Historical Regulations of APN Services in the US

Historical Regulations of APN Services in the US

Historically, the provision of APN services in the US is regulated by the state. As a result, the care provided by FNPs varies from one state to the other. The variation is especially dependent on the levels of knowledge among the nursing practitioners. In some states, FNPs work independently. However, collaborations are evident between FNPs and other nursing practitioners in other states. As such, APN differs sharply between states, especially in Mississippi, where scope and practice are different from other places (Pearson, 2012).

In states where collaboration agreement is an option, the nature of roles, duties, tasks, and prescription varies. For instance, in Mississippi, the role of the FNP is limited to routine lab tests, prescription of physical therapy, and interpretation of diagnostic studies. Such a scenario is not the same in other states like California, where diagnostic studies are left to physicians. In other states, lab tests are the preserve of lab technicians.

The provision of prenatal care and family planning services by FNPs is, however, similar between Mississippi and other states (Pearson, 2012). Similarities are also seen in the provision of, among others, child care, primary healthcare, minor surgeries, and counseling services. The practice and setting of FNPs are also similar between Mississippi and the rest of the US. For example, FNPs practice in almost all healthcare settings in the US. Their services are evident in healthcare departments, hospitals, community clinics, and healthcare centers (Pearson, 2012). Such similarities and differences have remained constant over the years.

The Legitimization Process

In the 1960s, there emerged various forces that saw the introduction of APN roles into the country’s healthcare system. The forces included the need for publicly funded health insurance, shortage of medical personnel, and increased need for primary healthcare services. All these factors motivated nursing practitioners to assume important roles in the healthcare system in Mississippi and other parts of America (Buppert, 2011).

As already indicated, several factors hindered the development of FNP roles in America. For example, APN roles were limited by the knowledge of the personnel. The scope of these roles was especially limited in states with low education levels. The government addressed this issue by putting in place regulations that stipulated the requirements to enter into this profession. In the 1970s, all states embraced legislative initiatives that changed laws on nursing practice. The new developments saw the introduction of FNP programs at the University of Washington. By 1973, more than 65 FNP programs were established in America (Buppert, 2011).

However, there was no single FNP program in Mississippi until the early 1980s. During this time, acts by the federal government required all nurses to be certified using the same standards. Mississippi was forced to introduce FNP programs to comply with the regulations put in place by the American Nurses Association in 1977 (Buppert, 2011).

In the 1980s, APN recorded slow but steady growth in all states. There were more than 133 programs and over 15,000 NPs engaged in this sector (Pearson, 2012). Mississippi was not left behind as it registered an impressive number of NPs in this field. However, the numbers varied from one state to the other, with some registering more than double the NPs in other places. Mississippi made use of federal government funds to support these programs. By the end of the 1980s decade, the state had spent over $100 million to educate more than 24,000 NPs (Buppert, 2011).

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There are several reasons why Mississippi recorded a low number of NPs compared to other states. For example, training programs were largely funded through grants from public health organizations situated in other states. The development of APN in this state saw the introduction of a Master’s program for NPs with a post-graduate certificate. In the early 1990s, NPs could choose between master and post-Masters degree programs. In Mississippi, there was the introduction of the National Organization of Nurse Practitioners during this time. Various publications, especially on FNP curricula, were made (Buppert, 2011).

In the early 2000s, there was an expansive and rapid growth of NPs not only in the US but also in other parts of the world. According to Pearson (2012), the number of NPs in the world rose to over 130,000. Education, accreditation, and certification are important aspects of Advanced Practitioner Registered Nurse (APRN) accreditation in the world.

For one to be accredited as an APN,