Should Advance Nurse Practitioners be Allowed to Practice Independently?

 

Author: Hussain Ahmad (MScN AKU)

ShouldAdvanced Nurse Practitioners be Allowed to Practice Independently?

Advanced nurse practitioners play a crucial role in improving the quality of patient care and have significant potential to support healthcare systems worldwide while reducing the overall workload. Research indicates that advanced nurse practitioners positively impact health care through their specialized knowledge, qualifications, and ability to provide holistic care (Kerr & Macaskill, 2020). The International Council of Nurses and other regulatory bodies have officially accepted advanced nurse practitioners, and their role is recognized in more than 50 countries around the globe. They work independently to diagnose and treat the patients, alleviating the workload of physicians, improving cost-effectiveness, and enhancing overall patient satisfaction. Considering the expertise and skills of advanced nurse practitioners, they should practice independently to address the healthcare workforce shortage, enhance patient care, and promote a cost-effective healthcare delivery system.

Advanced Nurse Practitioners (ANPs) are highly qualified professionals with critical thinking, evidence-based knowledge, decision-making skills, and problem-solving abilities (Wakefield et al., 2021). They possess the competencies required for patient care, diagnosis, and treatment of minor ailments and can provide physician-equivalent care in primary care settings. (Barnett et al., 2022). The above evidence suggests that nurses are capable of practicing independently, and their autonomy will lead to more efficient healthcare delivery. Therefore, ANPs should be encouraged to practice independently to improve the healthcare system.

ANPs' independent practice would be beneficial in addressing the healthcare workforce shortage. Pakistan faces a significant shortage of physicians, particularly in rural areas. In Pakistan, the physician-to-patient ratio is 1:1300, which is much lower than the recommended ratio by the World Health Organization (Muhammad et al., 2023). Moreover, this shortage is alarmingly high in rural areas due to the reluctance of physicians to perform their duties in the peripheries. This results in limited access to healthcare facilities, as well as compromising patients' diagnosis and treatment. Nurse practitioners work independently to benefit patients and help reduce physicians' workload, enhancing cost-effectiveness and increasing the overall satisfaction of patients. Nurse practitioners can provide standardized care compared to physicians and accomplish similar or greater outcomes in terms of lowering cost and waiting time and improving patient satisfaction. ANPs can fill this significant gap by providing cost-effective and quality care, along with diagnosis and treatment in primary care settings (Barnett et al.,2022). Allowing APNs to practice independently will enhance patient care, lower costs, and promote health equity while addressing healthcare disparities.

Though there is a lack of recent literature on this topic, some articles still argue that NPs are unable to practice individually due to the limited exploration of clinical skills and knowledge as compared to physicians. Nurse practitioners who practice independently may compromise the quality of care due to their limitations and administrative workload. Some claim that nurse practitioners do not have the same exposure to training and clinical experience as physicians. This difference in training could affect their ability to manage complicated critical situations on their own (Coalition, 2010). Additionally, physicians are considered to be the team leaders of the health care system, and NPs may need the supervision of a physician to ensure that patients receive standardized care. The lack of a standardized curriculum and clinical training for nurse practitioners (NPs) can result in variations in their readiness for independent practice. Recent research shows that advanced nurse practitioners (ANPs) possess critical thinking, decision-making, and evidence-based skills that enable them to provide care comparable to that of physicians. Their ability to practice independently enhances the effectiveness of healthcare without compromising quality. ANPs are trained to manage minor health issues, ensuring efficient patient care even in challenging situations, making them well positioned for independent practice.
Nurse practitioners should be eligible for independent practice because they play a vital role in the healthcare system. We know that nurses are the backbone of the healthcare system. Nurse practitioners have advanced training abilities to diagnose and provide treatment at primary, secondary, and tertiary levels and provide high-quality and cost-effective care to low-income populations. They also reduced the gap or deficiency of health care workers. Discussions about their scope of practice continue, and evidence strongly supports the skills and effectiveness of nurse practitioners. Granting nurse practitioners full practice authority is not merely a policy decision; it is a crucial step toward establishing a more equitable, effective, and sustainable healthcare system.