Exploration of Advanced Practice Registered Nurses (APRN) Roles

As you advance from RN to APRN, think about how your role and scope of practice will change. While completing this assignment, consider the Nurse Practice Act and the rules and regulations within your state of AZ. Remember, not all states have adopted the APRN Consensus Model. Refer to the APRN Model Acts. Develop an 875- to 1,050-word paper that addresses the following: Include a minimum of 3 references from past 5 yrs. Cite all references according to current APA guidelines(7th ed). Do not submit PDFs or JPEGs. Your work should be submitted in Microsoft Word. Define full, reduced, and restrictive practice. What is the current scope of practice in Arizona? Define the role of the following APRNs and identify areas of possible overlap in their roles: Nurse practitioners (NPs) Certified nurse midwives (CNMs) Clinical nurse specialists (CNSs) Discuss any salary and reimbursement variances by APRN role. Include information on any salary disparities based on gender, race, or geographic location. Submit to SafeAssign Be sure to use 7th ed APA format and in-text citations. Title page and References should be formatted per APA Grammar and spell check before posting

Student Name

Institutional Affiliation

Course

Instructor

Due Date

Exploration of Advanced Practice Registered Nurses (APRN) Roles

 Full, Reduced, and Restrictive Practice
APRN scope of practice is determined by each state, and the level of practice can be described as full, reduced, or restrictive practice.
Full Practice: States that grant APRNs full practice authority allow them to evaluate patients, diagnose, interpret testing, formulate and implement a treatment plan, and order and prescribe medications independently (Rowe, 2024). APRNs are allowed to perform these functions without physician supervision or collaboration. Full practice states support the APRN Consensus Model in promoting the APRN profession to practice autonomously.

Reduced Practice: This describes a situation where APRNs collaborate with a physician through a formal agreement to prescribe medication or perform certain patient care activities (Rowe, 2024). This arrangement limits an APRN's autonomy since they are obligated to maintain some level of physician oversight.

Restrictive Practice: APRNs in a restrictive practice state operate under direct supervision, delegation, or team management of a physician while providing patient care (Rowe, 2024). They cannot have an independent practice and are heavily regulated regarding diagnosis and prescribing.

Current Scope of Practice in Arizona
Arizona is a full-practice state for APRNs. According to the Arizona code, Nurse Practitioners have prescriptive authority to diagnose and treat without physician supervision or a collaborative agreement. Arizona has adopted some APRN Consensus Model components that allow APRNs to practice their profession autonomously in environments with much-needed health professional gaps in rural and underserved areas (Poghosyan et al., 2022). The Arizona State Board of Nursing regulates the licensure and practice of APRNs to ensure that the practitioners offer needed standards of care as well as education.

Roles of NPs, CNMs, and CNSs
Despite the common educational pathways for Nurse Practitioners, Certified Nurse Midwives, and Clinical Nurse Specialists, the roles and areas of specialization differ. Nevertheless, there exist areas that the roles played by the three overlap.

Nurse Practitioners (NPs): NPs are advanced practice registered nurses who are educationally prepared to provide primary and specialty care to patients throughout the life cycle. They evaluate and diagnose acute and chronic conditions, promote health and wellness, and stress disease prevention (Wheeler et al., 2022). The State of Arizona NPs are autonomous with full practice authority, meaning they can prescribe medications and carry out plans of care with no restrictions. They can be found in many different types of settings, from basic primary care to specialized practices such as cardiology.

Certified Nurse Midwives (CNMs): CNMs primarily deal with women's reproductive health, including their prenatal care, childbirth, and postpartum care. They are prepared for independent management of low-risk pregnancies and deliveries, gynecological care, and primary care throughout a woman's life (Wheeler et al., 2022). In Arizona, CNMs may practice independently, and their role may also be merged with that of NPs in women's health and primary care settings.

Clinical Nurse Specialists: CNSs are advanced practice nurses who focus on clinical experience, for improvement in health care systems, and health outcomes of patients. These nurses are normally specialized in one field, including gerontology, oncology, or critical care. Though CNSs usually take up leadership and consulting responsibilities, they are allowed to deliver direct patient care, particularly in specialized settings, so their roles often overlap with those of NPs in clinical practice (Wheeler et al., 2022).

Nursing Paper & Essays Writing Service

Salary and Reimbursement Differences
Salaries for APRNs are highly variable depending on role, location, and experience. There is even a wage gap based on gender, race, and location regarding the APRN workforce.

Salary Based on Role

Nurse Practitioners (NPs) in Arizona can earn an estimated annual income of about $115,000 (Phillips, 2021). However, some specialties-for example, those working in cardiology or oncology-may receive higher salaries than NPs that work in primary care. On average, CNMs are paid an average salary of approximately $110,000 in Arizona (Phillips, 2021). . Salaries vary depending on various practice settings. For instance, midwives working in a hospital tend to get better remunerations than those practicing their professions in independent birth centers. The salaries for Clinical Nurse Specialists have averages at about $105,000 or slightly below that of NPs and CNMs (Phillips, 2021). CNS in an administrative or leadership position may make higher. Further, NPs and CNMs have their reimbursement rates similar to physician services for the same service. The ability of the APRNs to bill independently opens up greater possibilities in earning more than what could have been attained previously. CNSs, often work in a consultative manner, receiving quite different reimbursement pressures since their work is usually related to health system improvement rather than direct-to-patient billing (Phillips, 2021). .

Salary Disparities Based on Gender and Race: The APRNs' wages also have gender and racial disparities. Across the nation, male APRNs tend to earn about 7% more than their female counterparts. The APRNs of color tend to make less money compared to white people (Phillips, 2021). These probably emanate from the negotiation practices, settings of employment, and accessibility to career opportunities that influence these outcomes.

Geographical Salaries: APRNs salaries in Arizona are primarily based on geographical location. APRNs practicing in major cities such as Phoenix or Tucson are paid more than those practicing in less populated areas (Poghosyan et al., 2022). The rural regions of Arizona have extended APRNs less restrictive practice conditions in hopes of attracting APRNs to their regions. However, there are still noticeable salary differences among APRNs practicing in rural regions compared to urban ones.

References

Kleinpell, R., Myers, C. R., & Schorn, M. N. (2023). Addressing Barriers to APRN Practice: Policy and Regulatory Implications During COVID-19. Journal of nursing regulation, 14(1), 13–20. https://doi.org/10.1016/S2155-8256(23)00064-9 

Phillips, S. J. (2021). 33rd annual APRN legislative update: unprecedented changes to APRN practice authority in unprecedented times. The Nurse Practitioner, 46(1), 27-55. https://journals.lww.com/tnpj/fulltext/2021/01000/33rd_Annual_APRN_Legislative_Update__Unprecedented.6.aspx 

Poghosyan, L., Stein, J. H., Liu, J., Spetz, J., Osakwe, Z. T., & Martsolf, G. (2022). State-level scope of practice regulations for nurse practitioners impact work environments: Six state investigation. Research in nursing & health, 45(5), 516–524. https://doi.org/10.1002/nur.22253 

Rowe, S. J. (2024). Policy Review and Recommendation: Full Practice Authority for Nurse Practitioners in the Southwestern United States. https://soar.usa.edu/scholprojects/160/ 

Wheeler, K. J., Miller, M., Pulcini, J., Gray, D., Ladd, E., & Rayens, M. K. (2022). Advanced Practice Nursing Roles, Regulation, Education, and Practice: A Global Study. Annals of global health, 88(1), 42. https://doi.org/10.5334/aogh.3698