Nurse’s License as a Way to Solve Problems


As healthcare in the United States evolves, advanced practice registered nurses (APRNs) are beginning to play a critical role in improving patient outcomes. Despite the apparent benefits of advanced care nursing practice, there are significant barriers for APRNs to practice at the fullest extent of their training, experience, and education. These limitations are usually associated with the inconsistency of state regulations connected with licensure, physician-related issues, and payer policies. American Nurses Association (ANA) has elaborated an initiative to address these issues state by state. The present paper offers an overview of the proposed strategy and its implications for advanced care nursing in Florida. The proposed strategy is expected to improve patient outcomes and improve the cost-efficiency of healthcare.

Initiative Overview

APRNs are skilled healthcare workers, whose expertise can improve the affordability of healthcare services in the United States. However, according to Barbarito (2016), these specialists are unable to work to the full extent of their knowledge and training due to the need for operating under the supervision of a physician. The need is usually connected to payer policies since nurses are forced to be in practice as employees of physician practice, hospitals, or other entities (Hain & Fleck, 2014).

Therefore, nurses are often unable to bill for their services directly. Additionally, some states have not adopted full practice authority licensure and practice laws for NPs (Hain & Fleck, 2014). Moreover, some physicians resist the changes in APRN’s scope of practice (Barbarito, 2016). The ANA’s initiative aims at removing the identified barriers by working with local constituent member associations.

The initiative is designed to help remove geographic and practice setting limitations for APRNs by unifying licensure and scope of practice. Hain and Fleck (2014) state that “eliminating variances in state licensure and scope-of-practice and removing barriers to independent practice are necessary elements of providing superior primary care” (para. 18). ANA proposes to have a single-advanced practice registered nurse license that allows APRNs to provide services and bill for them independently (Hain & Fleck, 2014). Additionally, all the regulations are to be updated according to the latest empirical research to ensure the best patient and financial outcomes. In short, the initiative seems to be an adequate way of addressing the identified issues.

Implications for Clinical Practice

The initiative will have a considerable impact on my clinical practice. ANA’s collaborations with the nurses association in Florida resulted in a revision of many laws and rules in the state. These revisions are summarized by Toney-Butler and Martin (2019) and include changes in definitions, licensure, and scope of practice. According to this summary, there has been a breakthrough in the matter, which allows APRNs to perform their duties without the supervision of physicians in some cases (Toney-Butler & Martin, 2019).

Therefore, in my clinical practice, I will be able to assess, diagnose, create treatment plans, prescribe medications, and bill patients without physicians interfering. At the same time, the collaborations need to continue, since the scope of practice is not yet completely unified with other states (Toney-Butler & Martin, 2019). However, the initiative is likely to improve patient outcomes since physicians will have more time to attend to other patients.


APA’s initiative is a laborious endeavor that aims at addressing the barriers that prevent APRNs from providing services to the full extent of their training and education. The identified barriers include physicians’ resistance, payer policies, and licensure. These barriers can be removed by unifying APRN’s scope of practice policies and updating them to adhere to the latest evidence. The strategy is expected to improve cost-efficiency and the quality of care.


Barbarito, A. (2016). Expanding the scope of practice for advanced practice registered nurses: A legislative call to action. Law School Student Scholarship, 712. Web.

Hain, D., & Fleck, L. (2014). Barriers to NP practice that impact healthcare redesign. The Online Journal of Issues in Nursing, 19(2), manuscript 2. Web.

Toney-Butler T.J., & Martin R.L. (2019). Florida nursing laws and rules. Web.