In the state of Florida, the NPA now allows APRN’s to practice independently with a few practice authorities in place. Some of the requirements include a completion of three specific graduate level courses within a timeframe, at least 3,000 clinical hours, and a financial responsibility of liability coverage. The APRN may engage in autonomous practice only in primary care practice of family medicine, pediatrics, or internal medicine. They can admit, manage care, and discharge the patients.
“A collaborative practice agreement is a written statement that defines the joint practice of a physician and an APN in a collaborative and complementary working relationship” (Herman & Ziel, 1999). In my opinion, APRN’s should have a collaborative agreement with a physician. Whether they are new or have been practicing for a long time, coming across a diagnosis or situation they are unfamiliar with may happen. Having the resource of bouncing ideas off of a physician with more education or experience is beneficial for the nurse and the patient.
With a collaborative practice agreement, APRN’s work under a physician but can independently prescribe after the appropriate education, courses, and approval by the Florida board of nursing. If the NP is practicing autonomously, they may prescribe any drug and schedule II-V controlled substances. I agree that APRN’s should be able to prescribe to their ability. The prevalence of nurse practitioners seeing patients is increasing daily, therefore, in order to see the abundance of patients, this is beneficial and necessary. The appropriate education and pharmacology courses prepares them for the job. “The authority of prescription has become a reality amongst nurses in a great number of countries in response to growing demands for healthcare, tight budget constraints and the growth of nursing specialties as a result of the expansion and advancement of their scope of practice” (Ling, et al., 2018).
Treatment of a rash is within the scope of a CNP. The practitioners are trained to perform thorough physical assessments, obtain medical histories, diagnose, and treat accordingly. “A registered nurse who has acquired the expert knowledge base, complex decision-making skills and clinical competencies for expanded practice, the characteristics of which are shaped by the context and/or country in which s/he is credentialed to practice” (Fagerstrom, 2012). It is partly necessary for the CNP to have experience in the appropriate point in the lifespan, however, in a broad spectrum it can be done. This also goes back to the collaboration between the APRN and the physician. If they are unfamiliar with the certain condition, it is a learning opportunity to refer to the physician, develop the appropriate treatment plan for the age, and prescribe the correct medications.
Fagerstrom, L. (2012). The impact of advanced practice nursing in healthcare: recipe for developing countries. Annals of neurosciences. 19(1): 1-2.
Florida Scope of Practice Policy (2020). Practice Authority. Retrieved from: https://scopeofpracticepolicy.org/states/fl/
Herman, J., and Ziel, S.(1999). Collaborative practice agreements for advanced practice nurses: what you should know. AACN Clinical Issues. 10(3): 337-42.
Ling, D.L., Lyu, C.M., Liu, H., Xiao, X., and Yu, H.J. (2018). The necessity and possibility of implementation of nurse prescribing in China: An international perspective. International Journal of Nursing Sciences. 5(1): 72-80.
Locate your state’s nurse practice act (NPA) and associated regulations governing prescribing by advanced practice nurses (CNPs, CRNAs, CNMs, CNSs). Answer and discuss the following in this forum:
- Does your NPA require the APRN to have a collaborative agreement with a physician? Discuss whether you think the NPA should or should not require the APRN to have a collaborative agreement, and explain why/why not.
- Does your NPA require the APRN to have a prescribing agreement with a physician? Discuss whether you think the NPA should or should not require the APRN to have a prescribing agreement, and explain why/why not.
- Does your NPA permit APRNs to prescribe all classes (schedules) of medications? Discuss whether you think the NPA should or should not permit APRNs to prescribe all classes of medications, and explain why/why not.
- Describe collaborative approaches to treating rashes across the lifespan. Should the CNP treat without a collaborator or consultant? Support your statements based upon evidence.
Remember to respond to at least two of your peers. Please see the Course Syllabus for Discussion Participation Requirements and Grading Criteria.