Nurse Practitioners and Advanced Directives in Florida – Legal Responsibilities and Practical Approaches

Responding to Sita

Hello Sita,

Thank you for your enlightening post. It’s critical to understand the laws and regulations in your state that govern nurse practitioners’ roles and obligations, especially when it comes to advanced directives (ADs). In Florida, it is clear that nurse practitioners work under the overall supervision of a physician, and the signing of AD paperwork is normally the physician’s domain (Katz et al., 2020). However, if NPs practice autonomously, they may have the right to sign ADs, which is consistent with the trend of governments broadening NP practice privileges.

The example you described demonstrates the vital role that palliative and hospice care may play in improving a patient’s quality of life and minimizing suffering, especially in cases like the one you encountered. These services can give comprehensive assistance, symptom management, and emotional care to individuals suffering from severe or terminal illnesses. It is critical for NPs to approach this topic with sensitivity and empathy, concentrating on teaching the patient and family about available services rather than conveying a sense of therapeutic failure.

Two main recommendations stand out for improving access to palliative and hospice care for vulnerable and marginalized groups. First and foremost, improving NP understanding and training on these services is critical. NPs should be skilled in identifying patients who may benefit from palliative or hospice care and communicating these alternatives effectively. Utilizing community-based resources, such as collaborating with churches to educate communities such as the African-American population, can efficiently spread knowledge and develop trust (Odhiambo et al., 2022). This method acknowledges the impact of cultural influences and community dynamics on healthcare decisions. Second, NPs must improve their communication abilities. Incorporating these suggestions into your practice as an NP can help improve patient outcomes, particularly in vulnerable and underserved groups, and ensure that clients receive treatment consistent with their beliefs and preferences.

References

Katz, P. R., Ryskina, K., Saliba, D., Costa, A., Jung, H.-Y., Wagner, L. M., Unruh, M. A., Smith, B. J., Moser, A., Spetz, J., Feldman, S., & Karuza, J. (2020). Medical Care Delivery in US Nursing Homes: Current and Future Practice. The Gerontologist, 61(4). https://doi.org/10.1093/geront/gnaa141

Odhiambo, L. A., Ezinne Anaba, Stephens, P. C., Cheruvu, V. K., & Zullo, M. D. (2022). Community-Based Approach to Assess Obstructive Respiratory Diseases and Risk in Urban African American Churches. Journal of Immigrant and Minority Health, 25(2), 389–397. https://doi.org/10.1007/s10903-022-01405-w