1. What factors do you think impede acceptance and recognition of APRNs contribution to
healthcare access?
Joel (2013) points to the inability to define the scope of advanced practice nursing with any consensus. She further indicates that the reason the scope is undefined relates directly to role uncertainty and role ambiguity of advanced practice nurses. This is evidenced by the numerous different names and regulation applied to advance practice nurses throughout the different countries of the world (Joel, 2013). This creates confusion and roles do not transfer equally from one geographic location to another. This lack of clarity regarding the advanced nursing role results in underuse of the NP, and is a severe impediment to the patients that NPs could be and should be caring for.
Advanced nursing practice (ANP) is not always accepted by the medical field or by other nurses (Joel, 2013). Therefore, this further creates role ambiguity among APN and also for those that they work with.
Varied educational requirements contribute to the role ambiguity surrounding ANP. The educational requirements have changed recently in the US and are not consistent from county to county. 50% of the countries surveyed may only have masters level nursing degrees Furthermore, legislation, credentialing, and standards of ANP need to be standardized across the US and among other countries in order for role confusion to be minimized (Joel, 2013).
2. In what specific ways does legislation, rules, and regulations impact availability and
access to care provided by APRNs
Many APNs are not allowed to practice to the fullest extent of their knowledge (Joel, 2013). Therefore, many patients who could be receiving high level, quality care are not doing so. Including itself, four of the five states surrounding Texas have reduced or restricted practice for advanced practice nurses (AANP, 2022) .
Full practice authority does not equate to independent practice. Some states have agreements in which the NP can transition from full to independent practice after a specified amount of time working under a collaboration agreement with a physician or other NP (Phillips, 2019).