State Practice Agreements

1 State Practice Agreements Every state has established a set of practice agreements for nurse practitioners. These agreements define the scope of practice for these professionals besides the qualifications requirements. Since the regulatory authorities have not developed a multistate license for nurse practitioners, these professionals have to comply with the practice agreements for their respective states. Nurse practitioners are provided with individual state licenses allowing them to offer services in a single state. These licenses provide nurses with a full, restricted, or limited practice mandate. The National Council of the State Board of Nursing has acknowledged the need to change practice regulations for nurse practitioners. Nurses have also made proposals to regulatory bodies to practice in different states without stringent state practice agreements.

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2 Practice Agreements in Texas State In Texas, nurse practitioners are recognized as fully qualified primary care providers.

However, the state has imposed a restricted practice agreement for nurse practitioners (Nurse Practitioner Schools, 2020). Under the restricted practice, these professionals are supervised by a physician. Nurses need to have a formal agreement with the supervising physician. The agreement details practice privileges in line with educational preparation, area of specialization, and nurse experience level. Notably, Texas has not limited the number of supervising physicians for a nurse practitioner (Nurse Practitioner Schools, 2020). Delegation of duties is, however, performed according to Texas law and regulations.

Collaboration Issues The law clarifies that nurse practitioners can only practice within the scope of their educational preparations and experience. The career choice of these professionals is not restricted. Nurse practitioners can participate in interdisciplinary teams. They can also consult with physicians and other nurses on the best care to give their clients. Notably, Nurse practitioners are responsible healthcare professionals. They take part in peer review activities and other professionals' tasks to enhance the quality of patient care.

Barriers to Independent Practice Resistance from physicians and other healthcare professionals is a huge barrier to nurse practitioners' independent practice (Russell-Babin & Wurmser, 2016). The difference in educational preparations between physicians and nurse practitioners has long been a contentious issue (Lane, 2016). The American College of Physicians feels that nurse practitioners are not fully qualified to offer physicians and medical doctors services. The American Medical Association holds similar perceptions. The shortage of nurses also hinders NPs from

3 independent practice. The shortage does not support the expansion of the nurse practitioners’ roles (Lane, 2016).

Resolutions Advocacy and lobbying are the best interventions to eradicate the barriers to the independent practice of nurse practitioners. During advocacy, nurse practitioners' unique educational preparation, experience, and skills need to be emphasized. Policymakers have to be informed of the value nurse practitioners can bring to care experience and patient care outcomes.

Further, physician professional bodies need to be brought on board to ensure resistance to the independent practice of NPs is minimized. Physicians need to be encouraged and informed that nurse practitioners are sufficiently educated and prepared primary caregivers.

Conclusion Although the scope of practice for NPs varies from state to state, these professionals have become an integral element of nursing practice. Some states allow nurses to engage in independent practice, whereas others require them to be supervised by a physician. Physicians should recognize NPs as equal partners to enhance care delivery and minimize the practice conflicts between these parties.

4 References Buppert, C. (2020). Nurse practitioner's business practice and legal guide. Jones & Bartlett Learning.

Nurse Practitioner Schools (2020). Texas nurse practitioners: The fight for full practice authority. https://www.nursepractitionerschools.com/blog/texas-np-practice-authority/ Lane, I. A., (2016). In defense of the nurse practitioner: Removing barriers to practice. createspace Independent Publishing Platform, Russell-Babin, K., & Wurmser, T. (2016). Transforming care through top-of-license practice.

The Journal of Excellence in Nursing Leadership, 47(5), 24-28. http://doi:10.1097/01.NUMA.0000482527.15743.12