Overview of the Topic
Advanced Practice Registered Nurses (APRNs) substantially impact the establishment and execution of regulations in the healthcare system. Manly, APRNs are highly trained and skilled healthcare professionals who have a major impact on the regulatory, legal and ethical models in their practice scope. Under the regulatory framework, APRNs champion reforms in regulations that guide their practice, such as practice scope rules and licenses. In line with the legal framework, APRNs deal with complicated legal problems like legal restrictions, malpractice, and liabilities on their practice scope. Normally, APRNs work with other health experts to pledge adherence to legal codes while offering healthcare services and operate to tackle legal problems that may occur in their line of duty. Lastly, concerning ethics, APRNs handle dilemmas such as professionalism, privacy and confidentiality, informed consent, and patient autonomy. They ensure that ethical principles are respected when delivering patient care and interactions with other health staff and healthcare institutions. Generally, the APRN’s role is ever evolving such that they are involved in shaping healthcare directions from legal, ethical, and regulatory lenses, which depict their commitment to promoting patient-centered care and the highest scope of healthcare practices.
Literature Review of the Topic
APRNs play a fundamental in influencing healthcare policies and practices. Clinical nurse specialists, certified nurse midwives, and nurse practitioners are part of the APRNs, are highly trained and skilled, and provide vast primary and specialty care services. According to Kugo & Lugo (2014), the regulatory impact of APRNs is described in the Institute of Medicine (IOM) Future Report. The report stresses the prerequisite for regulatory reforms at the state and national levels that champion the full use of nurses’ competence in satisfying the country’s health needs. Removing scope of practice barriers for caregivers is imperative to ensure that nurses practice to the full magnitude of their training and education. As such, this effort corresponds with initiatives to stretch the APRN’s practice scope where they are permitted to offer various healthcare services individually without collaboration consensus or doctor’s guidelines. APRNs can promote care access in underrepresented regions with a limited number of primary care physicians by championing the eradication of these obstacles.
Many research studies are focused on understanding the ethical concerns in APRN research by examining issues connected to various ethical principles like informed consent, patient autonomy, privacy and integrity. Studies reveal that APRNs grapple with ethical dilemmas relating to other professionals and health firms when delivering patient care. Maynes III & Maynes (2023) report that APRNs play a substantial part in tackling ethical concerns and guaranteeing patient-focused care. Usually, APRNs offer care to patients with severe conditions. For instance, the ethical impact of APRNs is identified in palliative care when they partake in advanced care development. These nurses collaborate with clients and their families to educate them about end-of-life choices, objectives of healthcare services, and treatment alternatives. These dialogues are critical as they enable APRNs to respect the patient’s demands and customize the care to their health needs such that they consider their beliefs and values.
Moreover, many studies focus on understanding APRNs’ legal impact by examining problems such as legal barriers to their practice scope, malpractice, and liability. According to Schorn et al. (2022), APRNs encounter various issues because of different state laws. Such obstacles include licensing, limited administrative authority, treatment limits, a need for physicians’ permission, and prescribing restrictions. These legal limitations influence the APRN’s capability to offer comprehensive care and limit patient access to health services, especially in rural regions where home health approval limitations are predominant. Although initiatives for championing APRNs’ full practice authority exist, obstacles highlight the legal issues APRNs encounter. Therefore, tackling these obstacles is critical to guarantee impartial access to health services and utilize the APRN’s capability to meet the health requirements of the nation.
Application to Practice
The regulatory, legal, and ethical frameworks have substantial implications for APRN practice. Notably, the regulatory models impact APRNs’ practice scope and administrative powers as they shape their duties and efforts in health institutions. Particularly, the regulatory changes are directed at eradicating practice barriers, allowing APRNs to practice to their full magnitude of training and instruction (Kugo & Lugo, 2015). Further, the legal framework determines how APRNs deliver care services by focusing on licensing, collaborative consensus, and liability problems. The advocacy efforts to champion legislative reforms and enhance regulations that grant APRNs full scope of practice allow them to work more independently, increase their performance in healthcare provision, and grant impartial access to healthcare services (Schorn et al., 2022). Lastly, the ethical framework influences the manner in which APRNs deliver healthcare services to clients by ensuring that the care provided considers ethical principles such as respect, nonmaleficence, maleficience, justice, and patient autonomy. APRNs must adhere to ethical regulations when connecting with patients, workmates, and other healthcare colleagues. When APRNs honor ethical principles and use them to make clinical decisions during practice, they develop trust with patients and deliver quality care to them (Maynes III & Maynes, 2023).
Moreover, APRNs’ regulatory, legal, and ethical impact enables them to be integrated into multidisciplinary healthcare teams. APRNs work with doctors, social workers, pharmacists, caregivers, and other healthcare experts to provide quality care. They offer insightful ideas and suggestions because APRNs are highly skilled and educated, promoting patient results.
Real-life examples
Ethical dilemmas are persistent in healthcare, and one real-life scenario involves the interplay between religion and science. Mainly, FNPs must get informed consent before implementing a treatment plan. This is necessary to ensure that they respect patient autonomy and their ability to make health choices. However, FNPs may become frustrated when patients’ religious and cultural beliefs contradict the scientifically proven treatment plan. ANA Code of Ethics asserts that FNPs must honor the patient’s differences such that they respect the client’s values, religious beliefs, and lifestyle (Faubion, 2024). As such, the FNP must honor the family’s choice and offer support.
Proposed Changes Challenge
Various challenges hamper the APRN role guidelines regarding the legal, regulatory, and ethical impact. For instance, the scope of practice regulations is different from one state to another, as some require collaborative agreements and prescribing power to enable APRNs to operate independently. Some limitations deny APRNs the autonomy and capability to provide adequate care to clients, such as diagnosing, treating, and prescribing drugs without consulting a physician (Morris, 2023). There is a need for advocacy efforts to eradicate unnecessary practice barriers and enhance APRN’s practice freedom. This will ensure that they satisfy their responsibilities appropriately.
References
Faubion, D. (2024). 20 Common Examples of Ethical Dilemmas in Nursing + How to Deal With Them. Retrieved from NursingProcess.Org: https://www.nursingprocess.org/ethical-dilemma-in-nursing-examples.html#:~:text=Ethical%20Dilemma%3A,-Health%20and%20nursing&text=Nurses%20may%20feel%20frustrated%20because,instead%2C%20nurses%20may%20feel%20helpless.
Kung, Y. M., & Lugo, N. R. (2015). Political advocacy and practice barriers: A survey of Florida APRNs. Journal of the American Association of Nurse Practitioners, 27(3), 145-151. doi: 10.1002/2327-6924.12142
Maynes III, D. L., & Maynes, M. R. (2023). Ethical Considerations and Palliative Care in MCS. In Mechanical Circulatory Support (pp. 1–20). Cham: Springer International Publishing. https://doi.org/10.1007/978-3-030-86172-8_19-1
Schorn, M. N., Myers, C., Barroso, J., Hande, K., Hudson, T., Kim, J., & Kleinpell, R. (2022). Results of a national survey: Ongoing barriers to APRN practice in the United States. Policy, Politics, & Nursing Practice, 23(2), 118–129. https://doi.org/10.1177/15271544221076524
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