Issues Affecting Nurse Practitioners: Prescribing Authority

Running head: ISSUES AFFECTING NURSE PRACTITIONERS
Issues that Affect Nurse Practitioners
Name
University

ISSUES AFFECTING NURSE PRACTITIONERS 2
Abstract
The purpose of this essay is to look at the barrier that impact the role of a nurse practitioner in a
health organization and one issue will be selected to determine how the impact it has on the role
of nurse practitioners in the healthcare system. The aspect of managing the issue will also be
discussed in the paper within the legal and professional boundaries.

ISSUES AFFECTING NURSE PRACTITIONERS 3
Introduction
A nurse practitioner is a healthcare provider with advanced education, training and expert
knowledge in diagnosing, managing and treating complex acute and chronic conditions.
Depending on their state or country’s legislation, they can order for diagnostic tests, prescribe
medication, admit patients in hospitals, request for patient referrals and perform minor, non-
surgical procedures on patients (International Council of Nurses, 2018). Nurse practitioners
began coming to the foreground during the 1960s and their role was formally brought about by
Loretta Ford, a nurse educator, and Henry Silver, a medical doctor, in 1965 (Stewart & DeNisco,
2018, p.4).
The program Ford and Silver created was meant to cater to the underserved and remote
populations who had nursing shortages The first program was meant to be based on pediatrics
but it ended up advancing clinical practice by enabling students to diagnose patients and provide
primary care (2018, p.4). In the 1970s, the nurse practitioner programs grew from funding by the
federal government to deal with doctor shortages especially in the remote parts of the country. In
1971, the state of Idaho became the first to allow nurse practitioners to prescribe medication in
the United States (2018, p.4). In Australia and New Zealand, nurse practitioners obtained their
prescriptive authority in 2001 while in the UK and Canada, nurse practitioners began prescribing
medication in1998 and the early1990s respectively (Fong, Buckley & Cashin, 2015).
Literature Review: Barriers to Nurse Practitioner Role
There are barriers/issues that continue to affect the scope of practice within which nurse
practitioners work one of which is resistance from physicians (Buchsel & Yarbro, p. 66). Nurse
practitioners face resistance especially from doctors because of their expanding role which now

ISSUES AFFECTING NURSE PRACTITIONERS 4
allows them to prescribe medication, diagnose patients and refer them for further treatment.
Many physicians see this as an encroachment on their profession because the difference in roles
between doctors and nurses is diminishing (Elder, Evans & Nizette, 2009, p.72).
There are issues with regulation resulting from rapid population growth which
necessitates changes in health policy to meet the increasing healthcare demands. The most
prominent issues that nurse practitioners face are prescribing medication and being able to
practice independently (Cowen & Moorhead, 2011, p.35). Most of the regulations that govern
this profession are not backed by evidence or research but they instead create a barrier to the
effective practice and provision of care by these nurses (2011, p. 35). Another issue that affects
nurse practitioners is that they have to know and observe both the state and federal legislation of
where they practice.
This affects their job performance because a new bill introduced in government might be
done with the best intention but it can impact on their ability to do their job (2011, p.36). An
example of harmful legislation is the Medical Home Bill of the United States. The original
purpose of this bill was to provide a centralized healthcare delivery system for children with
special needs but this goal was later expanded to cover the needs of adults in a patient-centered
medical home. The legislation that mandated these homes was written to include only physicians
and excluded nurse practitioners despite the fact they played an integral part in these homes
(2011, p.36). The issue that will be analyzed in this essay is prescribing authority and how it
affects nurse practitioners.