Should Nursing Practitioners Have the Same Level of Autonomy as Medical Practitioners?

 

Author: Shahid Ullah (MScN AKU) 

Should Nursing Practitioners Have the Same Level of Autonomy as Medical Practitioners?

Transforming contemporary healthcare, advanced nurse practitioners are connecting the divide between nursing and medical practice, altering patient care in unprecedented ways. Registered nurses require the knowledge and ability that is essential to keep independence in their practice, but what is autonomy in nursing? Autonomy in nursing means that you make yourself able to do patient care decisions independently, as per their knowledge and experience take the most suitable action for patient.The debate over nurse practitioner autonomy has started from a long period of time. Advanced nurse practitioners have been planned as an answer to access healthcare. So, the conversation regarding the level of medical independence for  remains restricted. Lockwoodet al. (2022). The professional autonomy of medical practitioners concerns the independence of physicians to make choices grounded in their professional expertise and judgment in the treatment and care of their patients and to act in the best interests of patients and society. (Ruhnke et al., 2000). I strongly agree that advanced nurse practitioners' complete autonomy is necessary for improving healthcare delivery because of their knowledge, extensive training, expertise, and experience, which allow them to deliver high-quality, fairly priced care. To overcome workforce shortages in economies worldwide.

Considering the knowledge, skills, and experience of nurse practitioners (NPs), autonomy is important for attaining full practice authority and effective reimbursement for NP work. Legal requirements that require collaboration with medical practitioners frequently work as a foundation for this autonomy. Research indicates that strong collaborative relationships can enhance patient outcomes, including shorter waiting times, improved prescribing practices,

reduced treatment durations and lower costs (Schadewaldt et al., 2013). Ensuring that nurse practitioners (NPs) have the autonomy to operate fully within their areas of expertise is essential not only for the patients' and healthcare system's effectiveness but also for the well-being and job satisfaction of the NPs themselves. (Schadewaldt et al., 2013).

The healthcare manufacture is consistently affected by workforce shortages in economies worldwide. The exposure of this structural shortage becomes evident when outside influences, such as the COVID-19 pandemic, worsen the deficiency of personnel in clinical settings. The existing patterns in healthcare workforce development around the world, examine theoretical ideas about workforce shortages, and explore policies to tackle them. Nurse practitioners (NPs) are receiving additional education and training to provide similar services. (Neprash et al., 2020). The literature reviewed highlighted the importance of an environment that allows ANPs to practice independently, referred to as 'living it.' This encompasses a feeling of independence, authority over one’s surroundings, comprehension of task control, and self-governance, which ANPs characterize as essential. Lockwood et al. (2022). In light of the COVID-19 pandemic and the public health situation, federal and state authorities in the United States took significant steps to eliminate temporary or permanent barriers to nurse practitioner practice. (O'Reilly-Jacob et al., 2022) Nursing is acknowledged globally as the “backbone” of any health system. (Torrens et al., 2020). The role of advanced nurse practitioners in healthcare, highlighting their potential to provide high-quality, cost-effective care. Recent studies show they can provide care parallel to physicians . (Bulut et al., 2025).

Although findings suggest that while certain areas may experience barriers, the specified temporary lifting of state-level restrictions is inadequate to guarantee that nurse practitioners can fully exercise their scope of practice immediately. (O'Reilly-Jacob et al., 2022) Primarily, the requirement for collaboration with medical practitioners (MPs) is necessary for maintaining high standards of patient care and safety. Critics frequently argue that nurse practitioners may lack the extensive medical education that medical practitioners get, which is vital for effectively handling complex cases and making precise diagnoses. (Schadewaldt et al., 2013). Another issue is the risk of fragmented care and the absence of continuity in patient management. The discussion surrounding the various levels of clinical independence for advanced nurse practitioners is somewhat restricted. Advanced nurse practitioners have conveyed feelings of 'straddling' among the fields of medicine, nursing, and various other allied health professions, which has led to the underutilization of their clinical autonomy in practice. (Lockwood et al., 2022)

The debate over nurse practitioner (NP) autonomy is continually progressing, with an increasing body of evidence confirm their capacity to provide high-quality, cost-effective care that is on par with that of physicians. Research indicates that advanced nurse practitioners (ANPs) are confident of operating independently, which leads to improved patient satisfaction, decreased wait times, and effective management of chronic illnesses. The COVID-19 pandemic has facilitated policy reforms, showcasing the potential advantages of greater NP autonomy. Nevertheless, challenges persist, such as inconsistent regulations and the insufficient utilization of ANP clinical independence. Tackling these issues through policy reforms and the establishment of standardized practice regulations could significantly improve healthcare access and efficiency.