Week 6 NR506 NP scope of practice

13 August 2024

Week 6 NR506 NP scope of practice Week 6- Scope of Practice and Patient’s Healthcare Accessibility

I plan to practice as an Advanced Practice Nurse (APN) in the state of Illinois after completing my master’s degree in nursing and obtaining a Family Nurse Practitioner (FNP) certification. The practice of nursing in Illinois is governed by the Illinois Nurse Practice Act, which establishes the standards and guidelines for nursing practice, including those specific to Advanced Practice Nurses. According to the Act, to be eligible for an APN license, a nurse practitioner must graduate from an accredited advanced practice nursing program and provide evidence of completing a curriculum that qualifies them for a specialized license (Illinois Nurse Practice Act, 225 ILCS 65/). Additionally, nurse practitioners must hold an active Registered Nurse (RN) license and pass a background check in Illinois (Illinois Nurse Practice Act, 225 ILCS 65/).

The Illinois Department of Financial and Professional Regulation (IDFPR) is responsible for accrediting APNs in Illinois, issuing licenses, and overseeing their practice. The IDFPR ensures that nurse practitioners meet the necessary competency standards to deliver quality healthcare and holds them accountable for their professional conduct (Illinois Department of Financial and Professional Regulation, n.d.). In Illinois, continuing education is mandatory for nurse practitioners, requiring them to complete 80 hours of continuing education (CE) every two years (Illinois Nurse Practice Act, 225 ILCS 65/). The advanced nurse training curriculum in Illinois includes health assessment, pathophysiology, advanced pharmacology, health promotion, disease prevention, and population-based treatment (American Association of Nurse Practitioners [AANP], 2018).

Upon completing 4,000 hours of clinical practice and 250 hours of continuing education or training, nurse practitioners in Illinois are authorized to independently prescribe medications, including Schedule III-V controlled substances (Illinois Nurse Practice Act, 225 ILCS 65/). However, nurse practitioners must consult with a physician before prescribing benzodiazepines or Schedule II narcotic drugs and are limited to prescribing a 30-day supply of controlled substances (AANP, 2018). Illinois is classified as a reduced-practice state, meaning nurse practitioners must work under the supervision of a physician, which limits their ability to practice independently (AANP, 2018).

The Illinois Nurse Practice Act allows for advanced practice nurses to gain full practice authority without a written collaborative agreement or physician supervision after completing at least 250 hours of continuing education and 4,000 hours of clinical practice post-certification (Illinois Nurse Practice Act, 225 ILCS 65/). This full practice authority enhances their ability to provide comprehensive primary care to patients, including assessments, diagnosis, treatment, patient education, and the ordering and interpretation of diagnostic tests and procedures (AANP, 2018).

During the COVID-19 pandemic, the demand for primary care providers increased significantly, and the full practice authority for APNs provided a critical relief in managing the healthcare needs of the population. Illinois faced numerous challenges during the pandemic, particularly in urban areas with high COVID-19 case numbers. The autonomy granted to nurse practitioners allowed them to reach a larger number of patients without experiencing burnout, and the adoption of telemedicine further extended their reach to rural and underserved areas (Diegel-Vacek, Cotler, Reising, & Corbridge, 2021).

However, the restrictions on practice autonomy for nurse practitioners in Illinois have been a barrier to addressing healthcare disparities, especially in high-poverty regions. Research indicates that states with restrictive practice environments for nurse practitioners experience higher healthcare inequities, greater chronic disease burdens, primary care shortages, higher medical costs, and lower national health rankings (Issues at a Glance: Full Practice Authority, 2021). Studies have shown that nurse practitioners' care results in fewer unnecessary hospital readmissions, reduced avoidable hospitalizations, higher patient satisfaction, and fewer unnecessary emergency room visits compared to care provided by physicians (Diegel-Vacek et al., 2021).

Given these challenges and the evolving healthcare landscape, many nurse practitioners consider relocating to states with full practice authority to improve career prospects and expand their scope of practice. However, Illinois is my home, and I intend to continue practicing here after graduation. Despite the limitations imposed by the current regulations, I am committed to advocating for better practice conditions that enable nurse practitioners to provide the highest quality care to their patients. The Illinois Nurse Practice Act provides a pathway for APNs to achieve full practice authority, and by raising awareness and advocating for policy changes, we can work towards a more supportive practice environment for nurse practitioners in Illinois.

Nurse practitioners are increasingly filling roles traditionally held by physicians. For example, in November 2020, Edward-Elmhurst Health in Chicago’s western suburbs laid off approximately 15 urgent care doctors and replaced them with nurse practitioners (Schencker, 2020). This shift underscores the growing recognition of the value and capabilities of nurse practitioners in providing high-quality, cost-effective care.

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