What Can Nurses Do Independently? Expanding the Scope of Practice

Nurses play an essential role in the healthcare system, providing a wide range of services to patients of all ages and medical conditions. They work collaboratively with physicians and other healthcare professionals to provide high-quality care and support to patients. The demand for healthcare services is increasing, and there is a shortage of physicians, leading to an expansion of the scope of practice for nurses. In this article, we will discuss what nurses can do independently, the benefits and challenges of independent nursing practice, and examples of independent nursing practice in healthcare settings.

Scope of Practice for Nurses

The scope of practice for nurses is defined as the range of activities and responsibilities that a nurse is authorized to perform within the legal and ethical guidelines of their profession. Nurses have different levels of nursing practice, including licensed practical nurses (LPN), registered nurses (RN), and advanced practice registered nurses (APRN). Each level has its own educational and licensing requirements and specific roles and responsibilities.

LPNs work under the supervision of RNs and physicians, providing basic nursing care, such as measuring vital signs, administering medications, and assisting with patient hygiene. RNs have more advanced training and can perform a broader range of nursing activities, such as administering treatments, managing patient care plans, and supervising LPNs and nursing assistants. APRNs are highly trained nurses with graduate-level education and advanced clinical experience. They can provide independent care to patients, including prescribing medication, diagnosing and treating illnesses, and ordering and interpreting diagnostic tests.

Nurses work in a variety of healthcare settings, including hospitals, clinics, nursing homes, and home health agencies. They provide care to patients of all ages and medical conditions, from newborns to the elderly. Nurses work in acute care, ambulatory care, home health, and many other areas of nursing practice.

Independent Nursing Practice

Independent nursing practice refers to the ability of nurses to provide care and services independently, without physician oversight. APRNs, such as nurse practitioners, clinical nurse specialists, nurse midwives, and nurse anesthetists, are authorized to practice independently in many states. They can perform a range of activities, including prescribing medication, ordering and interpreting diagnostic tests, and providing primary care services.

Nurse practitioners are APRNs with advanced training in diagnosing and treating illness and disease. They can provide primary care services, such as physical exams, diagnosing and treating illnesses, and prescribing medication. They can also refer patients to specialists and other healthcare professionals as needed.

Clinical nurse specialists are APRNs with expertise in a specific area of nursing practice, such as pediatrics, oncology, or critical care. They can provide direct patient care, educate other healthcare professionals, and lead quality improvement initiatives.

Nurse midwives are APRNs with specialized training in obstetrics and gynecology. They can provide prenatal care, attend childbirth, and provide postpartum care to mothers and babies.

Nurse anesthetists are APRNs with advanced training in administering anesthesia to patients. They can provide anesthesia services independently or in collaboration with anesthesiologists.

To become an APRN, nurses must have a graduate-level education, pass a national certification exam, and obtain a state license. The requirements vary by state, and some states require physician oversight or collaboration.

Benefits and Challenges of Independent Nursing Practice

Independent nursing practice has several benefits, including increased autonomy and flexibility, improved patient outcomes, and expanded access to healthcare services. APRNs can provide high-quality care to patients in underserved areas where there is a shortage of physicians. They can also provide care to patients with chronic conditions who require ongoing management and support.

Independent nursing practice also has some challenges, such as limited resources and support, potential liability issues, and the need for ongoing education and training. APRNs may face challenges in obtaining reimbursement for their services from insurance companies, which can limit their ability to provide care to patients who need it. They may also face legal and ethical issues related to the scope of their practice and their ability to provide certain services independently.

Another challenge of independent nursing practice is the need for ongoing education and training. APRNs must stay current with the latest research and clinical practices to provide high-quality care to their patients. They must also continue to develop their clinical skills and knowledge through continuing education and training programs.

Despite these challenges, independent nursing practice has the potential to enhance the quality of care for patients and improve the efficiency of the healthcare system. By providing independent care to patients, APRNs can reduce the burden on physicians and improve access to healthcare services for patients.

Examples of Independent Nursing Practice

There are many examples of independent nursing practice in healthcare settings. Nurse practitioners, for example, can provide primary care services to patients in a variety of settings, including clinics, hospitals, and nursing homes. They can diagnose and treat common illnesses, prescribe medication, and provide preventive care, such as vaccinations and cancer screenings.

Clinical nurse specialists can provide specialized care to patients with complex medical conditions. For example, a clinical nurse specialist in oncology can provide care to patients with cancer, including chemotherapy administration, symptom management, and emotional support.

Nurse midwives can provide prenatal care, attend childbirth, and provide postpartum care to mothers and babies. They can also provide family planning services and gynecological care to women of all ages.

Nurse anesthetists can provide anesthesia services independently or in collaboration with anesthesiologists. They can provide anesthesia for surgical procedures, pain management, and emergency care.

Conclusion

In conclusion, nurses play a critical role in the healthcare system, providing a wide range of services to patients of all ages and medical conditions. Independent nursing practice, including the practice of APRNs, has the potential to expand access to healthcare services, improve patient outcomes, and address the shortage of physicians in many areas. While independent nursing practice has some challenges, the benefits of this practice model outweigh the challenges. It is essential for healthcare organizations and policymakers to support and expand independent nursing practice to improve the quality and efficiency of the healthcare system.

References:

  1. American Association of Nurse Practitioners. (2021). Nurse Practitioner Fact Sheet. Retrieved from https://www.aanp.org/about/all-about-nps/np-fact-sheet
  2. American Association of Colleges of Nursing. (2021). The Doctor of Nursing Practice (DNP) Degree. Retrieved from https://www.aacnnursing.org/DNP
  3. National Council of State Boards of Nursing. (2021). APRN Consensus Model. Retrieved from https://www.ncsbn.org/consensus.htm
  4. Institute of Medicine. (2011). The Future of Nursing: Leading Change, Advancing Health. Washington, DC: National Academies Press.

Marlene J. Shockley

My name is Marlene J. Shockley, and I am a Registered Nurse (RN). I have always been interested in helping people and Nursing seemed like the perfect career for me. After completing my Nursing Degree, I worked in a variety of settings, including hospitals, clinics, and home health care. I have also had the opportunity to work as a Travelling Nurse, which has allowed me to see different parts of the country and meet new people. No matter where I am working, I enjoy getting to know my patients and their families and helping them through whatever medical challenges they may be facing.