I have to reply to this post. Nurse practitioners are held to certain ethical and medical standards to safeguard both the patient
I have to reply to this post.
Nurse practitioners are held to certain ethical and medical standards to safeguard both the patient and the provider. It is the duty of each individual nurse practitioner to know the guidelines and regulations in their individual state and educate their practice sights on these restrictions. Each state has slightly different regulations, but are typically divided into three categories: Full Practice, Reduced Practice, and Restricted Practice (American Association of Nurse Practitioners, 2023). In simplest terms, a Full Practice state refers to one in which an NP can care for the patient autonomously in all stages of care: assessment, diagnosis, treatment, and prescribing (American Association of Nurse Practitioners, 2023). In a Reduced Practice and Restricted Practice state there are strict guidelines as to how and when a physician is needed to supervise and co-treat with the NP (American Association of Nurse Practitioners, 2023).
Florida is considered a Restricted Practice state due to regulations set forth by the Florida Board of Nursing and require, in many cases, supervision by a physician (Florida Senate, 2020). One example of how this looks different is the practice of a Nurse Practitioner signing a death certificate. In Florida, a Nurse Practitioner can sign a death certificate without a co-signing physician, as long as they have been approved for autonomous practice (Florida Board of Nursing, 2024). However, in other states such as Arkansas and Alaska, NPs can only sign the death certificate if they work in a hospice setting or have a co-sign with a physician within a set time period (Stevens & Landes, 2021).
When considering my own personal practice as a Nurse Practitioner, it can be difficult to determine what my “preferred” regulatory practice setting would be. In the most general sense, a Full Practice state seems to be the one in which NPs can be used to their fullest capacity and truly have a marked impact in healthcare gaps. However, I can appreciate the fact that with the added responsibility and freedom also comes a lot more liability. Reduced practice states have guidelines for specific treatment and diagnosing regimens for a reason; more complex medications and treatments, such as Schedule II Drugs, can potentially cause irreparable harm to the patient, so they must be prescribed with great care and intimate knowledge of the patient’s condition.
Regulatory laws help to govern NP practice by ensuring qualifications and licensing requirements are met (Online Sunshine, 2024). They help to define and highlight scope of practice guidelines, as well as determine consequences for failing to comply. Regulatory laws are typically determine by the individual state, and can vary greatly from on jurisdiction to another. As was stated previously, it is the responsibility of each NP to know their state’s regulations and guidelines to ensure compliance in their practice.
References
American Association of Nurse Practitioners. (2023). State practice environment. State Advocacy. Retrieved from: https://www.aanp.org/advocacy/state/state-practice…
Florida Board of Nursing. (2024). Can an APRN sign death certificates? Licensing. Retrieved from: https://floridasnursing.gov/help-center/can-an-aprn-sign-death-certificates/Links to an external site.
Florida Senate. (2020). CS/HB 607 Health Care Practitioners. Retrieved from: https://www.flsenate.gov/Session/Bill/2020/607/Ana…
Online Sunshine. (2024). The 2023 Florida statutes. 464.012: Licensure of Advanced Practice Registered Nurses; Fees; Controlled Substance Prescribing. Title XXXII(464). Retrieved from: http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0400-0499/0464/Sections/0464.012.htmlLinks to an external site.
Stevens, J. D., & Landes, S. D. (2021). Assessing state level variation in signature authority and cause of death accuracy, 2005-2017. Preventive medicine reports, 21, 101309
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