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Learning Objective 1: The learner will be able to discuss the different types of independent nurse practitioner practices and characteristics of nurse practitioners in those practices.
Learning Objective 2: The learner will be able to identify barriers to nurse practitioner independent practice in a practice restricted state and discuss strategies to overcome them.
The role of the Advanced Practice Registered Nurse (APRN) continues to expand and attract support and attention from policy makers and healthcare leaders in the US and worldwide. Many APRNs have successfully started and maintain an independent practice. What are the barriers APRNs face when starting their own practice (financial, legislative, business etc.)? Based on a review of literature and the most current survey data, these issues are discussed and explored. This presentation identifies barriers to practice and characteristics of independent Nurse Practitioners in Florida, a state which has significant ARNP practice restrictions.
Methods:
A survey consisting of 39 items addressing demographics, characteristics, barriers to practice, and business practices of nurse practitioners in independent practice was created and administered electronically to nurse practitioners in Florida.
Results:
The survey identified specific characteristics of nurse practitioners and barriers to practice. The majority of participants were aged 41-60, were MSN prepared, had been an NP for more than five years and were in independent practice less than 10 years. More than half of the respondents had no formal business plan or marketing strategy and had minimal start up costs. The top five barriers identified were inability to sign death certificate, inability to perform involuntary psych patient admission, inability to prescribe controlled substances physician supervision/protocol requirement and payment to a physician for their independent practice protocol.
Conclusion:
Nurse practitioners in Florida are involved in exciting and innovative independent practices but face many barriers to practice. The majority do not employ marketing or business strategies to develop and promote their practices and face significant legislative barriers as well. While previous studies have identified some of the legislative barriers to practice, more data is needed to fully explore all the barriers that my impede nurse practitioners from developing successful independent practices.
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