Advanced Practice Registered Nurses’ Scope of Practice: Discussion

Subject: Nursing
Pages: 4
Words: 1191
Reading time:
6 min
Study level: Master


Advanced Practice Registered Nurses (APRNs) are healthcare professionals with a large scope of duties defined by such organizations as American Nursing Association and State Boards of Nursing. Nowadays, with a shortage of medical personnel, Advanced Practice Registered Nurses have become the major actors of medical profession in nursing practice due to their unique experience combining practical skills and advanced knowledge. The ability of APRNs to assume responsibilities for healthcare management in emergency situations and prescribe treatment in acute cases places them between doctors and nurses, allowing for greater role in medical settings. This paper hypothesizes that the scope and influence of advanced nursing is constantly growing, making them indispensable specialists in healthcare practice.

Advanced Registered Nurse Roles and Scope of Practice

The role of APRNs is defined by American Nursing Association (ANA), Nursing Scope and Standards of Practice, and the Code of Ethics for Nurses. ANA defines APRN’s role in healthcare settings as “protection, promotion, and optimization of health and abilities; prevention of illness and injury; facilitation of healing; alleviation of suffering through the diagnosis and treatment of human response” (American Nursing Association. Scope of Practice, para. 3) ANA sees APRN’s role as mainly determined by clinical settings and practices but not confined to them. This role is further elaborated in The Nursing Scope and Standards of Practice, that give broader meaning to APRN’s role.

The Nursing Scope and Standards of Practice significantly widen APRN’s scope of work. These standards refer to nurses’ practices as “direct patient care [], school nursing, administration, education, informatics, research, consultation, entrepreneurship, and public policy development” (CNNe, 2021, p. 277). Such definition implies not only clinical expertise, but the development of professional standards and active role in pursuing education and development. Many of these principles are echoed in The Code of Ethics for Nurses where all spheres of nursing practice are reflected.

The Code of Ethics for Nurses defines nurses’ roles in relation to patients, practical work and profession. The Code of Ethics places emphasis on nurses’ professional values such as respect of confidentiality, social justice, and person-centered care in relation to patients (Stievano & Tschudin, 2019). In the professional field, it outlines such characteristics as professional competence, fitness to practice and the ability to learn (Stievano & Tschudin, 2019). In practical work, the accent is made on patient safety, ethical behavior and dialogue. From the above sources, one can conclude that nursing scope of practice is rather broad and includes not only nurse-to-patient interrelations but possibilities for personal growth, education, and research. The fact that APRNs enjoy larger scope of authority than ordinary nurses strengthens their role to include decision-making and personal responsibility for patient outcomes.

APRNs’ practice is regulated by four roles these specialists may embrace. These roles include “certified registered nurse anesthetist (CRNA), certified nurse-midwife (CNM), clinical nurse specialist (CNS), and certified nurse practitioner (CNP)” (Buck, 2021, p.25). These roles are attained through education programmes that are nationally accredited and degree-granting. Moreover, there are six population foci to specialize in when undertaking certification processes. These population areas include “family/individual across the lifespan, adult-gerontology, pediatrics, neonatal, women’s health/gender-related and psych/mental health” (Buck, 2021, p. 24) Graduates who successfully completed these programmes take certification exams at the end of education to be allowed to work as APRNs.

Certification exams include the understanding of a chosen role and a population focus one has chosen to specialize in. The results of the exams are not assessed by nursing boards but by professional organizations of APRNs engaged in practical work. This allows the get objective results and serves to enhance patient safety. In case the exam is passed successfully, the licensure process takes place; individuals are granted the title of independent practitioners and they can start their work.

Influential Nursing Organizations

To advance the scope and influence of nursing, professional nursing organizations were created. In my opinion, three most influential of them are American Nursing Association (ANA), National League for Nursing (NLN) and National Nurses Organizing Committee. American Nursing Association aims to represent the interests of nurses in the USA, elaborating standards of work to provide high-quality patient care and, at the same time, promote nurses’ well-being in the workplace. National League for Nursing aims to promote quality education for nurse leaders and is comprised of healthcare specialists who devote their efforts to educate professional nurses (Fitzpatrick, 2018). National Nurses Organizing Committee is engaged in promoting innovative efforts in nursing field to protect nurses in their workplace.

Most of all I would like to join ANA as it is engaged in elaborating laws and practices that facilitate and regulate nurses’ work in medical settings. ANA’s mission is to “lead the profession to shape the future of nursing and health care” (American Nursing Association). The goals of ANA include creating models for nursing practice and promoting nurses’ leadership roles. These goals fit in very well with my worldview as I believe that regulation in medical setting is necessary to promote patients’ well being and ensure that the staff is competent to do its work.

Moreover, I believe that establishing new codes, such as Code of Ethics and Code of Practice is extremely important to protect nurses, educate them and see to it that they embrace the quality standards accepted in the field. Helping to resolve such problems as inadequate stuffing, floating or incompetence, ANA gives nurses a powerful leverage over their working environment so that they can improve the conditions they work in. Membership in ANA could significantly improve my practice as I would be able to have my say in the law-making and decision-making processes to introduce improvements in the nursing practice field.

Controversial Issue Likely to Affect My Scope of Practice

One of the most controversial issues in nursing practice is that of floating. It is a typical hospital practice used by most medical institutions when there is a lack of nurses at some units due to sickness, unscheduled leaves, or staff shortages (Brown, 2018). Hospitals believe floating to be a good practice since it allows hiring nurses without recruiting and, for some time, exactly needed by medical institutions. However, floating often has a negative effect on nurses’ role and scope of practice by stretching them outside the limits.

Thus, when floated a nurse may be given responsibilities outside her scope of practice which may result in poor care and mistakes. Moreover, a nurse’s role may be changed to whatever role is needed in a new place. Floating matters greatly to advanced registered nurses since usually APRNs have specific qualifications and scope of practice they do not want to change. However, in new units, nurses may be given tasks they have never handled before, resulting in poor patient care.


Advanced Practice Registered Nurses have become indispensable specialists in healthcare setting since their qualifications combine deep academic knowledge with a set of practical skills. APRN’s scope of practice is constantly growing due to their unique position in healthcare. Taking care of patients’ needs, doing research and educational work, APRNs enjoy diversity of tasks most nurses do not have. This, together with high professional level and moral standards, makes this profession highly needed in diverse healthcare settings.


American Nursing Association. Scope of Practice. Web.

Brown, T. (2018). Nurses are talking about: Floating and rapid response duty. In J. M. Paté (Ed.), Understanding the legal risks of nurse leaders: Part 4 (pp. 12-14). AAACN Viewpoint.

Buck, M. (2021). An Update on the Consensus Model for APRN Regulation: More Than a Decade of Progress. Journal of Nursing Regulation, 12(2), 23-33. Web.

CNNe, K. C. R. M. R. (2021). The New Nursing Scope and Standards of Practice. Nephrology Nursing Journal, 48(3), 276-278. Web.

Stievano, A., & Tschudin, V. (2019). The ICN code of ethics for nurses: a time for revision. International nursing review, 66(2), 154-156. Web.

Fitzpatrick, J. J. (2018). Do We Always Measure What Matters in Nursing Education?. Nursing Education Perspectives, 39(6), 334-334.


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