Advanced practice nursing roles and competencies

Advanced Practice Nursing

Compare and Contrast the APRN and MDs scope of practice.

The scope of practices for APRNs is to focus on specific areas of medicine which can be transferred from the hospital to a clinic, skilled nursing facility or outpatient care center. The basic idea is that an RN with several years of experience and advanced training can offer effective health care solutions for families / children. Some of the different areas they are practicing in include: adult / family / pediatric, / gerontological care, psychiatry and mental health. This means that they have a number of duties they will perform to provide primary care to patients. The most notable include: taking / evaluating health histories, conducting physical exams, diagnosing / treating common acute illnesses, giving immunizations, managing high blood pressure / diabetes, ordering / interpreting X-rays / other laboratory tests, counseling on disease prevention / healthy lifestyles and referring patients to other health providers when needed. This is showing how the APRN will serve more in a general practice setting. ("American Nursing Association," 2010) ("Louisiana State Board of Nursing Guidelines," 2011)

While MDs, can serve in a general practice setting or specialize in specific areas of medicine. Under the LSBN scope of practice, they are considered to be highly trained healthcare professionals with precise knowledge. This is different from APRNs, by using their specialized skills to provide more advanced care to patients who have complex diseases. Yet, some of their duties in a general practice setting will involve similar tasks often given to APRNs. Most notably: taking / evaluating health histories, conducting physical exams, diagnosing / treating common acute illnesses, giving immunizations, managing high blood pressure / diabetes, ordering / interpreting X-rays / other laboratory tests, counseling disease prevention / healthy lifestyles and referring patients to other health providers when needed. This is showing how MDs can use their knowledge in either healthcare environment. Whereas APRNs; are strictly limited to specific kinds facilities, duties and as a gatekeeper in controlling costs. ("American Nursing Association," 2010) ("Louisiana State Board of Nursing Guidelines," 2011)

Part 2: Under SB 192, Louisiana would be the only state in the nation with such a regulatory structure. How would this affect current APN practice? Is this a step backwards in the progress we've made?

The new regulatory structure is streamlining the responsibilities of nurses. This is taking place with physician oversight boards regulating the industry and their responsibilities. These shifts are different from other states, by combing the APN responsibilities with those of MDs. This is a step forward by acknowledging how the discipline is contributing significantly to the quality of healthcare provided and its costs. However, these changes are ignoring the established practices of nursing industry boards. This is problematic, as they feel that there is reduced levels control by effectively transferring oversight to physicians' organizations. In this aspect, the changes are either a step forward or backwards depending upon the perspective which is taken. ("Removing Healthcare Barriers," 2010)