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Legal Problems Facing Nurse Practitioners

Legal Problems Facing Nurse Practitioners

Although being a nurse practitioner is a rewarding job, issues and challenges have plagued our profession since its inception. The year 2023 is no exception, with more worries than ever plaguing those in the medical field, including nurse practitioners.

With so much going on in healthcare right now, it may be difficult to determine what the most pressing issues are for nurse practitioners. With the ongoing struggle for full practice authority to concerns about workplace violence, NPs face numerous challenges on a daily basis as providers in a variety of settings. This article, “The 25 Most Important Current Issues Facing Nurse Practitioners in 2023,” will assist you in focusing on what is most pressing in our profession in order to stay on top of what is most important.

(The following are the 25 most pressing issues confronting nurse practitioners in 2023.)

ISSUE #1: Workplace safety
Workplace-related injuries and illnesses have increased in the healthcare industry in recent years. Healthcare workers, including NPs, are suffering from severe, even fatal, illnesses and injuries as a result of the pandemic and insufficient staffing. Shift work, long hours, job-related anxiety, missed breaks, and rushing to complete tasks can all lead to “musculoskeletal and other injuries, infections, changes in mental health, and, in the longer term, cardiovascular, metabolic, and neoplastic diseases,” according to an NIH research review.

ISSUE #2: Insufficient staffing
Inadequate staffing is one of the most pressing current issues confronting nurse practitioners on multiple levels. Nurse practitioners were in high demand even before the pandemic and the widespread resignation in healthcare. The predicted job growth for nurse practitioners through 2030 was 54% in 2020. With NPs resigning early, changing jobs, and leaving the profession due to high stress, the current NP staffing situation is only worsening.

Furthermore, a lack of nurses, techs, aides, and other ancillary personnel increases the burden on nurse practitioners and slows down all aspects of healthcare. Working in an overburdened system puts NPs under more stress.

Despite the fact that working as a nurse practitioner has been ranked as the top healthcare job for 2022, our profession still has many challenges.

Stress is one of the most pressing issues confronting nurse practitioners today, and it has reached a tipping point. NPs working in hospitals and inpatient settings, in particular, are more stressed than those working in ambulatory care (although there is plenty of stress in both environments). Anxiety and pressure from understaffing, overscheduling, workplace violence, patent demands and threats, and administrative expectations can make an NP’s job extremely stressful.

With patients and bosses asking us to do more than we can physically handle in one day, it can be difficult to keep all of our balls in the air. It’s no surprise that nurse practitioners are suffering from burnout and emotional/psychological issues at a higher rate than in previous years.

ISSUE #4: Overbooking
Profit, as we all know, is the bottom line in healthcare. The system cannot function if the organization cannot pay its employees and expenses. Because of these financial considerations, many medical organizations press providers to accept more patients than they can handle and impose timeframes for shorter visits, causing stress for NPs. Furthermore, due to time constraints, nurse practitioners who value the importance of health teaching and wellness assessment are forced to cut this critical component of patient care.

Because back-to-back appointments are the norm, NPs must work longer hours after patient hours to catch up on phone calls, charting, and record reviews.
Legal Problems Facing Nurse Practitioners

ISSUE #5: Occupational Violence
Workplace violence is a very hot topic right now, and it is now front and center in healthcare. Who would have guessed ten years ago that working in a hospital would regularly put healthcare providers in danger? Yes, our brave emergency room and psychiatric staff have long dealt with difficult patients, but workplace violence has now spread to every aspect of healthcare.

Unfortunately, workplace violence is one of the current issues confronting nurse practitioners that has largely gone unnoticed by hospital administration and the general public until recently, when the media began to highlight an increase in this troubling trend.

ISSUE #6: The Need for Self-Care
Fortunately, nurse practitioners are realizing that self-care is the only way to keep our sanity and keep coming to work every day. If we do not take breaks when they are needed, it is unlikely that our employers will. Many nurses are not built to look out for number one, but in order to survive in our current environment, we have all learned (and hopefully are applying) the phrase work-life balance.

This is one of the current issues confronting nurse practitioners, and it is something that some of our seasoned nurses, as well as many others, must work on to ensure their long-term viability.

ISSUE #7: Working long hours
Many hospitals still require staff, including nurse practitioners, to work 12-hour shifts. Furthermore, due to excessive and compressed patient schedules, nurse practitioners in ambulatory settings frequently need to work beyond their 8-hour shift to complete the administrative end of their jobs. Many NPs who are stuck in the rut of outdated hospital schedules and long work hours are feeling the sting as other types of jobs now offer flexible scheduling and work-from-home options.

NPs are increasingly looking for jobs that are less stressful, such as those that do not require long hours.

ISSUE #8: Weekend and holiday coverage
One of the long-standing issues confronting nurse practitioners is the requirement to work on days when the rest of the world is off. Working on weekends, holidays, and on call can be exhausting. Yes, we are aware that a career as a nurse practitioner may entail such a schedule. Even so, after many years of this grind or when our schedule interferes with family priorities, some NPs get tired of it and fantasize about a life in a different profession or job with more regular hours and no need to work on typical days of rest.

ISSUE #9: Job rigidity
Aside from working long hours, weekends, holidays, and on call, the job of an NP can be rigid in other ways. Although working as an NP may provide more flexibility than working as a nurse, many of us still need to punch the clock and be available at all times while on duty.

