ABSTRACT
In the United States, Advanced Practice Registered Nurse (APRN) regulations are determined at the state level, through legislation and rule making. The lack of an evidence base to APRN regulation has resulted in a patchwork of varied regulations and requirements for nurse practitioners. The author begins this article by reviewing the history of the Equal Rights Amendment (ERA) in the United States and describing her study that assessed APRN fullpractice authority in states that ratified the ERA versus states that opposed it. She presents the study findings, limitations of the comparison, and discussion of the findings and implications. In conclusion, the findings demonstrated that progress toward full APRN practice will require building strategies for political support and framing the need to update APRN regulations in a manner that aligns with each state's social and political values.
ABSTRACT
PURPOSE: This study examined factors aligned with advocacy among advanced practice registered nurses (APRNs) by examining the relationships among demographics, years of RN and APRN experience, education levels, affiliations with professional organizations, perceptions of barriers to practice, political activism, and willingness to speak to the media. DATA SOURCES: This was a secondary analysis of online survey data (N = 884) from APRNs in Florida. All APRNs with an e-mail address with the state nursing board or a Florida Coalition of Advanced Practice Nurses' membership organization received an e-mail requesting their participation to the survey. CONCLUSIONS: Having a high educational level and involvement in a professional organization are each individually statistically associated with perceiving practice barriers, engaging in political activism, and willingness to speak with media. Emerging nurse leaders need an understanding of policy issues, an appreciation of the potential of the profession, and enhanced advocacy skills. IMPLICATIONS FOR PRACTICE: To address the nation's health needs, APRNs need to recognize practice barriers, develop advocacy skills, and take action for policy changes to enhance the legal authority to practice to full extent of APRNs' education and training.
Subject(s)
Health Policy , Nurse Practitioners/psychology , Politics , Professional Autonomy , Advanced Practice Nursing/education , Florida , Humans , Surveys and QuestionnairesABSTRACT
The widely varied regulations in the 50 states often limit consumer access to nurse practitioners (NPs). In 22 states, the Board of Nursing (BON) must share NP regulatory authority with another profession, usually physicians. This study examines the relationship between the BON as the sole authority regulating NPs or sharing that authority with another profession and the NP regulatory environment. Independent t tests compared the NP regulatory environments for consumer access and choice in states with sole BON regulation with those in states with involvement of another profession. The states' NP regulatory environments were quantified with an 11-measure tool assessing domains of consumer access to NPs, NP patients' access to service, and NP patients' access to prescription medications. BON-regulated states were less restrictive (P < .01, effect size 1.02) and supported NP professional autonomy. Entry into practice regulations did not differ in the two groups of states. Having another profession involved in regulation correlates with more restrictions on consumer access to NPs and more restrictions to the full deployment of NPs.
