Week 1: Barriers to Practice
1.) Identify and describe practice barriers for all four APNs roles in your state and
discuss these barriers on a state and national level. The four roles include the nurse
midwife, nurse anesthetist, nurse practitioner and clinical nurse specialist.
Like RNs, the scope of practice for APRNs varies in each state and specialty. According
to Kumar & Williams (2018), the House Bill 1337/Senate Bill 1594 was passed and
signed and became the law on October 1, 2018, and this allowed for the title of Advanced
Registered Nurse Practitioner (ARNP) to be changed to Advanced Practice Registered
Nurse (APRN) for all four categories of APRNs in Florida, which includes nurse
practitioners (NPs), clinical nurse specialists (CNSs), certified nurse midwives (CNMs),
and certified registered nurse anesthetists (CRNAs). According to Buck (2021), there are
23 states granting full practice authority for APRNs, however, the state of Florida is not
one of them. In the state of Florida, it is required for APRNs to have a collaborative
practice agreement (CPA), which according to Buck (2021) “is a written statement that
defines the joint practice expectations and regulatory requirements of the working
relationship between an APRN and a physician, or another APRN in some jurisdictions”
(p. 27). The CPA is also required for APRNs prescriptive authority (Buck, 2021)
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