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NURS 6052 Discussion Healthcare Issue Impacts Organizations essay assignment
In one of the hospitals I work in, there has been a shortage in hospitalist physicians. At times, the organization was paying a huge sum to fill this shortage with locum physicians. In Washington State, Nurse Practitioners (NPs) are allowed to practice unrestricted, therefore, the organization hired 5 NPs to work as hospitalists. This not only was a cost-effective solution but was also an employee retention solution, as many physicians were leaving the organization due to burn out. However, there are 16 states and 3 U.S. Territories that have reduced practice regulations and 12 states that have restricted practice (State Practice Environment, n.d.). These restrictions limit access to care. When I worked in Texas, the clinic that I worked in had a waiting list for primary care appointments that went out 45-60 days due to a shortage in physicians and the limitations put upon NPs scope of practice. If Texas had full practice authority for their NPs, they could have done like my current organization did and hired more NPs to fill the void, therefore increasing the access to care.
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Description of the National Healthcare Issue
Physician supply has been impacted due to the long training times, the capacity of medical schools, and the lack of residency positions (Auerback et. al., 2018). Due to the reduced number of physicians treating patients, we have seen an increase in the number of advanced practice registered nurses (APRN), especially NPs and physician assistants (PAs) that have overlapped with the care that physicians provide. Although this has helped address the shortage of primary care providers and specialists, the restrictions put on NPs in certain states has become a barrier for them to practice fully and fill the need for more care providers. For instance, in New York, there are written practice agreements between NPs and physicians (Poghosyan et. al., 2018). In 2015, New York adopted the Nurse Practitioner Modernization Act that would remove these practice agreements for NPs that had at least 3,600 practice hours, however sadly it has not been fully adopted and NPs are still limited in their scope of practice. Texas is another state that limits NPs practice by requiring that they practice under the supervision of a physician within a 75-mile radius (Wofford, 2019). These regulations affect patient’s access to care and do not assist in achieving the nation’s goal of efficient and cost-effective care for all when limiting the skill set of less costly providers (Poghosyan et. al,. 2018).
In order to provide better access to care and more cost-effective care, we must adopt the same full practice authority for NPs in all U.S. states and territories. Giving NPs the right to practice their skills fully would alleviate the shortage of not only primary care provides but also specialists, where the access to care is often long.
References
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Poghosyan, Lusine, PhD, RN, Norful, Allison, PhD, RN & Laugesen, Miriam. (2018). Removing
restrictions on nurse practitioners’ scope of practice in New York State: Physicians’ and
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Practitioners, 30, 354-360. https://doi.org/10.1097/JXX.0000000000000040
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practitioners’ potential to deliver primary care and lead teams. Health Affairs.
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State practice environment. (n.d.). American Association of Nurse Practitioners.
https://www.aanp.org/advocacy/state/state-practice-environment
Wofford, P. (2019, July 8). Texas nurse practitioners fight for full practice authority. Nurse.org.