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Limitations of Practice as a Nurse Practitioner in Alabama
Simply put, limitations of practice refer to bars placed to specify the extent of the authority that a professional has to execute certain tasks. The healthcare system benefits from order and hierarchy by ensuring that the different necessary tasks that must be performed are distributed adequately based on the competencies expected of every professional. Different states operate different kinds of practice modalities for nurse practitioners including full, reduced, and restricted practice. In Alabama, the “Reduced Practice” is operational. This means that nurse practitioners have reduced permission to engage in certain activities that they would otherwise have the freedom to do in a full practice setting. This system also requires nurse practitioners to have career-long collaborative agreements with other healthcare providers. This is compulsory for NPs to be allowed to provide patient care at all.
While the ABN approves the NPs aspect of the collaborative practice, the agreement is not functional until the healthcare provider or physician involved has been cleared by the ALBME. They are expected to obtain and fill a Commencement for Collaborative Practice Form and pay a fee of $200 to the ALBME. The nurse practitioner is also expected to submit signed copies of the Quality Assurance Plan, and Standard Protocol: email advancedpractice@abn.alabama.gov. Considering the nature of the practice environment, it becomes necessary for a nurse practitioner to have a clear picture of what their duties are and what they are not licensed to do. Hence, the ABN has provided a form called Scope of Practice Determination Request. NPs can confirm if certain procedures or tasks are within their scope of practice according to state laws.
Full practice is the gold standard for nurse practitioners as prescribed by the National Academy of Medicine and the National Council of State Boards of Nursing. In such a practice environment, NPs will be licensed to evaluate and diagnose patients, request and interpret tests and examinations, initiate and manage treatment plans, and prescribe medications including controlled substances. Such a practice environment will help NPs function at the top of their capabilities and reduce the excessive dependency of the healthcare system on doctors. Prospective NPs should join hands with associations like the AANP to advocate for the implementation of full practice in all states.