NRP 508 Assignment 2 Navigating State-Specific Regulation

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Navigating State-Specific Regulation


In a highly regulated setting, Advanced Practice Registered Nurses (APRNs) carry out care operations. The actions taken by APRNs are influenced by the state-specific requirements for practice. At times, these guidelines might give off an impression of being hindrances to rehearse in unambiguous States. Interprofessional collaboration and practice between APRNs and other practitioners may be required to bridge these barriers, despite the fact that APRNs can break traditional barriers. 

The APRNs must continue to adapt to new obstacles as a result of their practice’s multiple roles and responsibilities. There is likewise a requirement for keeping up with morals by and by. The conventional notions of professionalism, difficulties encountered during the transition, and current regulatory environments in various States will all be evaluated in the near future.

NRP 508 Assignment 2 Navigating State-Specific Regulation

State-specific regulations and their effects 

State-specific regulations affect the capacity in which nurse practitioners can exercise their mandate. Current Issues in Advanced Practice Registered Nursing Nurse Practitioners (NPs) can evaluate and diagnose patients, order and interpret diagnostic results, initiate and manage treatment, and prescribe medications in states with full practice. Different states that have guidelines that lessen the act of NPs by restricting a few elements of the NP practice. 

The state wants the NP to be regulated for the rest of her career with another health care provider. According to State Practice Environment, section 2, 2018, some states have imposed restrictions on the nursing profession that require an NP to be supervised by another health provider for the entirety of their career in order to provide patient care. ANPs are impacted by state-specific regulations by restricting their practice in their qualifications-related areas.

NRP 508 Assignment 2 Navigating State-Specific Regulation

Administrative hindrances

Each State has different administrative hindrances for NPs. Under the Board of Nursing and Board of Medical Examiners, Alabama, Arkansas, California, and Delaware are among the states with a reduced practice organizational structure. Then again, Gold country, Arizona, Colorado, and Connecticut among different States give full practice to NPs. 

States with restricted practice are represented by Georgia and Florida. Regardless of the developing number of patients looking for care and the over expanding prevalence of nursing experts, a portion of the States don’t give a full award of training to the NPs. 44 percent of states and the District of Colombia have granted NPs full practice authority (Peterson, 2017, p. 2). Millions of Americans are denied the opportunity to receive professional care from NPs because the other states have either reduced or restricted practice authority. While some states do not restrict nurse practitioners’ activities, others have regulations that do.

NRP 508 Assignment 2 Navigating State-Specific Regulation

State regulations that delegate the practice authority to various nurse practitioners are to blame for the progress that can be seen in the series of state regulations. According to Gadbois et al., the fact that more than 21 states now permit the full practice indicates that states are placing an increasing amount of trust in nurse practitioners to make independent medical decisions without the supervision of physicians. 2015, p.3). 

There are hopes that even more progress will be made. The progress has been tremendous. To meet the country’s health needs, nurse practitioners must be granted full authority due to the impending shortage of health professionals in the United States. 

NRP 508 Assignment 2 Navigating State-Specific Regulation

The fate of NPs relies upon the abolishment of conventional boundaries including State guidelines and strategies, protection models, and institutional culture. According to Barnes (2015), p.2, it is necessary to provide APRNs with licenses, privileges, and insurance reimbursements based on their educational qualifications. The policymakers should be directed by system and guidelines gave by the nursing sheets of their particular states as a reasonable method for supplanting the guidelines currently set up High level Practice Enrolled Medical attendant (APRN).

APRNs play various parts and obligations. The medical caretaker expert is an authorized clinician that spotlights on dealing with a particular patient populace. It could be related to children’s health, adult gerontology, or women’s health (Woo, Lee, & San Tam, 2017, p. 4). 

NRP 508 Assignment 2 Navigating State-Specific Regulation

A registered nurse (RN) who has specialized in childbirth procedures and women’s health is referred to as a certified nurse midwife (CNM). In the US, just five States give full act of guaranteed nurture birthing assistant. Delaware, Missouri, Rhode Island, and New York are these. According to Woo, Lee, and San Tam (2017, p.5), the clinical nurse specialist (CNS) is an expert who is interested in evidence-based nursing practice and strives to provide safe, cost-effective, and high-quality nursing and specialty care. 

