Assignment 3: Week 9 Practicum Journal
Florida State Practice Agreements
Briefly describe the practice agreements for PMHNPs in your state (Florida).
Florida State has policies in place to govern the scope of practice for PMHNP. The policies indicate that all nurse practitioners (who include) PMHNP must be licensed to practice within the state before practicing as primary care providers. In addition, they must practice under the supervision of a licensed physician pursuant to a written protocol that must be filed with state’s board of nursing. The supervision must be for two years before they can practice to the full extent of their license. The protocol must indicate the method and degree to which the PMHNP would be supervised to include the duties and management areas of both the supervisor and supervisee, as well as the procedures and conditions that would require direct supervision. In addition, the policies note that PMHNP can only prescribe Schedule II-V controlled substance under the supervision of a physician as indicated in the protocol. However, the policies also allow PMHNP with appropriate experiences and/or proper training to acquire a federal waiver that would allow them to dispense buprenorphine-containing substances provided that the supervising physician is trained, certified and permitted to manage and treat opioid use disorder (Florida Board of Nursing, 2016; Scope of Practice Policy, 2019). Assignment 3: Week 9 Practicum Journal
Explain the two physician collaboration issues that you identified.
There are physician collaboration issues that are of concern to nursing personnel. These include the differences in perceptions on the essentials of collaboration as well as autonomous and supervised nursing practice. There is a general perception that both physicians and nurse personnel are professionals who have undergone the required training and should be allowed to independently practice. With this view, it is not surprising that the two professions would have misgivings about the essential nature of supervised collaborative practice. For there to be meaningful collaboration, there is a need for nurses and physicians to be exposed to supervised collaborative practice during training to overcome these barriers, with focus on providing clarity on meaning of collaboration and roles, dispelling concerns, and overcoming professional hurdles (Schadewaldt, 2013).
Explain what you think are the barriers to PMHNPs practicing independently in your state (Florida).
It is undeniable that there are barriers to independent PMHNP practice in Florida State, particularly in the face of requirements that they practice under the supervision of physicians in collaborative agreements. There are two specific barriers that are of concern. Firstly, reduced practice that is brought about by the collaborative agreements and protocols that insist on the presence of an outside health discipline when providing care, and yet PMHNP have the ability to engage in nursing practice elements independently without being regulated. Secondly, restricted practice that is brought about by the team, delegation and supervised management by physicians that determines what the nurse can and cannot do. The two barriers create a situation in which PMHNP are unable to practice to the full extent of their education (Peterson, 2017). Assignment 3: Week 9 Practicum Journal
Outline a plan for how you might address PMHNP practice issues in your state (Florida).
The PMHNP practice issues reported for the State of Florida are best addressed through advocacy with focus on making legislative changes that allow nursing personnel to practice to the full extent of their knowledge and license with minimal supervision. The advocacy would first identify the barriers, drawing attention to their demerits. This would then be followed by proposals on how specific improvements can be made and how contrary concerns would be addressed. Finally, legislation would be drafted and presented to the state legislators to debate and pass to increase the scope of nursing practice (Mason et al., 2016).
References
Florida Board of Nursing (2016). Updated standards for protocols: physicians and ARNPs. Retrieved from https://floridasnursing.gov/standards-for-protocols-physicians-and-arnps/
Mason, D., Gardner, D., Outlaw, F. & O’Grady, E. (2016). Policy & politics in nursing and health care (7th ed.). St. Louis, MO: Elsevier.
Peterson, M. (2017). Barriers to practice and the impact on health care: a nurse practitioner focus. Journal of the Advanced Practitioner in Oncology, 8(1), 74-81.
Schadelwaldt, V., McInnes, E., Hiller, J. & Gardner, A. (2013). Views and experiences of nurse practitioners and medical practitioners with collaborative practice in primary health care – an integrative review. BMC Fam Pract., 14, 132. DOI: 10.1186/1471-2296-14-132
Scope of Practice Policy (2019). Florida scope of practice policy: state profile. Retrieved from http://scopeofpracticepolicy.org/states/fl/ Assignment 3: Week 9 Practicum Journal