Contemporary Regulatory Obstacles to Full Authority Nursing Practice

ContemporaryRegulatory Obstacles to Full Authority Nursing Practice

ContemporaryRegulatory Obstacles to Full Authority Nursing Practice

Thehealthcare system has evolved rapidly, and nursing practitioners haveroles in achieving health outcomes in many people. According to apublication that was done by the Institute of Medicine in 2011, aboutthe future of nursing, it is reported that nurses should be advocatesby caring for people in complicated healthcare systems. However,there have been barriers in the healthcare system that limit theadvanced nursing practice. In this paper, some obstacles have beenhighlighted and the available solutions outlined


Toadvocate for nursing values and to shape the healthcare system. It isalso important to understand the legal and political determinants ofhealthcare. Other objectives include to examine the effect ofcontemporary regulatory obstacles to advances nursing practice andadvocating for policies that improve the nursing profession.

Explanationof the Controversy

Thelicensure of the state regulates nursing practices and this is anobstacle even to the nurses’ training and education. Licensure lawsregarding nursing practice are different for each state. A third ofthe nation has adopted licensures for nursing practice. Thelicensures allow the nursing professionals to order, diagnose andeven interpret diagnostic tests. Nursing professionals are requiredto meet educational requirements for licensure. The publication bythe Institute of Medicine realized that the restricted nursingprofessional practice regulation in some places was one of the mainbarriers to healthcare services (PEEPLES &amp FRANCIS, 1995).

Somephysician organizations have a feeling that physicians have a longertraining than nurses. Through this, they believe that nurses areincapable of giving quality care at the same level as physicians. TheAmerican College of Physicians identified the roles that nurses playin primary care as being important. This has created a lot ofconfusion about the role of nurses. A recent study reveals that eventhough there are few primary care providers, physicians are notlikely to support the roles that nurses play.

Anotherobstacle is payer policies that are linked to licensures and statepractice regulations. Nurses are forced to work below physicians inhospitals as well as in other entities. They have beenunderrepresented in decision-making processes (Golden &amp Miller,2013).

Inaddressing these obstacles, there should be policy initiatives.Legislative reforms focus on the issues faced by nurses such as payerpolicies and the scope of practice. Organizations such as theAmerican Nurses Association advocates for these policy initiatives byallowing nurses to practice according to their training andeducation. Another important step in addressing the obstacles iswidening the role that nurses have in delivering primary case despitethe shortages (Golden &amp Miller, 2013).


Healthcareprofessionals have had challenges in meeting the demands of thediverse population. There has been a shortage in the workforcedelivering primary care. Through education and training, nurses canperform many tasks in primary care with the ability to achievedesirable clinical outcomes. Nurses are defined by their employmentagreement and extent of the practice. This has most of the timedisregarded their extent of training and education. The obstaclesthat have been discussed in this paper decrease the contribution ofnurses towards achieving the aims of healthcare which include betterhealth, better care and lower costs in getting healthcare services.Giving solutions to these obstacles require attention from thenurses, nursing organizations, and payers as well as policymakers(Allen, 2014).


Allen,P. (2014). Nursing Home Culture Change and Social Work Practice. JContemp Med Edu

Gordon,Miller. (2013). Understanding barriers to basing nursing practiceupon research: a communication model approach. Journal Of AdvancedNursing, 21(1), 154-157.


  • Publication Source

TheJournal for Nurse Practitioners

  • Author Criteria

Article-PrescribingCompetencies for Advanced Practice Registered Nurses

Authors-Tracy Klein and Louise Kaplan

TracyKlein, is the advanced practice consultant for the Oregon State Boardof Nursing in Portland.

LouiseKaplan, is an associate professor in the College of Nursing atWashington State University in Vancouver.

Regulatorsand expatriates have a desire in ensuring that advanced practiceregistered nurses (APRNs) are fully armed to acquire prescriptiveauthority. A study was carried out to approve on the competenciesthat could be adopted to prepare APRNs for a full role on thehealthcare systems. Prescribing competencies lays an establishmentfor evidence-based legislation, and regulation by state boards, whichcould allow APRNs to attain their maximum potential.