Due to the rapid changes and complexity in healthcare, nurses are pursuing higher education and specialized training. This specialized training has produced what we now call advance practice nurses. Advance practice nurses can function independently or in partnership with other physicians. These nurses play a vital role in healthcare. There are four types of advance practice nurses; clinical nurse specialist, nurse anesthetist, nurse midwives, and nurse practitioners. The role of the nurse practitioner has changed from being an assistant to meeting the healthcare needs of patients when no physician is available. Nurse practitioners may specialize in a variety of settings, but are not limited to; primary care, acute care, palliative care, infectious disease, and gerontology. Becoming a nurse practitioner requires a Master of Science in nursing, post masters, or Doctor of nursing practice (Britt, 2012). The services provided by nurse practitioners include; diagnosing and treating health problems, adult and well child checks, prescribing medications, teaching health promotion while promoting disease prevention (Britt, 2012). Healthcare reform which has led to increase accessibility of healthcare has created more opportunities for nurse practitioners in the primary care setting (AAON, 2014).
Nurse practitioners are visible in the acute and critical care settings. In the acute setting, they are using evidence based practice to manage care of the critically ill (AAON, 2014). According to the American Association of Nurses, “nurse practitioners are more likely to adhere to clinical practice guidelines that improve patient outcomes (AAON, 2014). Nurse practitioners tent to engage patients in their care by helping them understand t and measures they can take for improvements (Britt, 2012). Despite the enormous contributions nurse practitioners are giving to healthcare, there are barriers to the potential of what a nurse practitioner can give back to their community. The state scope of practice laws are the most significant (Naylor, & Kurtzman, 2010). These laws govern practice and prescriptive authority. There are some states more restrictive than others. Reimbursement is another issue affecting nurse practitioners.
There are legal concerns regarding reimbursement for services provided by nurse practitioners (Perry, 2009). Other barriers NPs face include; poor physician attitude, lack of respect, and poor communication. The poor physician attitude may be due to lack of physician knowledge regarding the role of the nurse practitioner (Clarin, 2009). When there is difficulty understanding the NPs role, then there is difficulty with collaboration, which in turn affects the patient. As the scope of practice for nurse practitioners varies from state to state, the nurse practitioners role is becoming more dominant due to the demands because more people are able to afford healthcare. It is imperative for barriers to be removed that would allow NPs to use their training and education to the fullest. Nurse practitioners are an essential component to the healthcare team and medical community. With such emphasis being placed on preventive care, nurse practitioners will be recognized as an asset.
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