare facilities to seek medical care, support, and guidance for varying health conditions. Typically, the timeliness and quality of care depend on the availability of nurses and how different states authorize them to practice. In the United States, the advanced practice nurse can operate under full practice authority, limited practice, or restricted practice. These levels determine the scope of practice, which represents the professional activities that a nurse is authorized to perform (American Association of Nurse Practitioners, 2023). Comparing Florida with another state helps elucidate how nurses perform in different states and the impact on patient care.
California is a restricted practice authority state. In such areas, the State practice and licensure laws restrict the nurse’s capacity to engage in at least one practice element (American Association of Nurse Practitioners, 2023). The implication is that the nurse’s ability to assess patients, order tests, prescribe medications, and other professional activities is highly restricted. Under restricted practice, State laws also prompt nurses to work under a physician supervision for all of their practice scope (American Association of Nurse Practitioners, 2023). Although there might be some autonomy when carrying out some functions, nurses cannot act as independent practitioners. As Androus (2023) explained, the California Board of Registered Nursing outlines the guidelines that specify the scope of supervision needed for nurses to perform standardized procedure functions. Although physician collaboration is essential, the organization where nurses work specifies how they are supervised.
The situation is different in Florida, which has made significant strides as far as independent practice is concerned. Beginning July 2020 through HB 607, advanced practice nurses were allowed to apply for an unrestricted license after completing 3,000 hours of work under an MD’s or DO’s supervision (Clark, 2023). This law paved the way to full practice authority in Florida. Under full practice authority, the State practice and licensure laws allow advanced practice nurses to perform all activities independently. In this case, nurse practitioners can assess patients, diagnose, order tests, and initiate treatments (American Association of Nurse Practitioners, 2023). The exclusive authority also allows nurses to prescribe medications and controlled substances while practicing to the full extent of their education and training.
The difference in the scope of practice has profound implications on patient outcomes and other critical aspects of healthcare delivery. According to Jividen (2023), full practice authority is associated with increased access to care and better healthcare efficiency. As a result, it can help States respond to the increased demand for primary care providers, particularly in rural and underserved areas (Zwilling et al., 2021). Doing away with restrictions further empowers nurse practitioners to deliver comprehensive healthcare services and reduce delays (American Association of Nurse Practitioners; Jividen, 2023). Therefore, better outcomes for patients, families, and healthcare providers can achieved through increased independence.
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The push for full practice authority to empower advanced practice nurses to perform as independent practitioners continues in various states. Besides increasing their availability and improving healthcare efficiency, independent practice can help reduce healthcare costs by preventing the duplication of roles and unnecessary patient care delays. High patient satisfaction is also achieved through timely care and availability of nurses who can provide comprehensive, patient-centered care. Advanced practice nurses are adequately trained to meet these objectives, which underlines the importance of more empowerment to make independent decisions.
References
American Association of Nurse Practitioners. (2023). Issues at a glance: Full practice authority. https://www.aanp.org/advocacy/advocacy-resource/policy-briefs/issues-full-practice-brief
American Association of Nurse Practitioners. (2023). State practice environment. https://www.aanp.org/advocacy/state/state-practice-environment#california
Androus, A. B. (2023). For NP’s in “restricted” states, how do physician chart reviews and sign-offs work? Registered Nursing.org. https://www.registerednursing.org/articles/np-restricted-states-how-physician-chart-reviews-sign-offs-work/#:~:text=The%20difference%20between%20%22reduced%22%20and,state’s%20board%20of%20registered%20nursing.
Clark, E. M. (2023). Nurse practitioner practice authority: a state-by-state guide. NurseJournal. https://nursejournal.org/nurse-practitioner/np-practice-authority-by-state/#:~:text=Currently%2C%20Alaska%2C%20Arizona%2C%20Colorado,and%20Wyoming%20are%20full%20practice
Jividen, S. (2023). Full practice authority for nurse practitioners by state. nurse.org. https://nurse.org/education/np-full-practice-authority/
Zwilling, J., Fiandt, K., & Ahmed, R. (2021). Comparison of rural and urban utilization of nurse practitioners in states with full practice authority. The Journal for Nurse Practitioners, 17(4), 386-393. https://doi.org/10.1016/j.nurpra.2020.12.033
Sample Answer 2 for NUR 512 Module 4 Discussion Practices in other states
Nursing practice in Texas and Florida reveals a composition of standards, regulations, and a shared commitment to excellence. Governed by distinct boards, the nursing scopes in these states illuminate the expectations, responsibilities, and pathways for nurses. This discussion explores the landscapes of Texas and Florida, unraveling the similarities that emphasize patient well-being, ethical practices, and the factors of licensure and ongoing education.
The scope of nursing practice in Texas, as managed by the Texas Board of Nursing, entails various standards applicable to all nurses. These standards involve adherence to the Texas Nursing Practice Act, knowledge of federal, state and local laws, and regulations affecting nursing practice. Nurse practitioners are expected to promote a safe environment, administer medications through physician supervision, report and document client information, and respect client privacy (Texas BoN, 2021). Moreover, active participation in education and counselling reflects a commitment to holistic evidence-based patient care within the scope of practice.
Additionally, Texas nursing standards highlight the obligation to obtain orientation and training for new equipment or technologies, and notify supervisors when leaving nursing duties. More so, collaboration within healthcare teams, delegating appropriate responsibilities, and verifying licensure and credentials of personnel are influences of the nursing practice in Texas. These standards underscore the commitment to maintaining a high level of professionalism, competence, and accountability within the healthcare landscape of the state (Texas BoN, 2021). Accordingly, Texas nursing scope sets procedures, patient types and reimbursable services.