The guaranteed enlisted nurture anesthetist (CRNA) works as a team with other clinical specialists to guarantee the outcome of different operations. In preparation for surgery, they collaborate with surgeons, dentists, anesthesiologists, and other practitioners to guarantee the safe administration of anesthesia. They also keep an eye on the patient throughout the course of the procedure and afterward.

NRP 508 Assignment 2 Navigating State-Specific Regulation

Care that is centered on the patient The provision of care that is centered on the patient necessitates practice and collaboration between various professions. The APRNs can work together with other wellbeing suppliers to cooperate collectively and share proficient information and abilities to work on understanding quality consideration (Farrell, Payne and Heye, 2015, p.1). Socialization models that facilitate the development of an interprofessional mindset are provided by interprofessional education. Then, patients can easily switch providers and specialties.

Moral issue

High level Professionals face different moral issues throughout their work. For example, a guaranteed nurture birthing specialist (CNM) may confront a moral issue because of fetus removal (Nora, Zoboli, and Vieira, 2015, p.2). The CNM may face an ethical challenge if a patient wants to have an abortion for a variety of reasons. 

NRP 508 Assignment 2 Navigating State-Specific Regulation

The Advanced Practitioner faces an ethical and moral quandary because he or she must both meet the needs of the patient and safeguard life. The Professional can conquer what is happening by weighing both, the case and the earnestness that would warrant the requirement for a chosen fetus removal. In the event that the condition isn’t perilous, the medical caretaker may maybe guide the patient to adjust her perspective.

Ideas of impressive skill

The idea of calling alludes to the occupation following scholastic capabilities. Then again, impressive skill alludes to the nursing practice in a way that matches the preparation of the APRNs. The profession and professionalism of a registered nurse differ from those of an advanced registered nurse (Barnes, 2015, p. 3). This might be on the grounds that the calling of RN has lower scholarly capabilities than APN. Similarly, in terms of professionalism, the RN can provide patient care but cannot perform additional APN functions like diagnosis and prescription. 

NRP 508 Assignment 2 Navigating State-Specific Regulation

The specialization of medicine, which caused a shortage of primary care physicians, was one of the historical factors that led to the development of APN roles. In order to meet the demand for primary care, this necessitated that registered nurses collaborate with physicians and work together. 

The improvement of Medicaid and Federal medical care expanded the extent of wellbeing administrations arrangement, expanding the interest for nurture specialists (Charm, Lee and San Hat, 2017 p.3). The primary contributions that have led to the advancement of APRNs to where they are today are the ongoing examination of the scope of practice and nurse practitioner education program.


The administrative climate around which the APRNs work influences their approach to working. As we have seen, various States have different administrative frameworks set up to direct the way in which the APRNs approach the amazing skill and moral issues overall. A portion of these guidelines will generally have more damage than anything else on the APRNs. 

There is a requirement for getting away from the conventional controlled framework as this has been making hindrances for the APRNs. The APRNs additionally need to have a between proficient joint effort and practice between with other wellbeing experts to work with the most common way of acclimating to arising issues in impressive skill and morals overall.


Barnes, H. (2015). Exploring the factors that influence nurse practitioner role transition. The Journal for Nurse Practitioners11(2), 178-183. 

Farrell, K., Payne, C., & Heye, M. (2015). Integrating interprofessional collaboration skills into the advanced practice registered nurse socialization process. Journal of Professional Nursing31(1), 5-10.

Gadbois, E. A., Miller, E. A., Tyler, D., & Intrator, O. (2015). Trends in state regulation of nurse 

practitioners and physician assistants, 2001 to 2010. Medical Care Research and Review72(2), 200-219. 

National Academies of Sciences, Engineering, and Medicine. (2016). Assessing progress on the Institute of Medicine report The Future of Nursing. National Academies Press. 

Nora, C. R. D., Zoboli, E. L. C. P., & Vieira, M. (2015). Ethical problems experienced by nurses in primary health care: integrative literature review. Revista gaucha de enfermagem36(1), 112-121.

Peterson, M. E. (2017). Barriers to Practice and the Impact on Health Care: A Nurse Practitioner Focus. Journal of the advanced practitioner in oncology8(1), 74.

State Practice Environment. (2018). Retrieved from

Woo, B. F. Y., Lee, J. X. Y., & San Tam, W. W. (2017). The impact of the advanced practice nursing role on quality of care, clinical outcomes, patient satisfaction, and cost in the emergency and critical care settings: a systematic review. Human resources for health15(1), 63.