Can you assist with a response using 200 word minimum w/ two references?
An advanced practice registered nurse (APRN) is a registered nurse who has obtained a master’s degree or higher (Boehning & Punsalan, 2023). The advanced nurse practitioner (APN) role has existed since the late 1960s (Brom et al., 2018). It was created by Dr. Loretta Ford, an American educator and nurse who specialized in public health, and Dr. Henry Silver, an American doctor who specialized in pediatrics.
Several types of APRNs exist and include certified nurse-midwife (CNM), certified registered nurse anesthetist (CRNA), clinical nurse specialist (CNS), and nurse practitioner (NP). This profession has been proven to be vitally important in our health system, especially during the COVID-19 pandemic. With a shortage of physicians, APRNs helped fill the void by providing patients the much-needed health guidance and care. Despite their steadfast work ethic and despite their specialty, there are states that restrict them from full practice authority. This means that they must enter into a collaborative agreement with physicians rather than practicing on their own. It is noteworthy to state that the APRN pays the physician for the collaborative agreement, usually per chart.
There are three categories of APRNs: full authority, reduced authority, and restricted authority. Each state’s board of nursing laws are different. In states that allow full practice authority, APRNs are allowed to evaluate, diagnose, and treat their patients independently; In states that allow reduced authority, APRNs are required to have a collaborative agreement with a physician; and, in states that allow restricted authority, APRNs are required to be overseen by a physician for the full length of their career. Areas of nursing specialty to choose from are broad and include gerontology, pediatrics, women’s health, neonatal, and psychiatric/mental health.
California NPs were restricted just as Florida NPs were. However, in September of 2020, their law granted the Assembly Bill 890 which went into effect on January 1, 2023. This bill clearly states that certified NPs can apply for full authority given that they completed four thousand six hundred direct patient care hours. They must also have kept their license clear and active. Areas of nursing specialty these California NPs may choose from are limited to gerontology, pediatrics, women’s health, neonatal, and psychiatric/mental health. Florida, on the other hand, had restrictions lifted when the HB607 bill was signed on March 11, 2020. Florida requires NPs to have a clear and active license, and complete 3000 clinical hours which may include didactical as well as direct patient care hours. Family, internal, and pediatrics are areas allowed for Florida full authority NPs to practice.
As you can see there are different laws NPs must abide by per state in order to practice independently. It is thus best for NPs to contact their state board of nursing directly for clear instructions. Although California and Florida state laws are not as lax as Washington State, gaining full authority is definitely something to celebrate. It has already benefited patient care tremendously by diagnosing and treating individuals who would have still been waiting to see a doctor.
Boehning AP, Punsalan LD. Advanced Practice Nurse Roles. [Updated 2023 Mar 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: to an external site.