I enjoyed reading your post as it highlights the fact that the fundamental differences that exist between a CRNP, CNM, and a PA assistance, lies in their scope of practice. A Family nurse practitioner or APRN has a wide variety of specialties which in some cases, is conducive to the patients. Most patients believe that as an APRN, you can prescribe any medication as long as a diagnosis is established. The APRN profession encompasses a wide variety of advanced nursing specialties; hence a wide variety of scope of practices issues is associated with this profession (Citizen Advocacy Center). This is because sometimes patients believe that as a nurse practitioner you can provide any services they need. At my clinical site today we had a patient who came in for a regular pap smear but while checking her vital signs and doing her labs, her blood pressure was so elevated and the urine dipstick indicated a glucose level of greater than 2000. The patient was referred to the ER and she started crying and requesting to know why they could not prescribe her blood pressure medications. The NP is WHNP and can not prescribe medications for blood pressure and diabetes but it was difficult for the patient to understand NRNP 6552: Advanced Nurse Practice in Reproductive Health Care.
The scope of practice for APRNs is also very dynamic as they can acquire new knowledge through education and take on new roles. “The scope of the advanced practices evolves through experience, acquisition of knowledge, evidence-based practices, technology development, and changes in the health care delivery system. Therefore, advanced practice registered nurses may need to practice in new settings, perform new procedures, and develop new skills during their professional careers” (Texas Board of Nursing).
Reference
Citizen Advocacy Center (CAC): Scope of Practice FAQs for Consumers. Advanced Practice Registered Nurse (APRNs). Retrieved from; www.ncsbn.org/APRNS_Scope_of_practice_FAQs_for_Consumers.pdf
Texas Board of Nursing: Practice-APRN scope of practice. Retrieved from; https://bon.texas.gov/practice_scope_of_practice_aprn.asp
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