Barriers of Independent Advanced Practice Nursing in New Jersey

Question One 

Advanced practice nurses, such as nurse midwifes, nurse practitioners, nurse anesthetists, and clinical nurse specialists are not allowed to practice without the supervision of a physician in New Jersey. Even though the APNs mentioned have adequate education and training to exercise primary healthcare without collaborating with an expert physician, they cannot prescribe medication, discharge and admit patients, or diagnose a patient in the mentioned state ( National Academies of Sciences; Engineering; and Medicine, Institute of Medicine, & Committee for Assessing Progress on Implementing the Recommendations of the Institute of Medicine Report The Future of Nursing: Leading Change; Advancing Health, 2016) . State and federal government policies have handicapped APNs to the extent they cannot practice independently, barriers that impede efficient healthcare services provision in New Jersey’s hospitals. Therefore, in New Jersey, APNs are deemed deviant if they practice without being supervised by a physician. 

Question Two 

Various entities on the state and national level remain competitive against APNs, primarily campaigning for the continued prevention of their full involvement in care prevention. The entities reject the notion of fully authorized APNs to practice care vehemently, citing different reasons. For instance, according to the American College of Physicians, according APNs independence to practice on same levels as trained doctors would be detrimental. The above entity emphasizes that if APNs are allowed to practice independent of supervision from physicians, patient care quality will be diluted significantly ( National Academies of Sciences; Engineering; and Medicine, Institute of Medicine, & Committee for Assessing Progress on Implementing the Recommendations of the Institute of Medicine Report The Future of Nursing: Leading Change; Advancing Health, 2016) . The American College of Physicians believes that APNs are not capable of providing patient-centred care that is comprehensive and mandates the presence of a trained medical team. Another entity that undermines APNs ability to provide patient care independently is the American Medical Association (AMA). According to the association, patients can only receive quality care through a team led by a physician. Further, AMA emphasizes that patient care is a function of teamwork, which makes the presence of a physician necessary when the APN is dispensing care as directed. Finally, the Council of Medical Specialty Societies advocates against APNs being allowed to practice patient care independently. According to the entity, even though awarding APNs independence to practice is a good idea, they should be compelled to complete a standard time under the supervision of a physician before being allowed to diagnose and treat patients. 

Question Three 

Advocating for APNs and would require the input of lawmakers at the state and national government level. In New Jersey, key policy makers who could influence allowing APNs to practice independently include the Kevin Drennan, the current Executive Office of Senate Majority and Christine Shipley, the Executive Office Senate Republican ( NJ legislature - Our legislature , n.d.) . Additionally, on the state level, Anthony J. Cimino, Executive Office of the Assembly Majority and Executive Office Mark H. Duffy would help influence formulation of a policy that allows APNs to practice independently. On the national government level, President Joe Biden and Vice President Kamala Harris would ensure Congress enacts a policy that accords APNs power to practice independently. 

Question Four 

On the state and national level, various interest groups would help influence policy formulation favoring independent practice for APNs. For instance, in New Jersey, nurses and physicians would lobby for the change of the current policy that prevents APNs to practice independently ( Louw, Turner, & Wolvaardt, 2018) . Additionally, patients could advocate for APNs to be accorded the authority to practice patient care independently. On the national level, bureaucratic agencies and public officials would be influential in helping the creation of policies that could allow APNs to diagnose and treat patients without the involvement of physicians. Therefore, different stakeholders would help to create policies aimed towards according APNs independence to practice patient care, as discussed. 

Question Five 

Interest groups could advocate for APNs practice independence using several methods. For instance, the above entities could use the lobbying technique to influence the creation of policies that abolish need for APN-physician collaboration for patient care to be dispensed. Lobbying is performed by public officials and involves providing research data, educating relevant policy formulation bodies on the need for APN independence to practice patient care, and drafting bills towards the same ( Louw, Turner, & Wolvaardt, 2018) . Similarly, interest groups could use grassroot mobilization to advocate for the creation of policies that allow APNs to practice care independently. Under the above method, interest groups involve citizens in their campaign aimed towards granting APNs independence to diagnose and treat patients. Finally, interest groups could use litigation to achieve their objectives, through presenting their request in court and requesting for legal intervention. 

References 

Louw, A., Turner, A., & Wolvaardt, L. (2018). A case study of the use of a special interest group to enhance interest in public health among undergraduate health science students.  Public Health Reviews ,  39 (1), 1-12.  https://doi.org/10.1186/s40985-018-0089-4 

National Academies of Sciences; Engineering; and Medicine, Institute of Medicine, & Committee for Assessing Progress on Implementing the Recommendations of the Institute of Medicine Report The Future of Nursing: Leading Change; Advancing Health. (2016). Removing Barriers to Practice and Care. In  Assessing progress on the Institute of Medicine report the future of nursing . National Academies Press. https://www.ncbi.nlm.nih.gov/books/NBK350160/ 

NJ legislature - Our legislature . (n.d.). New Jersey Legislature.  https://www.njleg.state.nj.us/legislativepub/our.asp