1. Identify and describe practice barriers for all four APNs roles in your state and discuss
these barriers on a state and national level. The four roles include the nurse midwife,
nurse anesthetist, nurse practitioner and clinical nurse specialist.
One major practice barrier for nurse midwives and clinical nurse is professional
regulation, including regulation of the nurse midwife role and education (Fealy et al,
2018). Nurse midwives have varying jobs in different settings which makes it difficult to
specify the nurse midwife's role. Education also varies across the country making it
difficult to regulate as well. For example, a nurse may go to school in Missouri to
become an APN and be a nurse midwife, but they may eventually work in Illinois.. The
laws in Missouri will be much different than they are in Illinois. It is important to always
research the state laws where you receive your degree and where you plan to practice.
The same practice barrier applies to clinical nurse specialists (CNS). The CNS role can
sometimes be difficult to distinguish from other job positions in the medical setting
(Thurby-Hay, Whitehead, & Nelson, 2020) . The amount of CNS programs is also far
lower than the other APN specialites. This makes it difficult for registered nurses
seeking the CNS speciality to find and be accepted into a program.
A practice barrier for nurse practitioners at the state and national level is the
inability to prescribe medications without a prior prescriptive agreement with a
collaborating/overseeing physician (Illinois Nurse Practice Act). As a new nurse
practitioner, an overseeing physician must collaborate with the nurse practitioner for
medication administration. This becomes more complicated with Schedule II narcotics.
In order to prescribe Schedule II narcotics, the prescription must be delegated by an
overseeing physician.
For Nurse Anesthetist, one major practice barrier the CRNA scope of practice.
Although pain management is within the scope of practice of a nurse anesthetist, the
state of Illinois has challenged the ability for nurse anesthetist to provide chronic pain
management services (Malina & Izlar, 2014). Illinois is one of four states to challenge
this scope of practice. This would affect CRNAs at the state and national level because
it will affect where CRNAs apply for jobs. States that limit the scope of their CRNAs will
eventually face a CRNA shortage.
2. Identify forms of competition on the state and national level that interfere with APN's
ability to practice independently.
At the state and national level, APNs have competition with other mid-level
providers, such as physcian assistants, and doctors. Although APNs are more cost-
effective in most practices, many patients prefer to see doctors compared to mid-level
providers (Abraham et al, 2019). Maybe this is because of their educational background
or a pre-concieved notion that the patient may have. APNs also have to compete with
physcian assistants who are also considered mid-level providers. Although APNs are
able to work independently in some states, finding a job working in the established
practice of a doctor ensures that they will have a continuous flow of patients.
3. Identify the specific lawmakers by name at the state level (i.e., key members of the
state's legislative branch and executive branch of government)
The current govenor of Illinois is J. B. Pritzker of the Democratic party, who took
office in 2019. Dick Durbin and Tammy Duckworth, both Democrats, are the Illinois
This study source was downloaded by 100000884024057 from CourseHero.com on 11-19-2024 13:57:41 GMT -06:00
https://www.coursehero.com/file/228429837/Week-1-Discussion-docx/
these barriers on a state and national level. The four roles include the nurse midwife,
nurse anesthetist, nurse practitioner and clinical nurse specialist.
One major practice barrier for nurse midwives and clinical nurse is professional
regulation, including regulation of the nurse midwife role and education (Fealy et al,
2018). Nurse midwives have varying jobs in different settings which makes it difficult to
specify the nurse midwife's role. Education also varies across the country making it
difficult to regulate as well. For example, a nurse may go to school in Missouri to
become an APN and be a nurse midwife, but they may eventually work in Illinois.. The
laws in Missouri will be much different than they are in Illinois. It is important to always
research the state laws where you receive your degree and where you plan to practice.
The same practice barrier applies to clinical nurse specialists (CNS). The CNS role can
sometimes be difficult to distinguish from other job positions in the medical setting
(Thurby-Hay, Whitehead, & Nelson, 2020) . The amount of CNS programs is also far
lower than the other APN specialites. This makes it difficult for registered nurses
seeking the CNS speciality to find and be accepted into a program.
A practice barrier for nurse practitioners at the state and national level is the
inability to prescribe medications without a prior prescriptive agreement with a
collaborating/overseeing physician (Illinois Nurse Practice Act). As a new nurse
practitioner, an overseeing physician must collaborate with the nurse practitioner for
medication administration. This becomes more complicated with Schedule II narcotics.
In order to prescribe Schedule II narcotics, the prescription must be delegated by an
overseeing physician.
For Nurse Anesthetist, one major practice barrier the CRNA scope of practice.
Although pain management is within the scope of practice of a nurse anesthetist, the
state of Illinois has challenged the ability for nurse anesthetist to provide chronic pain
management services (Malina & Izlar, 2014). Illinois is one of four states to challenge
this scope of practice. This would affect CRNAs at the state and national level because
it will affect where CRNAs apply for jobs. States that limit the scope of their CRNAs will
eventually face a CRNA shortage.
2. Identify forms of competition on the state and national level that interfere with APN's
ability to practice independently.
At the state and national level, APNs have competition with other mid-level
providers, such as physcian assistants, and doctors. Although APNs are more cost-
effective in most practices, many patients prefer to see doctors compared to mid-level
providers (Abraham et al, 2019). Maybe this is because of their educational background
or a pre-concieved notion that the patient may have. APNs also have to compete with
physcian assistants who are also considered mid-level providers. Although APNs are
able to work independently in some states, finding a job working in the established
practice of a doctor ensures that they will have a continuous flow of patients.
3. Identify the specific lawmakers by name at the state level (i.e., key members of the
state's legislative branch and executive branch of government)
The current govenor of Illinois is J. B. Pritzker of the Democratic party, who took
office in 2019. Dick Durbin and Tammy Duckworth, both Democrats, are the Illinois
This study source was downloaded by 100000884024057 from CourseHero.com on 11-19-2024 13:57:41 GMT -06:00
https://www.coursehero.com/file/228429837/Week-1-Discussion-docx/
