Advanced registered nurses (APNs) are a critical component of all-around health care service provision; however, the scope of practice of APNs at the state level varies greatly, which affects the extent to which APNs are autonomous and their job description. These variations can be seen under the comparative lights of Florida and New York, highlighting that the play varies state by state, and only some places are the same depending on the laws set for healthcare provision.
Nurse Practitioners (NPs), Certified Nurse Midwives (CNMs), Certified Registered Nurse Anesthetists (CRNAs), and Clinical Nurse Specialists (CNSs) are some functions that APNs perform as Advanced Registered Nurse Practitioners (ARNPs) under Florida law. In Florida, NPs must be board-certified and can perform patient assessments, diagnose various medical conditions, order and consult on diagnostic tests, develop patient care plans, and issue prescriptions (Lavin et al., 2022). However, Florida law dictates that NPs must enter into written collaboration agreements with the overseeing physicians, which can limit those registered professionals in their respective practices in some specific situations. The main task of CNSs is to provide skilled clinical care in treatment specialties such as pediatrics or psychiatric-mental health, whereas CRNAs work under physician supervision with anesthesia assistance.
Contrary to what Florida provides for APNs, New York has an additional system for them to regulate. APNs are entitled to more space to operate independently. Registered nurses in New York enjoy the scope of practice autonomy, and their responsibilities include independently making treatment plans, ordering and misinterpreting diagnostic tests, and diagnosing and offering treatment to patients without a joint practice agreement with a physician (Martsolf et al., 2022). They also can prescribe drugs themselves. NPs from New York can start their practices, refer patients to other specialists, and work as primary care physicians in a wide range of healthcare fields because of their autonomy. In addition, the idea that NPs are now deemed not only primary doctors in New York but can also be responsible for lowering healthcare inequalities and ensuring that they have access to high-quality treatment, particularly in low-income areas, is also essential (Martsolf et al., 2022). The independent practice of NPs in New York does not require them to have a Credentials of Authority (COA). The COA document enables them to work with physicians on different specialized tasks.
Disparities existing in Florida and New York’s regulatory regimes shed light on the complexity of APN practice in other places and the role of state-specific laws as a determining factor of APN participation in healthcare provision. Even though New York and Ohio have an equal understanding of the importance of advanced practice nurses in the healthcare industry, the full-ground licensing of New York NPs exemplifies a more progressive approach to the widespread delivery of healthcare services (Smith, 2022). Implementing this agreement between nursing specialists and physicians in Florida will result in physicians having more say in the decision-making process, and this collaboration could be a good thing for their autonomy. These changes prove that regulators, healthcare institutes, and APNs should be involved in creating settings that will optimize the use of APNs in the healthcare system and protect them as they seek to achieve safe, patient-oriented, and effective care.
In conclusion, both states have different regulatory methods relating to autonomy and scope of practice, and they also acknowledge the importance of APNs in providing healthcare to communities. The main thing to ensure APNs deliver high-quality care and meet the demands of patients and communities is to ensure all project participants are aware of these differences.
References
Lavin, R. P., Veenema, T. G., Sasnett, L., Schneider-Firestone, S., Thornton, C. P., Saenz, D., … & Couig, M. P. (2022). Analysis of nurse practitioners’ educational preparation, credentialing, and scope of practice in US emergency departments. Journal of Nursing Regulation, 12(4), 50-62.
Martsolf, G., Kandrack, R., Poghosyan, L., & Ferrera, S. (2022). The Impact of the New York Nurse Practitioner Modernization Act on the Supply of Primary Care Nurse Practitioners: A Difference in Differences Design.
Smith, L. B. (2022). The effect of nurse practitioner scope of practice laws on primary care delivery. Health Economics, 31(1), 21–41.
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