Nursing is a large health care field that has enlarged its scope of practice over the years. In US history, the presence and influence of APNs was very important. The role of Nurse Practitioners has steadily expanded. First, was a horizontal movement to embrace expertise in medicine. Second, the scope moved vertically to encompass graduate nursing education. Since 1996 there has been a rapid, transformative evolution of the position APNs hold. Today APN Regulation includes specific elements i. e. licensure, accreditation, certification and education (LACE).
Each state independently determines the legal scope of practice, as well as the recognized roles of APNs and the regulation of entry level nursing programs. In the state, where I live, on September 21, 2002, the Illinois Society for Advanced Practice Nursing (ISAPN) was created to write the rules for administration of the Nursing and Advanced Practice Nursing Act. This Act is updated every seven years. The ISAPN board of Directors includes nineteen members who are advanced practice nurses.
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The President, vice president, secretary, treasurer, chairs, and representatives have 3 year terms.
They can be reappointed for one more year after that. They represent the interests of APNs in Illinois and meet at least every two months. In addition to these meetings, there are regional meetings every quarter. These meetings are open to the public and provide a way to give educational information on health issues to citizens. During these meetings, updates on policy and practice issues that affect APNs in Illinois are presented. On October 5th, 2007 Advanced Practice Nursing Act was updated. Licensed practical nurses, registered nurses, and advanced practice nurses worked together on topics and rules i. e.
education, licensing violations/discipline, continued competency, scope of practice, and structure of the nursing boards. They are monitored by ISAPN. APNs practice under directives of the Advanced Practice Nursing Act. They also practice under their own authority in ways appropriate to their specialty, scope of practice, education, and experience. The Act changed the professional relationship between physicians and nurses by expanding the scope of practice for APNs in hospitals and Ambulatory Surgical Treatment Centers (ASTC). APNs are authorized to practice across the nation and have prescriptive privileges in 49 states.
The Advanced Practice Nursing Act in Illinois allows APNs to prescribe, select, order, administer, store, accept samples of, and dispense over-the-counter medications, legend drugs, medical gases, certain controlled substances, and other preparations, including botanical and herbal remedies (Illinois General Assembly, 2011, 2012). To prescribe and dispense legend drugs and legend controlled substances (Schedule II, III, IIIN, IV, or V Controlled), an Illinois advanced practice nurse needs to have a collaborative agreement with a physician who delegates limited prescriptive authority to the nurse.
In addition to the requirements above some guidelines and limits are applied to prescribe medications. An APN may have one or more collaborating physicians. The physician’s scope of practice determines what services APNs can perform and what medications can be prescribed. Four categories of APNs are recognized in Illinois: certified nurse practitioner, clinical nurse specialist, certified nurse midwife and certified registered nurse anesthetist. I worked as a critical care registered nurse for all of my career years. Currently I’m in Acute Care Nurse Practitioner (ACNP) program.
This will result in career changes, because I see an increase need for ACNPs and want to be a part of that field. The standards of care for the ACNP include Nursing’s Scope & Standards of Practice and Standards for Acute and Critical Care Nursing Practice (American Association of Critical-care nurses (AACN), 2010). Nursing standards of care is foundation for ACNP practice. Education, acute care competencies, research, and evidence-based practice will expand nursing standards of care to ACNP’s practice. I look forward to learn and develop new skills to provide the best care for our clients.