These are systems and structures in the healthcare system that reflect negatively on the service rendered by NPs. Michigan operates the “restricted practice” regulatory structure which is the most limiting of the three; the other two being “full practice“and “reduced practice” practice.
In a restricted practice setting, NPs are not allowed to practice without supervision by another health practitioner such as a doctor or a dentist. They are usually placed in teams and their ability to carry out tasks that they have been certified and licensed to do based on their educational and experiential qualification are hinged on delegation.
Working in an environment as this dampens the NP’s motivation to work and champion progress in the healthcare system, particularly at the primary level. The “full practice” structure has been prescribed as ideal by the National Academy of Medicine as it enables NPs to give more. NPs should be able to take complex decisions concerning the clinical management of patients.
NPs and RNs must join hands in the campaign for the implementation of the full practice structure in all states.