Common Assignments: Writing in Nursing

1. How do licensure, accreditation, certification, and education (LACE) considerations differ for all four APN clinical roles (CNP, CNM, CRNA, CNS) for these three states: California, Washington, and Illinois? Provide evidence for your response. 2. Discuss what evidence-based strategies should be implemented to achieve continuity between state regulatory boards. Provide evidence for your response. 3. Is independent NP practice allowed in Florida? Discuss your opinion regarding independent NP practice in your state of Florida. Should NPs be allowed to practice independently? Provide evidence for your response. ** NEED REFERENCES** **DOES NOT NEED TO BE IN ANY FORMAT, AS I WILL TURN INTO POWERPOINT**

Running head: NURSING ASSIGNMENT
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Name of the Student:
Name of the University:
Author’s Note:

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Answer 1
The Advanced Practice Registered Nurse (APRN) has four critical roles that include
the Certified Registered Nurses Anesthetist (CRNA), Certified Nurse Midwife (CNM),
Clinical Nurse Specialist (CNS) and Certified Nurse Practitioner (CNP). These roles allow
APN to gain practical experience and give authority to make decisions related to the care of
patients. In case of licensing, accreditation, certification and education, these are regulated by
the State (Wholihan & Tilley, 2016). The states have control of the scope of practice, the
requirement of certification, authority, collaboration with licensed practitioners and
maintenance of the standard of practice. According to all the states, it is required that an
APRN to have a license in the respective stated that can be obtained by completing the
specified requirements such as a degree from an accredited school, background check and
approval of board certification. In California, there is a requirement that the applicants need
to have a current registered nurse license for the state prior to application of APRN license
that involves successful of completing the advanced nursing practice, masters of nursing
degree from an accredited nursing school that is recognized by the state of California (Gavaza
et al., 2017). With respect to Washington, The Nursing Quality Care Assurance Commission
is the regulatory body that is responsible for the management of Washington’s stated
advanced registered Nurse practitioners. As per the board license category of APRN, there
are critical roles of advanced nursing (Doh.wa.gov, 2020). These include CNM, CRNA and
Nurse Practitioner. Among these, Nurse Practitioner is considered as the most critical among
these and CNS are not stated to be licensed in the specified state. Moreover, the state does not
belong to the Nurse license compact. In the case of Illinois, the nurses need to be licensed by
the Illinois Department of Financial and Professional Regulation (IDPR), which recognize the
four roles of APRN. According to the National Council for State Boards of Nursing has listed
it, as a state with pending nurse compact legislature and thus, a nurse needs to hold an initial

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RN licensure in the particular state (Nursinglicensure.org, 2020). The APRN need to earn a
graduate or post-master certification in order to practice in the state and he or she needs to
complete a program that provided a preparation of the advanced practice certification known
as Nurse Practitioner Programs in Illinois. For certification, the nurse has to pursue an
examination-based certification on the Joint Committee on Administrative Rules.
Answer 2
At the time of reviewing the scope of practice for Nurse Practitioners (NP), it is
important to divide it into three defining practice, namely, reduced practice limits of an NP,
Full NP Practice and Restricted practice limits of an NP (Carthon et al., 2016). It can be
stated the six steps of Evidence-based Healthcare Regulation involve the development of
systematic review that can be applied for achieving continuity between stated regulatory
boards. As stated by Parker & Hill (2017), a full practice nurse is stated to be an NP who has
a license and is allowed to diagnose, interpret the diagnostic tests, treat patients and prescribe
privileges that can be regulated by the board of nursing with the oversight of physicians. In
case of reducing the practice, NP has full authority of practice and can work in a
collaborative manner under the supervision of a clinician. The restricted practice is liable for
limiting an NP in a number of full practices because it requires some degree of supervision.
The strategies that can be used for achieving continuity between state regulatory boards are
advanced practice education that helps in assessing and transforming the nursing profession
for meeting the needs of the changing healthcare sector. It involves the use of inter-
professional education, which is an intervention where the board members of the health and
social care professionals interact and collaborates for improving the inter-professional
collaboration (Peterson, 2017). This support others in recognizing the importance of Care vs
Cure. Therefore, it can be stated that education and training, the positive outcome of clinical
practice can be achieved. In this context, the role of NP is reported to be defined by the

