Read the assigned Hain & Fleck article, and discuss the following:
What are the barriers to APN practice identified in the article? Describe these barriers in your
own words.
What are your impression of the barriers to APN Practice? (Are you surprised by these barriers?
Is this new information to you? Have you ever been involved at the legislative level in nursing?
Do these barriers concern you or motivate you toward becoming an APN?)
Do these barriers represent Restraint of Trade? Why, or why not?
Your thoughts on how nurses can influence these barriers.
Professor Lane and class,
I understand there are barriers to face in every career path out there. I am in the beginning stages
of learning the barriers I may face as an NP. After reading the article assigned, I am beginning to
see the difficulties of being in a field that is so widely undefined.
Hain &Fleck (2014) lists such
barriers for NP’s as follows; state practice and licensure, physician related issues, payer policies
and other barriers including prescriptive privileges and job satisfaction.
State Practice and Licensure
The scope of practice for an NP varies from state to state.
According to Hain & Fleck (2014), only one-third of the nation has allowed NP’s to practice
with full authority; meaning practice to the full extent of their education. From state to state,
restrictions of practice may prevent an NP from practicing to their full extent. They may be
required to practice under the supervision of, or in collaboration with a physician. Because I live
in Iowa, according to the Iowa Board of Nursing [Wei14], I would be granted the ability to
practice independently; or without the supervision of a physician. If I were to move to a state
with greater restrictions, I would have to limit my practice, thus not preforming to the full extent
of my education.
Physician Related Issues
Because there are some states that require an NP to collaborate with
the physician, I can see where there may be issues with the physicians seeing a grey area in the
scope of the nurse practitioner. Collaboration is a difficult feat in most circumstances and I see
no differences in this one. Throw in confusion about the role of the nurse practitioner and
increase difficulty of collaboration even more. According to Hain & Fleck (2014), using the
traditional medical hierarchy, which encourages physicians to maintain dominance, promotes
difficulty in collaborative efforts and ineffective teamwork.
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