The nursing practice continues evolving due to progressive patient care needs and workplace issues. Amid these developments, the role of advanced nursing practitioners continues to be critical in patient care delivery, organizational change, and the evolution of nursing. There is also an urgent need for adequate nurse practitioners and continued support to enable them to provide care according to their education and training. However, many barriers exist in advancing nursing practice affecting nurse practitioners’ roles and hampering other aspects of care. The purpose of this discussion is to explore these barriers and potential solutions.
Barriers to advanced nursing practice include regulation factors, job characteristics, and organizational factors. Savatteri et al. (2021) found that the lack of standard regulations across states affects how nurse practitioners work and influence patient care across states. In some states, the lack of independent practice limits nurse practitioners’ role since they cannot work to the full extent of their training and education. This limitation further affects practitioners’ availability, particularly in rural areas where healthcare access and affordability problems are rampant (Ortiz et al., 2018). The other barrier to advanced nursing practice is inadequate knowledge and skills to work in primary care settings. Savatteri et al. (2021) observed that the availability of opportunities and access to special education for nurse practitioners are still limited. This barrier affects nurse practitioners’ availability and ability to implement their roles competently. The third barrier is the high nursing shortage. Typically, nurse practitioners work to the best of their ability when they are not overwhelmed. The nursing shortage hampers nurse practitioners’ job satisfaction, resulting in nurse turnover.
These barriers require multidimensional interventions due to their multilayered nature. The first practical intervention is to expedite the implementation of full practice authority across states. In full practice authority states, nurse practitioners can work independently to the full extent of their training without physician supervision (Ortiz et al., 2018). Such an intervention would be pivotal in the progress of advanced practice nursing since it will increase the availability of advanced nurse practitioners. The knowledge and training problem can be addressed by increasing opportunities for nurse training and supporting nurse education. The government should invest in robust nurse training programs at the local level to increase access to education. Increased training opportunities can also help to address the nursing shortage problem. Healthcare organizations should further develop robust organization-wide interventions to prevent nurse turnover to avoid the loss of skills associated with nurse turnover.
Patients require timely and adequate healthcare services irrespective of their needs, severity of illnesses, and other factors. However, such care cannot be addressed without effective solutions to barriers to advanced nursing practice. As highlighted in this discussion, barriers are manifold and include practice regulations, education and training problems, and a nursing shortage. These problems affect different states differently due to the difference in regulations, resources, and the number of nurse practitioners and physicians. Therefore, interventions should be state-centered, and support should be diverse according to the specific needs of an area, state, or organization. A commitment from the government and healthcare leaders is crucial to achieving a sustainable solution.
Ortiz, J., Hofler, R., Bushy, A., Lin, Y. L., Khanijahani, A., & Bitney, A. (2018). Impact of nurse practitioner practice regulations on rural population health outcomes. Healthcare (Basel, Switzerland), 6(2), 65. https://doi.org/10.3390/healthcare6020065
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