Expanding scope of practice: inter-professional collaboration or conflict?

Area of Science:

• Healthcare Policy
• Nursing Practice
• Interprofessional Relations

Background:

• The Patient Protection and Affordable Care Act has increased public visibility of interdisciplinary conflicts.
• Scope of Practice (SOP) expansion for advanced practice nurses (APNs) is a key area of contention, with state laws varying significantly.
• Current SOP limitations prevent APNs from practicing to their full potential, leading to unmet patient needs.

Purpose of the Study:

• To analyze the conflict surrounding Scope of Practice (SOP) expansion for advanced practice nurses (APNs).
• To explore the underlying values and professional identities driving physician and nursing perspectives on SOP.
• To propose a mediation strategy for resolving interprofessional conflicts regarding APN practice.

Main Methods:

• Analysis of the Patient Protection and Affordable Care Act's impact on interdisciplinary conflicts.
• Examination of state-specific Scope of Practice (SOP) laws for advanced practice nurses (APNs).
• Comparative analysis of physician and nursing professional values and identities in relation to SOP.

Main Results:

• Physicians' positions are rooted in historical professional dominance and identity.
• Nursing's stance emphasizes trust, professional recognition, and equitable high-quality care.
• Disparities in SOP create barriers to APN service delivery and patient access to care.

Conclusions:

• Resolving Scope of Practice (SOP) conflicts requires addressing the core values of both medicine and nursing.
• Mediation can facilitate dialogue by focusing on shared beliefs and mutual respect between professions.
• Acknowledging and building upon common values is essential for advancing APN practice and improving patient care.