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#2. The advanced practice registered nurse role requires an intensive set of clinical skills, knowledge, and integrative abilities that synthesize nursing knowledge. What does interprofessional collaboration mean to you? Provide examples with your rationale.

“Using team-based, interprofessional approaches that integrate behavioral health, high-performing primary care practices should be able to seamlessly combine the strengths of various disciplines to provide quality primary care at affordable prices” (Dunphy et al., 2022, p. 5). I used to work at a small acute hospital with an extensive rehabilitation program. I have experience dealing with patients with various neuromuscular disorders, including cerebrovascular accidents (CVA). Based on my experience, the critical factors in ensuring a successful multidisciplinary approach to managing stroke patients are early detection and ensuring the interdisciplinary team (IDT) members know about stroke management.

For example, a patient started slurring her speech and immediately noticed facial drooping. With the acronym FAST in mind, I immediately called a rapid response. FAST stands for Facial droop, Arm weakness, Speech difficulty, and Time (to call 911) (AHA, 2023). When I reached the rapid response team (RRT), my charge nurse, including other nurses, immediately swarmed into the room to help me assess for vitals, open up the e-chart, and call the primary care physician. In addition to the RRT, the neurology nurse practitioner of the hospital rushed to the unit as well. The neuro NP evaluated the patient and confirmed that the patient was having an acute stroke. I called 911 to transfer the patient to the nearest comprehensive stroke center.

It is essential to know the patient’s last known well Time for the stroke center’s ED to determine if the patient qualifies for specific treatments to manage the acute CVA event such as TPA. Also, as soon as the patient arrives in the ED, the provider will order a head CT scan to determine the type of stroke they are dealing with and then go from there to determine the next course of action regarding treatment. After which, the patient will undergo maintenance medication such as an anticoagulant will be prescribed. Lastly, rehabilitation with the help of physical, occupational, and speech therapy as well as physical medicine and rehabilitation (PM&R), doctors will be in place to help the patient recover to its optimal function. Interprofessional collaboration requires nurses, nurse practitioners/physician assistants, PT, OT, ST, attending physicians, specialists, PM&R, and case managers to coordinate a patient’s plan of care carefully. “Collaboration in health care can be described as the capability of every health care professional to effectively embrace complementary roles within a team, work cooperatively, share the responsibilities for problem-solving, and make the decisions needed to formulate and carry out plans for patient care” (Busari et al., 2017).


Choice #1: What changes in prescriptive authority have taken place in the United States in the past ten years? What are the implications of limited prescriptive authority for the advanced practice registered nurse (APRN)?

The nurse practitioner profession was created in the mid 60’s of the past century. It’s been more than 60 years since the first class of nurse practitioner graduated in Colorado. The initial rationale for creating the nurse practitioner profession was to remedy the physician shortage in the US and to increase affordable access to primary care, which is still a strong argument for the existence of NPs. A lot has happened in 60 years, nurse practitioners’ scope of practice as we know it today has little to do with what it was back in 1965 (Brennan, 2020). The profession was initially met with corporatism from the medical community and skepticism from consumers. The initial scope of practice was very restrictive and nurse practitioners weren’t permitted to prescribe medication.

However, the need to expand nurse practitioners’ scope of practice was quickly voiced. Shortly after its inception amendments were made to what nurse practitioners can practice. The US is a federal country with local state governments regulating over the medical professions and their respective scope of practice. This means that the nurse practitioner scope of practice didn’t expand uniformly throughout the country. To fulfill their needs, some states were quicker to expand NPs’ scope of practice than others, especially when it came to the prescription authority. In the state of California, nurse practitioners were first granted in 1986. 10 years later, in 1996, Californian NP were granted the authority to prescribe schedule III controlled substances, notably painkiller narcotics. In 2003 schedule II medications were added to NPs prescription authority. In 2012 the rule stating that NPs should be supervised for 6 months prior to receiving their own furnishing number was lifted. In 2023 the bill AB890 allowing NP to practice and prescribe medication without the need for any physician involvement was implemented (California Association for Nurse Practitioners, n.d.).

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