Nurse Practitioners (NP) are highly skilled, educated, and well-trained people. They have a huge responsibility towards their patients that they fulfill day in and day out. They are primarily autonomous, and that only increases the accountability that they have. They work in various healthcare organizations, including hospitals, clinics, private practices, government organizations, research environments, and more. They are capable of providing a wide range of services to their patients. These include, but are not limited to:
- Taking and maintaining patient histories
- Ensuring up to date medical records
- Taking histories from patients’ caregivers and family
- Offering primary healthcare services in rural areas
- Ordering all types of diagnostic tests
- Educating patients and their caregivers
- Collecting and compiling samples from patients
There are a lot of specialties that NPs can opt for when they are choosing their practice areas. But no matter what they choose, they must stick to the scope of practice that they have. A Nurse Practitioner’s scope changes depending on the state that they work in.
Level of Expertise
As of 2016, 21 states and the District of Columbia have permitted NPs to practice independently. It means that they don’t need to have a doctor continually checking upon them. They can prescribe medication, sign death certificates, order therapy, and more. And there is a ton of proof that tells us that NPs are more than capable of performing their monumental tasks independently, without any supervision.
A journal published the outcomes of NPs during 1990 and 2008. It compared NPs and physicians’ and found no difference in patient satisfaction or patient health outcomes. During their online Master of Science in Nursing, NPs go through all sorts of training and guidance and the most up to date knowledge that brings them to the same level of expertise as physicians. Not just that, a lot of other organizations have spoken about NPs and their efficiency, high performance, and effects on patients like the Institute of Medicine, Federal Trade Commission, the American Association of Retired Persons, and more. Moreover, the American Association of Nurse Practitioners (AANP) published a report in 2016 that stated that NPs have a low rate of malpractice, only 1.9 percent.
Scope of Practice
If you are related to the field in any way, you must have heard the term “Scope of Practice” thrown around. It refers to all the actions and procedures that NPs are legally allowed to perform or follow. Of course, this is all within the terms of their license. This scope of practice is different for each state. Some states allow NPs to take liberty with their scope of practice. Other states have created highly restricted roles for these Nurse Practitioners. They require them to be monitored by a physician while they do their work. Although the scopes differ from state to state, all nurse practitioners receive training and education to practice independently. They can provide patient care whether they have a physician that they have to report to or not.
According to the AANP, this is the scope of practice:
Nurse practitioners who have acquired their licenses are independent practitioners. They can practice in all types of situations like ambulatory, acute, or chronic.
They can act as a primary care provider or a specialty care provider. They assess, diagnose, manage, and treat chronic as well as acute illnesses and ailments. They are experts when it comes to health education and promotion as well as disease prevention. They are fully capable of conducting, supervising, and interpreting diagnostic laboratory tests. They are also capable of prescribing medication and other therapies. They educate and counsel their patients in several ways, among other things.
Nurse Practitioners can work independently as well as in collaboration with other healthcare professionals. They can conduct research, advocate for patients, and so much more. They serve individuals, families, communities, groups, and more.
NP Vs. RN
The scope of practice changes if you compare Nurse Practitioner and Registered Nurses (RN). RN is capable of making a diagnosis and starting treatment. They also handle case management and patient education. ON the other hand, an NP also prescribes medication, diagnostic tests and interpretation, and counseling.
NP Vs. Physicians
If we compare the scope of practice of NPs and physicians, we will see that there is not too much of a difference. In most cases, the difference comes down to the physician prescribing any medical diagnosis treatment. On the other hand, an NP can only give prescriptions and therapy in their specialty.
What is Independent Practice?
We have already discussed that Nurse Practitioners are allowed to provide patient care without a physician’s oversight. They can practice autonomously, conduct tests, diagnose, assess, and treat patients without a physician’s involvement. Thus, there are three states of practice that any state can allow. They are:
- Full practice (completely independent)
- Reduced practice (somewhat independent)
- Restricted practice (non-independent)
According to AANP, the state allows all Nurse Practitioners to assess patients, diagnose their illnesses, suggest diagnostic tests, interpret and prescribe medication or therapies. A few states where NPs can conduct full practice are Oregon, Vermont, Maine, among others.
States where NPs are only allowed to reduced practice allow NPs to engage in some of the elements that full practice allows them. They either limit some of the scopes or require a collaborative agreement with any health discipline outside the range. States that offer reduced practice to NPs are Ohio, Pennsylvania, Utah, among others.
States, where NPs can only perform to restricted practice can engage only in a few of the elements that a fully practicing NP participates in. These states require constant supervision or team-management by an outside health discipline. That is the only way that NPs can practice in restricted practice states. These states include but are not limited to Texas, Florida, Tennessee, and more.
Although all Nurse Practitioners (NP) are fully capable of working autonomously, their practices depend on the state being with or without any supervision. No matter what type of procedure they follow, they can handle multiple responsibilities and take care of them competently.