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Bills and Laws that Impact APRNs

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Course Name/Code

Professor’s Name

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Bills and Laws that Impact APRNs

All U.S. states and territories are governed by nursing practice laws contained in the

Nursing Practice Act (NPA). The NPA contains terms and phrases defined for each state board

of nursing to incorporate for enforcement. In this context, nursing practice can be categorized as

full, reduced, and restricted APRN practice. In full practice states, the licensure laws allow NPs

to evaluate patients, initiate and manage treatments, diagnose, order, and interpret diagnostic

tests, and prescribe medications and controlled substances (Boehning & Haddad, 2022). This

means they practice independently without the collaborative agreement of a physician or his

supervision. In reduced practice, nurse practitioners need to have a collaborative agreement with

a physician to offer patient care or limit various elements of their practice. In restricted practices,

state law demands career-long supervision, team management, or delegation by a different health

provider for NP patient care.

QA. States with reduced and restricted practice. What type of practice is legal in Florida?

Reduced: Alabama, Alaska, Arkansas, Illinois, Indiana, Kentucky, Louisiana, Mississippi, New

Jersey, New York, Ohio, Pennsylvania, South Carolina, West Virginia, and Wisconsin.

Restricted: Florida, California, Georgia, Michigan, Missouri, North Carolina, Oklahoma,

Tennessee, Texas, and Virginia.

Therefore, Florida state practice and licensure laws restrict NP license and practice based on the

kind of NP practice thus classifying NPs as primary caregivers (Bushy, 2019).

QB. Discuss why states that have removed barriers to practice have more NPs practicing in

rural areas.

In her interview, Joanne Spetz claimed that approximately 46 million Americans reside in

rural areas (an equivalent of 15% of the U.S. population). Therefore, compared to urban areas,
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individuals in these regions tend to be sicker or older with most experiencing issues like obesity,

smoking, and high blood pressure. Thus, lacking adequate care in rural areas exacerbates these

problems, and thus state licensure laws should minimize NPs' barriers to expanding health care

in rural regions (Spetz, 2024). Also, NPs are well-equipped and reliable to operate in rural

regions, unlike physicians. For instance, most NPs are trained in family and primary care making

them effective in administering rural individuals' complex and chronic healthcare needs.

Accordingly, MacKay et al. (2024) claim that numerous social and economic factors seemingly

reinforce NPs as primary caregivers in rural contexts. Some of these factors include their

education pathways. While most NPs may reside for two or three years to accomplish their

studies, physicians spend up to seven years, suggesting that NPs have more commitment to the

community in managing health needs. Moreover, based on an economic standpoint, the quality

of life and NP's earnings relative to their cost of living are sufficient in rural settings.

QC. Distinguish the differences in practice for government and nongovernment APRNs

(Military and VA).

While nursing practitioners operate collaboratively in the medical setting, Military, and

Veteran Affairs APRN vary from the scope of operation based on government and

nongovernmental terms and laws. For instance, VA NPs offer a variety of health services like

conducting wellness checks and offering mental health counseling. VA granted full practice

authority to NPs, allowing them to act as primary caregivers in government settings. VA forms

approximately 1,234 healthcare facilities within the U.S. and any NPS working under the VA

can choose any number of practice areas under government APRNs laws and terms (Sall et al.,

2019). Unlike VA and military APRNs under the government, nongovernment APRNs

administer health concerns among civilians and may lack the specialized skills to operate as full-
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practice NPS under the VA. While military APRNs have a wide prescriptive authority, VA

APRNs have some limits as required by the VA's national practice standards (Parker et al.,

2019). Finally, based on deployment and operational readiness, military APRNs are trained to

operate within austere contexts, unlike VA APRNs who are primarily needed during

emergencies.
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References

Boehning, A. P., & Haddad, L. M. (2022). Nursing Practice Act. In StatPearls [Internet].

StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK559012/

Bushy, A. (2019). LAWS AND RULES GOVERNING NURSING PRACTICE IN FLORIDA.

https://nursece.com/pdf/2033_V2_Florida_Laws_and_Rules.pdf

MacKay, S. C., Smith, A., Kyle, R. G., & Beattie, M. (2021). What influences nurses' decisions

to work in rural and remote settings?: A systematic review and meta-synthesis of

qualitative research. Rural and Remote Health, 21(1), 1-26.

/doi/abs/10.3316/INFORMIT.755809231307157

Parker, K., Igielnik, R., Barroso, A., & Cilluffo, A. (2019). The American veteran experience

and the post-9/11 generation. Pew Research Center, 419, 4372.

Sall, J., Brenner, L., Millikan Bell, A. M., & Colston, M. J. (2019). Assessment and management

of patients at risk for suicide: synopsis of the 2019 US Department of Veterans Affairs

and US Department of Defense clinical practice guidelines. Annals of Internal

Medicine, 171(5), 343-353. https://doi.org/10.7326/M19-0687

Spetz, J. (2024). A Policy Perspective: How NPs Expand Healthcare Access to Rural Areas.

Healthforce Center at UCSF. https://healthforce.ucsf.edu/blog-article/policy-perspective-

how-nps-expand-healthcare-access-rural-areas#:~:text=Nurse%20practitioners%20(NPs)

%20can%20expand,and%20chronic%20health%20care%20needs.