NR 500 Week 7 Assignment: Cultivating Healthful Environments References

NR 500 Week 7 Assignment: Cultivating Healthful Environments References

Halm, M. (2019). The influence of appropriate staffing and healthy work environments on patient and nurse outcomes. American Journal of Critical Care, 28(2), 152-156. https://doi.org/10.4037/ajcc2019938

Raso, R., Fitzpatrick, J. J., & Masick, K. (2020). Clinical nurses’ perceptions of authentic nurse leadership and healthy work environment. JONA: The Journal of Nursing Administration, 50(9), 489-494. DOI: 10.1097/NNA.0000000000000921

Scruth, E. A., Garcia, S., & Buchner, L. (2018). Work-life quality, healthy work environments, and nurse retention. Clinical Nurse Specialist, 32(3), 111-113. DOI: 10.1097/NUR.0000000000000376

Nurse practitioners (NPs) in Alabama have a reduced scope of practice. This means NPs are restricted to at least one practice element and require a career-long formal collaborative agreement with a physician. In Alabama, all collaborative practice agreements between an NP and a physician are approved by the Joint Committee of the Alabama Board of Medical Examiners (ABME) and the Alabama Board of Nursing (Hart et al., 2020). Besides, NPs in Alabama are acknowledged only based on their collaborative relationship with a qualified Alabama physician. NPs also have a restricted prescriptive authority. This means that for NPs to prescribe legend drugs, the drug type, dose, quantity, and number of refills must be authorized in the approved protocol signed by the collaborating physician (Hayes et al., 2023). Moreover, the prescribed medication must be on the list of medicines recommended by the joint committee and adopted by the ABME and the Board of Nursing. NPs must have a Qualified Alabama Controlled Substances Registration Certificate (QACSC) to prescribe Schedules III-V controlled substances.

NPs in Alabama face multiple barriers to independent practice. For instance, if the mandated collaborative relationship is disbanded, the NP ceases being recognized, even with advanced education and national certification. Unfortunately, NPs in Alabama are not issued with licenses. They are only certified and recognized in a collaborative relationship with a physician (Hart et al., 2020). According to the Alabama legislation, the NP-Physician collaboration requires professional oversight and direction as mandated by the rules and regulations of the ABME and the Board of Nursing. Furthermore, the agreement must comprise practice sites, prescription orders, and quality assurance (Mason et al., 2021). However, the collaboration does not necessitate direct, on-site supervision of the activities of the NP by the collaborating physician. The restricted practice in Alabama greatly inhibits the NP role. This is because, without a collaborative relationship, they are just recognized as registered nurses. They cannot practice to their full training and education and cannot carry out roles that nurses in states with full practice conduct independently.

References

Hart, L., Ferguson, R., & Amiri, A. (2020). Full scope of practice for Alabama nurse practitioners: Act now. The Journal for Nurse Practitioners, 16(2), 100-104. https://doi.org/10.1016/j.nurpra.2019.10.016

Hayes, W., Baker, N. R., Benson, P., & O’Keefe, L. C. (2023). The State of Advanced Practice Registered Nursing in Alabama. Journal of Nursing Regulation, 13(4), 44-53. https://doi.org/10.1016/S2155-8256(23)00030-3

Mason, D., Dickson, E., McLemore, M., And Perez, G. (2021) Policy and Politics in Nursing and Healthcare. 8th Edition. Elsevier Publishing. ISBN: 9780323554985