Policy Analysis and Influence Strategy

Topics: Health care, Advanced practice nurse, South Carolina Pages: 9 (2630 words) Published: February 9, 2015

Family Nurse Practitioners: The Forefront of Policy Change
Jeanene “Nikki” Bowen
Georgetown University

Family Nurse Practitioners: The Forefront of Policy Change
In 2010 President Obama signed into law The Patient Protection and Affordable Care Act, also known as The Healthcare Reform Act and Obamacare. Healthcare Reform ensures the population that they will be afforded insurance regardless of pre-existing conditions; the insurance will cover sick visits and wellness/preventative services. Due to the additional 32-46 million Americans who now have health care coverage there is a serious shortage of primary health care providers. This creates a critical need to find a resolution for the shortage of primary care providers. Advanced practice registered nurses (APRN), such as family nurse practitioners, can help fill the gap with an increase in scope of practice that allows them to practice to the full extent of their competence and education. Title 40, Chapter 33 of the South Carolina Code of Laws addresses the profession and occupation of nursing and sets forth the Nurse Practice Act. This Act explicitly lays out the role of the APRN. Section 40-33-20 defines the advanced practice registered nurse and declares the advanced practice nursing scope of practice. This law has not been updated in South Carolina since 2005 (South Carolina Legislature, 2013). On December 8th, 2014, Lauren Sausser, a journalist for The Post and Courier (a South Carolina Newspaper), published an article stating that State Representative, Jenny Horne, will introduce legislation this week to make it easier for advanced practice registered nurses to expand and practice independently in rural areas due to the shortage of primary care providers in the state (Sausser, 2014). As mentioned previously, South Carolina State Representative, Jenny Horne, is a political champion for increased scope of practice in South Carolina. Many organizations support the expansion of the scope of practice of the APRN. A few stakeholders in the policy change nationally and in South Carolina include the American Association of Retired People, the South Carolina Board of Nursing, Veterans Affairs, American Association of Nurse Practitioners, the South Carolina One Voice One Plan Action Coalition, The Institute of Medicine, and the Federal Trade Commission. All of the aforementioned organizations support the expansion of the scope of practice for more autonomy for advanced practice registered nurses and to increase the amount of primary care providers in the state of South Carolina. Opposition to the expansion of the scope of practice of APRN’s includes many physicians and the American Medical Association (AMA). The AMA feels that expanding the practice of APRN’s will compromise the quality and safety of care and will not solve the physician shortage problem (Robert Wood Johnson Foundation, 2014). It seems physicians also fear the competition that advanced practice registered nurses will bring to the table. Not only are providers stakeholders in this expansion of the scope of practice for APRN’s, but the patients are stakeholders as well. By the end of 2014 the Health Care Reform Act will contribute more than 800,000 patients to the health care system in South Carolina (South Carolina Coalition for Access to Health Care, 2014). These patients who now have the ability to see a health care provider may not have the access to care they are entitled to. The state of South Carolina has one of the most restricting scopes of practice for advanced nurse practitioners. The state practice and licensure law restricts nurse practitioners from practicing to the full extent of their education. South Carolina requires medical doctor supervision to be within forty- five files of a practicing nurse practitioner in order for them to perform patient care. The Coalition for Access to Health Care reports that no other...
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