Advanced Practice Nursing Scope of Practice - Essay Example

Scope of Practice in the Health Care Industry The scope of Practice has become a contentious issue in modern health care delivery systems, since the dividing line between medical abilities and legal authority often tend to overlap. This is the result of the dominant attitude of Medical doctors who are unwilling to cede their medical turf to the other health care professionals (HCP). In the present scenario, the patients are the worst affected, since they are caught between the crossfire of public interests/ patient protection and the self interests and lobbying attitude of the doctors for greater medical autonomy.

The present malady also arises from the licensing system and odious licensure laws, which leaves a large gap between the Registered Medical Practitioners and other HCP, in terms of medical autonomy and work ethos. The profession of RMP has evolved in such a way that there is no difficulty in reconciling their clinical abilities with their legal authority. Therefore, there are no legal barriers for doctors to venture into medical areas that lie outside their medical domain, or field of study and training.

There are no legal implications, only their self control and self knowledge may be the restraining factors. But this is not so in the case of other HCP, especially in the nursing profession. Since, on their own, they do not have legal authority to do certain actions relating to the welfare of the patients. They may not interpret patient clinical data or act independently on such data; (Practice Alerts & Guidelines. 2006). Till the recent past, even routine practices could only be performed with the consent of, and under the supervision of attending doctors.

The crux of the issue lies in the fact that they are not in a position to take medical decisions which are outside their legal scope and could only act in patients care and executing medical regimens prescribed by a licensed physician, (Practice Alerts & Guidelines. 2006). It may be argued that just as Doctors referred serious cases to specialists, nurses could be entrusted with the care and treatment of minor ailments, and serious ailments could be referred to registered doctors for treatment.

Doctors feel that their medical school education and professional training could not be undertaken by other HCP, and only, they are best suited to treat patients, irrespective of the severity of the disease the patient is suffering from. The Licensing regime has, by far, been the strongest impediment in the way of reforms in the medical field, since a license alone could justify grant legal authority for practice. The Colorado Legislation in 1998 was a piece of legislation that sought to remedy the prevailing malady in the system.

Under it, Mandatory Licensing and Registration became necessary for practicing health care professionals and the unregistered practitioners were enlisted in a public database bank. This resulted in the alleviation of the turf wars and clearly demarcated the operational areas of the medical profession and other HCP. The most significant aspect was that the lines of Legal authority and professional capabilities were clearly drawn up and nobody could provide medical care outside the scope of their authority, education, training and experience.

The next piece of legislation in this area was Regulated Health Profession Act, Ontario, which sought to maintain public health and service to society as paramount to the subservience of the economic considerations needs of the medical profession. It regulated the profession by defining the scope of the various elements of the profession and divided health care into controlled and authorized acts. Controlled acts could only be provided by highly skilled professionals and all other acts outside controlled could be performed by anybody.

The Ontario Act served basically to regulated the profession and serve as a role model for future legislation.It could be concluded that the implementation of reforms constitutes its real success , since a lot of supervening factors like level of education, delivery system, mode of payment, and procedures also come into play while initiation a reforms program in health care industry. Works CitedPractice Alerts & Guidelines. (2006). OP Office of the Professions. New York State Education Department.

Retrieved May 23, 2007, from http://www.op.nysed.gov/nurse-scope-lpn-rn.htm