PPACA Two provisions in the PPACA (Patient Protection and Affordable Care Act) that impact my current nursing practice are 1) the call for increased access to care and 2) the call for more preventive care. The Institute of Medicine (IOM) in its Future of Nursing report stated that nurse practitioners should be allowed to practice to the full scope of their education and training (IOM, 2010), which is something they are not permitted to do in every state. Many states require nurses to practice under the supervision of a physician, but as O’Brien (2003) pointed out, Advanced Practice Nurse Practitioners (APRNs) were trained to take the place of the physicians who were leaving the primary care field for specialized medicine. Nurses were trained and educated to be able to provide primary care—the same kind of care that physicians provide. And yet in many states they are not permitted to practice independently of physicians. As a result there is a serious limitation on access to care for people, because nurses cannot open their own facilities. Instead they must work in larger facilities that are limited...

If the PPACA is to be taken seriously, then my current practice of nursing should be such that the recommendations of the IOM are put in place so as to help increase access to care for patients in accordance with the Affordable Care Act.
An example of this issue is in Oklahoma where currently nurses are still required to practice...…the two provisions identified here. I want to be able to provide greater access to care by practicing to the full extent of my education and training without the supervision of a physician, and I want to be able to practice preventive care by putting people before profits. The ACA was written and passed for a reason and yet it seems that it is often overlooked and the details that made it worthwhile to pass are passed over and no one seems to mind. In my practice, I will aim to promote nursing independence and work to get legislation changed that will allow the ACA to be implemented as it should be. I aim also to boost the health literacy of patients and actually practice preventive care.

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