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As a matter of fact, the scope of advanced nurses’ practice is not homogeneous across the country. In the present day, the District of Columbia and 21 states have approved the status of full practice for nurse practitioners (“Where can nurse practitioners work without physician supervision?” n.d.). In other words, they are allowed to prescribe medications, diagnose, assess, and interpret diagnostic tests independently. At the same time, in a considerable number of states, including Louisiana, nurse practitioners’ autonomy is limited, and every health care provider should enter into a collaborative agreement with a physician to practice.
In general, this agreement controls nurses’ activities as it specifies what types of services they may provide, what procedures they may perform, what medical conditions may be treated with and without physician consultation, and what medications may be prescribed and managed (Credentialing Resource Center Digest, 2017). However, the Louisiana State Board of Nursing, advanced registered nurse practitioners, the state’s various medical facilities, including hospitals and nursing homes, and citizens should realize the inexpediency of a collaborative agreement. It may be regarded as a barrier to accessing health care that has a highly negative impact on its quality, and there are several factors that support this statement.
First of all, the shortage of primary care physicians may be currently observed in multiple states. Its main reasons include “an aging population, the growing number of insured Americans and too few medical school graduates” (“Nurse practitioners and the primary care shortage,” n.d., para. 3). As a result, rural areas in those states, where nurse practitioners’ scope of practice is limited and physician oversight is required, frequently remain underserved due to the absence of physicians. In other words, citizens cannot receive appropriate treatment as advanced registered nurses are not permitted to perform procedures or prescribe medications independently.
In addition, other professionals are not limited by any supervision agreement and may practice freely within their professional jurisdiction and on the basis of their licensure. No collaboration with specialists from other domains is required by regulation or statute (Schrand, 2010). That is why, in the case of nurse practitioners, their obligatory collaborative agreement as to the criteria for the practice and the superiority of physicians’ decisions in the case of non-agreement look unjust. Competent advanced registered nurses are professionals with experience, certification, graduate education, and expertise. They already collaborate with health care providers on a regular basis, and the application of different standards in relation to them is unacceptable. Moreover, compulsory collaboration may lead to conflicts between nurses and physicians that negatively affect patients and may cause delays in health care delivery.
On the basis of the analysis of the issue related to the autonomy of nurse practitioners, it is possible to conclude that a collaborative agreement between physicians and nurse practitioners is unnecessary and inexpedient. It contributes to the limited access to health care for citizens in rural areas where the shortage of physicians is obvious. Moreover, as competent specialists with appropriate education and licensure, advanced registered health care providers deserve to make decisions concerning the well-being of patients independently. In turn, differences in vision, experience, professionalism, and individual characteristics of nurses and physicians may lead to misunderstandings and conflicts between them. As a result, the quality of health care will be deteriorated due to delays caused by the absence of agreement.
References
Credentialing Resource Center Digest. (2017). What goes into an NP collaborative agreement? Credentialing Resource Center. Web.
Nurse practitioners and the primary care shortage. (n.d.). REGIS. Web.
Schrand, S. (2010). State-mandated collaboration for nurse practitioners. American Medical Association Journal of Ethics, 12(1), 52-54.
Where can nurse practitioners work without physician supervision? (n.d.). Simmons University. Web.
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