Anas restrictive 1955 definition of nursing

ANA's restrictive 1955 definition of nursing reinforced the practice of nursing as having independent
functions and being dependent on and delegated to by the profession of medicine. It also prohibited
nurses from diagnosing and prescribing.
By definition, the term scope of practice describes practice limits and sets the parameters within
which nurses in the various advanced practice nursing specialties may legally practice . Scope
statements define what APRNs can do for and with patients, what they can delegate, and when
collaboration with others is required. Scope of practice statements tell APRNs what is actually
beyond the limits of their nursing practice (American Nurses Association [ANA], 2003, 2012; Buppert,
2012; Kleinpell, Hudspeth, Scordo, et al., 2012). The scope of practice for each of the four APRN
roles differs (see Part III). Scope of practice statements are key to the debate about how the U.S.
health care system uses APRNs as health care providers; scope is inextricably linked with barriers to
advanced practice nursing. CRNAs, who administer general anesthesia, have a scope of practice
markedly different from that of the primary care nurse practitioner (NP), for example, although both
have their roots in basic nursing. In addition, it is important to understand that scope of practice
differs among states and is based on state laws promulgated by the various state nurse practice acts
and rules and regulations for APRNs (Lugo, O'Grady, Hodnicki, et al., 2007, 2009; NCSBN, 2012;
Pearson, 2012). On the Internet, scope of practice statements can be found by searching state
government websites in the areas of licensing boards, nursing, and advanced practice nursing rules
and regulations, or by visiting the NCSBN site (). Recent federal policy initiatives,
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including the IOM Future of Nursing Report, (2011). the PPACA (HHS, 2011), and the Josiah Macy
Foundation (Cronenwett & Dzau, 2010) have all issued recom mendations with important implications
for expanding the scope of practice for APRNs. The National Health Policy Forum
() and Citizen Advocacy
Center () reports state firmly that
current scope of practice adjudication is far too technical, subject to political pressure, and therefore
not appropriate in the legislative sphere. There must be a more powerful forum so that the public can
enter into the dialogue (see Chapter 22). As scope of practice expands, accountability becomes a
crucial factor as APRNs obtain more authority over their own practices. First, it is important that
scope of practice statements identify the legal parameters of each APRN role. Furthermore, it is
crucial that scope of practice statements presented by national certifying entities are carried through
in language in state statutes (Buppert, 2012). Our society is highly mobile and APRNs must
recognize that their scope of practice will vary among states; in a worst case scenario, one can be an