As the NP profession continues to grow, legal barriers to full practice authority remain
Legal barriers continue to bar NPs from full practice authority in many states.
Despite the growing popularity of nurse practitioners (NPs) – more than 916 million patients visited an NP within the last year – only 21 states and the District of Columbia grant NPs full practice authority. “Over 25 states have licensed, fully trained healthcare providers who are not practicing to their full education and training, and citizens of those states are missing access to care,” said Susan VanBeuge, DNP, APRN, and AANP Nevada State Representative. “With the primary care shortage in the United States being as acute as it is, we need all hands on deck to provide care.”
NPs are the providers of choice for millions of Americans, with more than 205,000 NPs currently licensed in the United States. That number is expected to increase to 244,000 by 2025, according to statistics released by the American Association of Nurse Practitioners (AANP) in anticipation of National Nurse Practitioner Week 2015.
The AANP attributes this growth to an increase in the prevalence of aging baby boomers, as well as the millions of new patients who are able to enter the healthcare system under the Affordable Care Act. More than 80% of NPs prepare in primary care programs, with 49% of those entering into family practice.
According to data from the AANP, 2 of 3 patients support legislation for greater access to NP services. “The hope of full practice authority is that it will increase access to care, particularly for underserved populations,” said LeAnn Holmes, DNP, APRN-FNP, FAANP, and AANP Nebraska State Representative. “There are regulatory barriers to providing care that are well within our scope of practice, including things like ordering home health care, certifying Medicare patients for hospice, and performing monthly exams for patients in skilled nursing facilities.”
Challenges aside, Drs. VanBeuge and Holmes express hope for the future of the NP profession.
“The advanced practice nursing we provide builds on the foundation as a nurse to bring evidence-based practice to our patients, communities, states, and nation,” said Dr. VanBeuge. “Find ways to keep [the] practice moving forward from the patient encounter to the policy level. APRNs must be involved not only in patient care, but at every level of clinical practice and healthcare policy.”
“It took 50 years to get to where we are today, but we still aren't done – we will never be done,” added Dr. Holmes.
- Celebrating 50 years of nurse practitioners [resource guide]. Austin, TX: American Association of Nurse Practitioners; 2015. http://assets.aanp.org/documents/2015/NPWeek2015.pdf; Accessed November 9, 2015.
- Nurse practitioners [infographic]. Austin, TX: American Association of Nurse Practitioners; 2015. https://www.aanp.org/images/about-nps/npgraphic.pdf; Accessed November 9, 2015.