By Melissa Wirkus Hagstrom, contributor Jul 14, 2020
Nurse practitioners, or NPs, are advanced practice registered
nurses who acquire graduate education at the master’s, post-master’s, or
doctoral level and obtain national board certification. You can find NPs in virtually
every type of setting—from major hospitals and medical centers to retail
clinics, rural facilities, surgical centers, medical practices, urgent care
settings and many others.
Assessment of the patient;
Ordering, performing, supervising and interpreting diagnostic
and laboratory tests;
Initiating and managing treatment, including prescribing
medication and non-pharmacologic treatments;
Coordinating patient care;
Educating patients and their families and communities.
The American Association of Nurse Practitioners (AANP) has
conducted over five decades of research that affirms NPs provide safe,
high-quality, cost-effective, patient-centered care.
How has the scope of practice for nurse practitioners changed
over the years? We connected with Sophia L. Thomas, DNP, APRN, FNP-BC, PPCNP-BC,
FNAP, FAANP, president of AANP, for an in-depth look at NP practice today.
tenens NP jobs across the U.S.
Scope of practice for nurse practitioners
NPs are licensed in all states and the District of Columbia, and
they practice under the rules and regulations of the state in which they are
licensed. Some states allow more independent practice than others.
“In 22 states and the District of Columbia, patients have full
and direct access to NPs, providing consumers a choice of healthcare provider,
and strengthening patient access to primary care,” Thomas said.
the AANP, NP practice includes (but is not limited to):
licensed, independent practitioners, NPs practice autonomously and in
coordination with healthcare professionals and other individuals.
Who regulates the scope
of practice for nurse practitioners?
While NPs are regulated at the state level, by that state’s
board of nursing, the AANP is a key association for nurse practitioners that
reviews and revises the scope
of practice guidelines for NPs at their annual meetings. The most
recent revision was published in 2019. This continual review process help
ensure that nurse practitioners are always up to date and held to the highest
clinical and ethical standards.
In addition to the AANP, nurse practitioners are also included
in the American Nurses Association (ANA). According to the ANA, they represent
and advocate for the interests of all advanced practice registered nurses (APRNs),
which include certified nurse practitioners (NPs), certified registered nurse
anesthetists (CRNAs), clinical nurse specialists (CNS), and certified nurse midwives
Full practice authority
and the COVID-19 pandemic
The scope of practice for NPs and other APRNs has been a topic of growing interest
in recent years. Many organizations are calling to protect and expand practice authority
for these types of healthcare professionals, in part to expand access to care.
“Supported by a growing body of evidence of the safe and cost-effective
provision of care by APRNs, there is a national call to remove all barriers to
full practice authority from organizations such as the Institute of Medicine
(IOM), the National Governors Association (NGA), the Federal Trade Commission
(FTC), the Bipartisan Policy Center, and the Veteran’s Health Administration
(VHA), among others,” according to ANA’s APRN policy
and advocacy page.
The ANA goes on to note that they have been working with their
constituent state nurses associations for years, aiming to remove regulatory
barriers for APRNs and allow them “full practice authority, which is generally
defined as an APRN’s ability to utilize knowledge, skills, and judgment to
practice to the full extent of their education and training.”
Advocates note that full practice authority has become more
important than ever during the COVID-19 global pandemic. Removing barriers to
practice allows NPs to fully leverage their skills and clinical experience to
assist in areas being hit hard.
“NPs are on the frontlines of the COVID-19 crisis and they are
expanding healthcare access for millions of Americans,” Thomas said. “Most recently,
during the COVID-19 pandemic, governors of Kentucky, Louisiana, New Jersey, New
York and Wisconsin suspended state regulatory barriers that limit NPs from
combatting the growing COVID-19 crisis. The actions enable these states to
surge the number of frontline care providers, treat patients with underlying
health conditions, and meet vital primary care needs.”
“AANP continues to urge governors to permanently waive
restrictive barriers that undermine patient access to NP-provided care. Many
states are considering legislation that would grant NPs full practice authority,”
“In the areas of the country where we continue to see an increase in cases,
we’re concerned and we’re committed to helping combat outbreaks,” she continued.
“People and policymakers need to remain vigilant—and everyone needs to continue
to play their part in wearing masks, handwashing, social distancing and
The AANP recently surveyed NPs nationwide to better assess the
impact of the COVID-19 pandemic on patients and NP clinical practice across
“Among some of the findings, the majority of nurse practitioners
(61 percent) are treating patients diagnosed with COVID-19. And 58 percent say
they are testing patients at their practices,” Thomas reported. “Lack of
testing is the most critical barrier facing NPs as they treat COVID-19 patients
in their communities. In fact, 47 percent of NPs cite a lack of testing as the
biggest barrier to caring for their patients during this crisis, and 69 percent
say that, in their communities, COVID-19 testing remains limited to patients
meeting a narrow set of criteria.”
“The NP profession is leading the way in adopting strategies to
meet patients’ ongoing healthcare needs. Over half of NPs are utilizing telehealth and virtual
platforms to provide care while reducing patient exposure to COVID-19.”
Tenens Nurse Practitioner Jobs and Salary CRNAs’
Role in Critical Care During the COVID-19 Pandemic
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