Advanced Practice Nursing Roles
Full Practice Bill 972 This bill introduced to the Florida Senate would allow to expand the scope of practice for advanced practice RNs such as to perform functions or acts within their speciality without a protocol agreement or supervision as currently. If proper requirements are met, advanced practice RNs would be authorized to admit patients, manage care, provide endorsement, and discharge without a physician (The Florida Senate, 2019b). APRN practice autonomy may vary by state, with states typically follow four types of scenarios. There is independent nursing practice, a transitory period of supervision before independent practice, a collaborative nursing practice with physician collaboration, and supervised practice with full supervision (The Florida Senate, 2019a). This bill will impact future practices by providing more autonomy to APRNs but also establishing greater responsibility. It will inherently shift the dynamics of hierarchy, administration, and care provision in the state health system. Collaborative agreements are an element of nursing autonomy which places a requirement for a nursing practice to maintain such agreements with a physician in order to have prescription authority (National Nurse-Led Care Consortium, n.d.).
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Involuntary Admission Involuntary admission also known as civil commitment is a legal intervention where an mentally ill individual is placed into either inpatient care or supervised outpatient treatment. Involuntary admission must be court-ordered or done by someone acting in judicial capacity for the individual. (SAMHSA, 2019). Florida has dedicated civil commitment laws, allowing for both involuntary inpatient treatment and assisted outpatient treatment. Inpatient treatment is used when a court finds clear and convincing evidence of mental illness, making the individual unable to make responsible decisions regarding voluntary treatment and without treatment would be incapable to survive, even with help (Treatment Advocacy Center, 2018). Most states have three forms including emergency hospitalization, inpatient civil commitment, and outpatient civil commitment. States commonly follow a two-fold standards with the patient must either have ‘grave disability’ (physical threat to self through inability to provide basic necessities) or ‘need for treatment’ (notion that without treatment, deterioration of health, psychiatric damage, and loss of ability to function will occur) (Treatment Advocacy Center, 2014). Involuntary admission laws may affect nurse practitioners since nurses have ensure that all protocols are followed during such patient admissions, including court orders and appropriate care is provided to psychiatric patients to ensure their own safety and of others. References National Nurse-Led Care Consortium. (2019). The state of full practice authority in the 2019 legislative session. Web. SAMHSA. (2019). Civil commitment and the mental health care continuum: Historical trends and principles for law and practice. Web. The Florida Senate. (2019a). House of Representatives staff analysis. Web. The Florida Senate. (2019b). SB 972: Innovation in the advanced practice registered nursing workforce. Web. Treatment Advocacy Center. (2014). Mental health commitment laws. A survey of the states. Web.
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Treatment Advocacy Center. (2018). Florida. Web.