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scope-of-practice and the employment agreement is usually not regarded in providing
education and training. The use of the Triple Aim of Healthcare can be used for better care
provision, lowering of healthcare cost and better health outcome.
Answer 3
Independent NP practice is restricted in Florida as NPs are limited in the abilities in
offering care. They might be expected to secure an expensive and collaborative agreement
under the supervision of the physicians for prescribing the basic medications and require the
approval of doctors in order to diagnostic test or taking responsibilities even though they are
well equipped in conducting the task. According to the Florida Association of Nurse
Practitioners (2017), it is pointed out that there is a shortage of Primary Care Physicians
(PCPS) is coupled with the ageing population. This results in limited access to care, the
increase in healthcare cost and reduce the quality of life. Moreover, it can be stated that the
changing restriction with respect to nurse practitioner licensure laws was used for
demonstrating in other states for increasing the access to primary care and reduction in cost.
There is discretion in healthcare insurance that is practiced, as some plans do not cover NP
services; thus, it affects the provision of the care. According to Cabbabe (2016), Florida is
one of the eleven stated in the U.S. that restricts the ability of NPs to practice and thus, many
patients are not aware of the fact that the NPS is expected to maintain supervision agreement
because they never meet a collaborating physician. Over several years, healthcare experts are
concerned about the issue of shortage of physicians. NP can fill this gap thus, advocating the
independent practice of NPs because the physician requires 11 to 12 years to complete
education and training, on the contrary, NPs complete it in six years (Adams & Markowitz,
2018). Therefore, over time, it would be more effective in enhancing the quality of life in
healthcare settings.

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References
Adams, E. K., & Markowitz, S. (2018). Improving efficiency in the health-care system:
Removing anticompetitive barriers for advanced practice registered nurses and
physician assistants. Policy Proposal, 8, 9-13.
Cabbabe, S. (2016). Should Nurse Practitioners Be Allowed to Practice
Independently?. Missouri medicine, 113(6), 436.
Carthon, J. M. B., Wiltse Nicely, K., Altares Sarik, D., & Fairman, J. (2016). Effective
strategies for achieving scope of practice reform in Pennsylvania. Policy, Politics, &
Nursing Practice, 17(2), 99-109.
Doh.wa.gov. (2020). Advanced Registered Nurse Practitioner License Requirements ::
Washington State Department of Health .Retrieved 18 February 2020, from
https://www.doh.wa.gov/LicensesPermitsandCertificates/NursingCommission/
NurseLicensing/AdvancedRegisteredNursePractitioner/LicenseRequirements
Flanp.org. (2017). About Us - Florida Association of Nurse Practitioners. Retrieved 18
February 2020, from https://www.flanp.org/page/About_Us
Gavaza, P., Kim, W., Rogers, T., Fry-Bowers, E., & Mosavin, R. (2017). Knowledge and
Opinions Regarding the Interface between Oral and Overall Health among California
Physicians, Dentists, Pharmacists and Advanced Practice Registered Nurse
Practitioners. Californian Journal of Health Promotion, 15(2), 59-68.
Nursinglicensure.org. (2020). Illinois APN Requirements | Become a Nurse Practitioner in
IL. Retrieved 18 February 2020, from
https://www.nursinglicensure.org/np-state/illinois-nurse-practitioner.html

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Parker, J. M., & Hill, M. N. (2017). A review of advanced practice nursing in the united
states, canada, australia and hong kong special administrative region (SAR),
china. International journal of nursing sciences, 4(2), 196-204.
Peterson, M. E. (2017). Barriers to Practice and the Impact on Health Care: A Nurse
Practitioner Focus. Journal of the advanced practitioner in oncology, 8(1), 74.
Wholihan, D., & Tilley, C. (2016). Fundamental skills and education for the palliative
advanced practice registered nurse. Advanced practice palliative nursing, 13-22.