Discussion Prompt • Are NPs able to practice independently in the state? • Based on the practice restrictions in your state, what are one or two identified barriers to NP practice? • Does your state require NPs to have a collaboration or supervisory agreement with a physician? • Does your state require ‘residency’ hours with a physician or NP before the NP can practice independently? How many hours? Do you support having residency hours as a requirement for independent practice?
The Nurse Practice Act in your State for Advanced Practice
The Nurse Practice Act (NPA) is a set of regulations that governs nursing practice. Territorial nursing boards adopt these regulations with the authority to control nursing practice (Lockhart, 2020). The Nursing Practice Act of California sets out the scope of nursing practice in California and defines the responsibilities of a nurse. As per these provisions, nurse practitioners are allowed to practice independently without physician supervision. The move by California’s nursing board to expand the scope of nursing practice to allow them to treat patients independently was targeted at lessening workforce shortages that plagued the state’s healthcare landscape. This move was also aimed at enhancing access to care.
Despite NPs in California having an expanded scope of practice, several barriers exist that limit their practice. Lack of prescriptive authority and lack of public awareness of nursing roles in healthcare are some of the perceived barriers to nursing practice in California (Busca et al., 2021). These barriers are nearly similar to the perceived barriers to nursing practice in other states.
California’s healthcare environment fosters healthy communication between nurses and physicians. Nurses are required to work collaboratively with physicians during care processes. California Board of Registered Nurses, under the nursing scope of practice, outlines the responsibilities of a nurse. Under these provisions, nurses are expected to collaborate with physicians. This creates a groundwork for care-coordinated approaches during the care process.
As per California’s new nursing regulations, NPS with at least 4600 hours of practice can practice independently. This is equivalent to three years of full-time practice. During the residency period, nurses are required to work under close supervision from independent nurse practitioners or physicians.
References
Busca, E., Savatteri, A., Calafato, T. L., Mazzoleni, B., Barisone, M., & Dal Molin, A. (2021). Barriers and facilitators to implementing nurse’s role in primary care settings: An integrative review. BMC Nursing, 20(1). https://doi.org/10.1186/s12912-021-00696-y
Lockhart, L. (2020). Nurse practice acts and the provision of safe, competent care. Nursing Made Incredibly Easy!, 18(3), 56–56. https://doi.org/10.1097/01.nme.0000658204.89628.2a