In terms of licensure, eligibility for endorsement in Texas requires graduation from an approved program, passing the U.S. national licensure exam, and recent nursing experience or NCLEX exam completion. The process involves creating a Texas Nurse Portal Account, submitting an online endorsement application, and completing final licensure within 15 business days. Moreover, regarding license renewal in Texas, nurses must have an active and compliant license, complete a minimum of 20 continuing education hours, and pay a renewal fee (Texas BoN, 2022). The renewal process includes specific requirements for continuing education in areas such as nursing laws and ethics.
Comparatively, the scope of nursing practice in Florida, as outlined by the Florida Board of Nursing, emphasizes understanding and adhering to the scope of practice, with a focus on patient care, delegation, and accountability. The key standards include knowing and conforming to the Florida Nursing Practice Act and the board’s rules thus promoting a safe environment, respecting patient privacy, and providing nursing services without discrimination (Toney-Butler & Martin, 2023). These standards highlight the commitment to patient-centered care, ethical conduct, and creating an inclusive healthcare environment within Florida’s nursing framework.
In both states, there is a strong emphasis on continuing education for nursing license renewal hence maintaining high standards of nursing practice. Although there are variations in requirements, the commitment revolves around promoting patient safety, advocate for moral behaviour, adhering to regulations, and ensuring professional competency. These principles highlight the dedication of both states to upholding the quality and integrity of nursing care within their respective scopes of practice. Ultimately, while challenges may exist in requirements and processes, the diligence to maintaining high standards remains consistent consequently reflecting a commitment to excellence in nursing practice across Texas and Florida.
References
Texas Board of Nursing. (2021). Nursing practice act, nursing peer review, & nurse licensure compact. Retrieved from: https://www.bon.texas.gov/pdfs/law_rules_pdfs/nursing_practice_act_pdfs/NPA2021.pdf
Texas Board of Nursing. (2022). Rules and regulations relating to nurse education, licensure and practice. Retrieved from: https://www.bon.texas.gov/pdfs/law_rules_pdfs/rules_regulations_pdfs/
Links to an external site. Toney-Butler, T.J. & Martin, R.L. (2023). Florida nurse practice act laws and rules. In: StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532859/
NUR 512 Module 5 Discussion Ethical Dilemma
Discussion Five: Describe a situation of ethical dilemma you have experienced in practice and how it was resolved.
I have faced many moral problems in my work but have found ways to solve them. In healthcare work, an ethical problem is when two or more choices are against each other. Each choice has a good reason, but picking one can hurt the values of another morality idea (Varkey, 2020). These problems usually come from disagreements between being kind, not harming others and letting people make their own choices. They also involve fairness and ensuring that everyone involved knows the facts before they agree to something. Doctors can make people anxious and unsure when patient health, rights, and access to care are at risk with no clear right answer. For patients and families, the outcomes of such dilemmas can negatively impact their physical or mental well-being, trust in the healthcare system, and satisfaction with received care. At their worst, unresolved ethical dilemmas may result in litigation or complaints that damage professional reputations and provider-patient relationships. Therefore, such situations must be recognized early and managed through open communication and multidisciplinary collaboration to find acceptable solutions.
I found out that a patient in their 60s had high blood pressure and cholesterol. After discussing treatment, the patient said they could not pay for their medicine. This caused a moral problem between my job to help patients’ sicknesses and their small money power. If not treated, their blood pressure and cholesterol can cause more serious health problems such as heart attack or stroke. But giving them medicines that they could not afford was just as wrong. After thinking about choices like normal drugs or help with paying for medicine, no quick fixes were found to make treatment cheap. I consulted with my collaborating physician and a hospital social worker to explore additional resources such as free clinics, prescription drug discount cards, or a long-term payment plan. Through multiple discussions, we developed a solution where the hospital agreed to cover half the medication costs for six months, allowing time to apply for programs to obtain sustainable treatment that addressed the patient’s health and my ethical duty of care.
I used several ways to resolve the ethical dilemma. One way was to sign the patient up for medical help from drug companies. Many programs give medicine at low cost or even for free to people with little money, no insurance, or insufficient insurance. They must meet certain rules first (NC Department of Health and Human Services, 2023). By filling out the forms with the patient, I might have helped them get help to pay for all of their medical treatment costs. A second option was to work with the hospital’s financial aid department to see if the patient qualifies for charity care coverage. Many hospitals offer financial assistance policies to lower healthcare costs for those unable to pay. An application for charity care may entirely or partially cover office visits, lab work, medications, and other services for a set period. This could address immediate treatment needs and provide time to explore additional long-term solutions. As a third resolution, I could refer the patient to a free or low-cost community health clinic for ongoing primary care management and prescription filling. Some clinics partner with social services to help uninsured patients get medications at no or minimal charge. While this may not be as convenient as one-stop care, it could effectively treat the patient’s conditions in the short term through a multi-pronged approach until more permanent insurance or financial assistance is obtained.
NC Department of Health and Human Services (2023). Medication Assistance Program | NCDHHS. Ncdhhs.gov. https://www.ncdhhs.gov/divisions/office-rural-health/office-rural-health-programs/medication-assistance-program
Varkey, B. (2020). Principles of Clinical Ethics and Their Application to Practice. Medical Principles and Practice, 30(1), 17–28. https://doi.org/10.1159/000509119