Due to the rising cost and complexity of health care, nurse practitioners (NP) are considered to be one of the most in demand professionals in contemporary society. According to the American Association of Nurse Practitioners (AANP), there are more than 205,000 NPs in the United States as of 2014, with an estimated growth to 244,000 by 2025. Nurse practitioners care for patients across the lifespan in a variety of settings and are one of the four recognized advanced practice registered nurse (APRN) roles, which also include Clinical Nurse Specialists, Nurse Anesthetists, and Certified Nurse Midwives. Since nurse practitioners provide high quality and comprehensive patient-centered care in the health care arena, standardized procedures are necessary to ensure that nurse practitioners not only have a clear understanding of their roles but also their responsibilities depending on their specialization and place of employment.

Roles and Specialties of Nurse Practitioners

According to the AANP, nurse practitioners (NPs) are licensed, autonomous clinicians focused on managing people’s health conditions and preventing disease across the lifespan. All nurse practitioners must complete a master’s or doctoral degree program and have advanced clinical training beyond their initial professional registered nurse experience which include comprehensive didactic and clinical preparation coupled with specialized knowledge and clinical competency to practice in primary care, acute care, and long-term health care settings. What sets nurse practitioners apart from other health care professionals are their unique emphasis on holistic healing which focuses on health promotion, disease prevention, and health education and counseling. By providing high-quality care, management, and advocacy, NPs guide patients in making smarter lifestyle choices, which lowers patients’ out-of-pocket expenses and provides innumerable solutions to the primary care shortage facing America today.

Standardized Procedure Requirements for Nurse Practitioners

Since NPs are considered to be vital leaders of the health care team, standardized procedures are required to ensure that they function within their scope of practice to meet the primary health care needs of their patients. According to the Board of Registered Nursing (BRN), standardized procedures are the legal mechanism for NPs to perform functions which would otherwise be considered the practice of medicine. Standardized procedures must be developed collaboratively by nursing, medicine, and administration in the organized health care system where they will be utilized. Since NPs work at various locations such as organized health care systems, acute care clinics, and home health agencies, standardized procedures must be formulated to ensure that the health care system functions competently and correctly.

Because of the nature of the Medical Practice Act and its strict authorization for physicians to diagnose mental and physical conditions, prescribe medications, and use other methods in the treatment of diseases, injuries, deformities, or other physical or mental conditions, standardized procedures are often required if any of these will be performed by a nurse practitioner. According to the BRN, a nurse practitioner may perform standardized procedure functions only under the conditions specified in a health care system’s standardized procedure and must provide the system with satisfactory evidence that the nurse meets its experience, training, and/or educational requirements to perform these functions competently. Since NPs provide services that frequently overlap the practice between nursing and medicine, standardized procedures include guidelines that require the nurse practitioner to seek physician consultation when clinically necessary. Because of this realization, only nurse practitioners that satisfactorily meet the standards delineated by the BRN are allowed to assume responsibility and accountability for the continuity of health care for all individuals seeking inpatient treatment and stabilization.

Conclusion

Although the scope of practice and demand for nurse practitioners are growing, written policies and protocols are still necessary in some states for advanced practice nurses to function safely and competently in the health care arena. As a result of this realization, NPs must understand that standardized procedures are not only necessary in providing uniformity but also consistency in protecting consumers from harm by meeting the mandatory requirements to practice safely in their area of employment according to state and legislative regulations.

Jonathan V. Llamas, DNP (c), BSN, RN-BC, PHN

Jonathan V. Llamas, DNP (c), BSN, RN-BC, PHN, is an ANCC board certified registered nurse and freelance writer from Los Angeles, CA. He received his BSN degree from West Coast University - North Hollywood in 2013 and is currently pursuing his DNP degree at Loma Linda University to become a Psychiatric-Mental Health Nurse Practitioner. In addition to this, he currently functions as an acute psychiatric registered nurse at Kaiser Permanenete - Los Angeles with previous inpatient experience in both the ER and ICU settings.

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