Due to state legislation, FNP’s in twenty-nine states are unable to practice at the full extent of their education and are restricted to practice with a collaborating physician. The exception to state practice authority restrictions are FNP’s working within the Veterans Administration (VA). The VA allows NP’s unrestricted practice authority regardless of the state of the NP practices in (Bosse et al., 2017). The states with restricted practice placed on FNP’s create barriers to access to high-quality, comprehensive, and cost-effective health care to the residents of those states. Additionally, in areas of vulnerable and underserved individuals, if the collaborating physician leaves the area the FNP is unable to continue to provide healthcare, which leads to loss of access (Dillon & Faye, 2017).
Multiple factors are impacting the increasing demand of primary care practitioners. Due to this increased demand the employment opportunities for FNP’s will greatly increase. According to the Health Resources & Services Administration “without changes to how primary care is delivered, the growth in primary care physicians will not be adequate to meet the demand in 2020” (Health Resources & Services Administration, 2013, para. 4). Subsequently, the demand for FNP’s is expected to grow by 22% by the year 2020 (Nurse Journal, n.d.).
As NP’s fight for full practice authority the opposition by physicians remains. The opinion is that physicians have received extensive training compared to that of an NP and they feel that NP’s cannot provide the same quality of care. Despite the shortage of primary care physicians, physicians are not likely to support expansion of practice authority of NP’s (Donelan, DesRoches, Dittus, & Buerhaus, 2013).
Throughout my years of providing nursing care in diverse areas of practice, I have developed a standard of care in which I approach all patients with and have adopted as my personal nursing philosophy. The philosophy that I have adopted is, treat every patient, family member, and colleague as an individual. Regardless of similarities, no two people or patients are the same. Every person has had a different upbringing, family values and traditions, and deal with circumstances differently. When interacting with others you must take all of these factors into consideration, be kind show compassion and empathy, and treat every person as an individual.