Nurse Autonomy in Practice - Special Academic Support

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Introduction

Nurses are on the front lines of patient care, and as such, they are uniquely positioned to provide high-quality, individualized care. However, nurses are often constrained by institutional policies and procedures that limit their autonomy in practice. This can lead to frustration and dissatisfaction with the nursing profession. Allowing nurses greater independence in their routine can improve patient outcomes and satisfaction and nurses job satisfaction and retention. When nurses are permitted to make decisions about their patients care, they can better provide care tailored to the individual. This can lead to better patient health outcomes and a more positive experience for patients and nurses.

Nursing Issue

The current nursing issue that is being debated and is of interest to me is the role of nurses in the healthcare system. There is a lot of discussion about whether nurses should be allowed to practice independently or if they should work under the supervision of a physician. This entails the scope of practice for nurses and whether they should be able to provide primary care independently or if they should only be able to provide care as part of a team. The issue at hand is: Should nurses be allowed to practice independently, or should they be required to work under the supervision of a physician? I support this part of the argument, because of several valid reasons. I will begin by addressing the causes behind allowing nurses to work without physician supervision.

Reasons Nurses Should be Allowed Independence in Practice.

Nurses are well Trained

Nurses are highly trained and educated professionals who can provide quality care without physician supervision. They can often provide care equal to or even better care than a physicians. Nurses receive comprehensive training in all aspects of patient care and are well-equipped to provide care independently (Buppert, 2020). Nurses are also required to complete continuing education courses to keep up with the latest advances in healthcare.

Nurses are the closest clinicians to Patients

Moreover, Nurses are typically the first point of contact for patients and their families, and they play a vital role in providing guidance and support. Nurses can help patients and their families navigate the healthcare system and provide emotional support when needed. Nurses are typically more readily available to patients than physicians and can provide timely care when needed. They are excellent communicators and can often build a strong rapport with patients and their families. This would benefit many patients, as they always require such close attention that it is challenging for physicians to offer. Nurses often have more flexible schedules than physicians and can often see patients on short notice. Thus, they can reach more patients if allowed to work independently (Buppert, 2020). Nurses are typically more cost-effective than physicians and can help reduce healthcare costs. Nurses can provide care equal to or even better than a physicians, but they usually charge lower rates. Many patients lie under the average, low wages, or poor categories and cannot meet expensive medical costs. Nurses can provide high-quality care to these patients at affordable prices.

Nurses are Strategically Placed in Healthcare

Another reason to allow nurse autonomy is that they are often the frontline care providers uniquely positioned to identify and address health concerns early on. Nurses are typically the first point of contact for patients entering a healthcare facility. This allows them to assess the patients condition and identify potential problems. They also have a deep understanding of the healthcare system and how it works, which helps them to navigate it effectively and efficiently. Nurses have a wealth of knowledge about the various components of the healthcare system and how they work together. This knowledge allows them to coordinate care for their patients effectively. Nurses deeply understand the nursing process and can identify problems and provide solutions. This will enable them to provide individualized care for each patients needs (Buppert, 2020). Thus, nurses can provide quality care without a physicians supervision.

Laws Support Nurse Autonomy

Furthermore, there are a few laws that support the independence of nurses in practice. The American Nurses Associations Code of Ethics for Nurses states that nurses have a professional obligation to act autonomously in providing nursing care and have the right to practice independently in making clinical judgments. The Nurse Practice Act in each state also outlines the scope of practice for nurses and establishes that nurses are independent practitioners (Buppert, 2020). Therefore, even the law supports the independence of nurse practice, contributing to the argument that they should be given a chance to advance healthcare.

Reasons Nurses Work Under the Supervision of a Physician

Physicians have better expertise than Nurses

Physicians are the experts in medicine and have the most knowledge about disease and treatment. This allows them to provide care that is more comprehensive and effective. Physicians receive a more detailed analysis of the human body and conditions and are more acquainted with patients needs. Nurses might not have some of the information physicians have, increasing the demand for physician supervision (Kraus & DuBois, 2017). However, Nurses take advanced courses to improve their knowledge in particular fields, making them suitable as physicians. In such cases, Nurses should be allowed to practice independently.

Physicians offer Higher Levels of Care

Physicians can provide a higher level of care than nurses. This is because they have more training and experience and can use more sophisticated medical equipment. They can also order and interpret diagnostic tests, prescribe medications, and perform complicated procedures like surgeries where required (Kraus & DuBois, 2017). These are some activities that nurses cannot accomplish alone, requiring a physicians assistance or presence to ensure they perform them correctly.

Nurse Supervision ensures safe and effective care

Nurses do not have the same level of knowledge and experience as physicians. Nurses are not trained to diagnose and treat medical conditions. They rely on physicians to provide this supervision so that they can ensure that they are providing safe and effective care. For example, a nurse may administer a medication to a patient prescribed by a physician (Kraus & DuBois, 2017). However, the nurse cannot change the dosage or frequency of the drug without the physicians approval.

Physicians Ensure Nurses Follow Correct Orders

Nurses need the supervision of physicians to ensure that they are providing care following the physicians plan of care. This includes following the physicians orders and carrying out the plan of care that the physician has created. For instance, nurses require supervision for critical procedures like inserting central venous catheters, initiating total parenteral nutrition and mechanical ventilation, and administering general anesthesia (Kraus & DuBois, 2017). These activities can worsen a patients health or even lead to death if wriggly done. This increases the petition for the requirement of nurse supervision in clinical situations.

Ensures Nurses work within their Scope of Practice and the Law

Nurses need the supervision of physicians to ensure that they are providing care per their scope of practice. This means that nurses must practice within the state Board of Nursing guidelines. These guidelines include the scope of practice for nurses, the standards of care, and the code of ethics. Nurses must practice within the guidelines set forth by the state in which they are licensed. For example, some states allow nurses to prescribe medication while others do not. If a nurse were to prescribe medication without a physicians supervision, they would practice outside their scope of practice and could be subject to disciplinary action. Nurses are not licensed to practice medicine, so they must work under the supervision of physicians or anything related to a medical diagnosis (Kraus & DuBois, 2017). This helps ensure that nurses are providing care under the law, preventing potential patient harm.

Conclusion

I think that the role of nurses in health care is underestimated, and more can be accomplished if nurses can have their independence in qualified areas. The decision of how much autonomy to allow nurses in their practice is up to the individual or organization. However, nurses can influence the law and policymakers to allow them more autonomy in practice, as it poses more benefits to overall health outcomes, to individual patients, and the community at large. There are possibilities of medication errors by Nurses when not under physician supervision, but this problem has been widely covered by nurses taking more studies to advance in specific areas. For instance, advanced practice Registered nurses have the knowledge needed to function as a physician in the areas of specialization.

Recommendations for Public Policy

Some recommendations regarding this issue include the following:

Allow nurses autonomy by removing restrictions on their scope of practice.
Encourage nurses to pursue advanced training and education to provide their patients with the best care.
Advocate for changes in state and federal laws to allow nurses to practice to the full extent of their training and education.
Support initiatives that give nurses more control over their practice environment, including decisions about staffing levels and patient care protocols.
Encourage hospitals and other healthcare organizations to create work environments that allow nurses to thrive and provide high-quality care.

References

Buppert, C. (2020). Nurse practitioners business practice and legal guide. Jones & Bartlett Learning. Web.

Kraus, E., & DuBois, J. M. (2017). Knowing your limits: A qualitative study of physician and nurse practitioner perspectives on NP independence in primary care. Journal of general internal medicine, 32(3), 284-290.

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