In contrast to many other non-medical careers where it is acceptable to arrive late, leave early, and think nothing of extending one’s break, nurse practitioners are bound by the organization’s expectations that we be where we are required when we are scheduled. In the middle of a busy day, leaving to get a cup of coffee at Starbucks is unlikely, and calling off has a negative ripple effect on the entire staff, making us feel guilty.

Keeping up with evolving technology is one of the current emerging issues confronting nurse practitioners. Because technological advances in the medical field are unlikely to slow, it is critical that NPs stay up to date on what is new and upcoming in this field. Electronic medical record software is frequently upgraded to newer and better versions. Patient scheduling systems, SMART beds, new and improved patient lifts, GPS patient and equipment tracking, wireless patient monitoring, and vests to monitor and collect physiological data are just a few examples of newer technology in the NP world. In our field, technological education is always ongoing.

ISSUE #11: Physicians’ continued disrespect
The conflict between NPs and physicians has existed since the beginning of nurse practitioners in 1965, when the first nurse practitioner training program was established. Although the situation appears to be much better than in the past, physician resistance persists, with some doctors advocating to keep NPs “in their place” in certain states by restricting and supervising those in our profession.

In general, NPs are proving themselves in the healthcare arena with our exemplary dedication to patients and knowledgeable expertise, gradually gaining the respect of physicians in the process.

ISSUE 12: Patient Expectations
Do patients appear to be more demanding lately than in previous years? One of the more personal current issues confronting nurse practitioners is how to keep patients happy despite the fact that they are more demanding and picky than in the past. Many institutions have made the “patient experience” a priority, with staff receiving incentives and lectures on the subject.

Patients in smaller practices want to have a say in their care, and there is an expectation that their provider will meet their needs. Shorter wait times and unhurried patient-centered care are expected at a time when our practice is being told to move faster with larger patient loads. Balancing two opposing expectations is extremely difficult for those working in the field.

Although NP salaries have increased in recent years, one of the current issues confronting nurse practitioners is compensation. Only half (51%) of NPs polled said they are satisfied with their pay. Nurse practitioners are still in high demand and will be for many years to come, so pay must be competitive to attract NPs.

With an average nurse practitioner salary of $118,040, you can expect the salary to rise due to a shortage of qualified NPs.

ISSUE 14: Wage discrimination based on gender
It is surprising to learn that wage disparities exist between male and female nurse practitioners. This could be because the majority of NPs are women. Although the wage disparity is closing, it is important to note that more men in our profession negotiate their salaries than women, who accept what is offered. With more males becoming NPs, it is hoped that wages for our profession will rise overall, as male workers tend to drive up wages in general.

ISSUE #15: Limited scope of practice authority
Restriction of our practice is one of the current issues confronting nurse practitioners that has persisted since our profession’s inception. We’re making progress, with 29 states and US territories now granted full practice authority. However, NPs are dissatisfied in the remaining states that are still practicing in the dark ages due to these outdated restraints. One of the most significant issues and stumbling blocks in our practice may be having our hands tied.

ISSUE #16: The current medical system is ineffective.
Our healthcare system is currently in crisis. We in the medical profession have all predicted this problem for years, but the pandemic has pushed our broken system to the forefront of one of the most pressing current issues confronting nurse practitioners. The rest of the US is sitting up and taking notice now that ERs have 8-12 hour (or longer) wait times, prescription costs have skyrocketed, and our medical staff is quitting.

Time will tell whether those in charge of our tangled web of healthcare-related systems do anything about this problem. Meanwhile, NPs are scrambling to figure out how to make the system work for their patients and practices.

ISSUE #17: Growing Litigation
According to Law360, not only are there more medical malpractice lawsuits being filed, but the monetary awards are also increasing into the hundreds of millions of dollars. Much of the increase in litigation can be attributed to the pandemic and its aftermath. We can expect more lawsuits as a result of the negative consequences of these unsafe situations as there is increased waiting time in ERs, for appointments, and for surgeries.

We are directly in the line of fire for costly litigation suits as providers. This knowledge only adds to the stress that NPs are under.

ISSUE #18: More geriatric nurse practitioners are needed.
Knowing that there is a growing need for adult-gerontology nurse practitioners may help those deciding which NP specialty to pursue. With the retirement of the baby boomers, this large population of older adults will require medical care. Longevity is increasing in this age group, which means many years of doctor appointments, surgeries, and long-term care needs.

Many people in this age group are determined to spend their golden years at home, necessitating the need for in-home provider services like those provided by home health, mobile medical services, and telemed hospitals.

ISSUE #19: Telemedicine is not going away.
Telemedicine is one of the current issues confronting nurse practitioners, and it has grown in popularity in recent years. Following the telehealth market and techniques has recently become a “must” for providers. The more familiar you are with telehealth, the more marketable you will be in your NP career, as well as a boost to your current practice.

Telehealth is expanding in novel ways faster than most people can keep up with. With overcrowded and understaffed ERs currently causing unheard-of long wait times, telemedicine may be the solution. By offering virtual ER visits, a hospital in Rochester, New York, is attempting to alleviate the burden on the area’s overburdened ERs.

ISSUE #20: Ongoing Updates and In-Service Training
Nurse practitioners must attend in-service and educational sessions on a regular basis to meet the demands of an ever-changing healthcare system. Furthermore, most states require specific training and hours for NPs to practice in accordance with their state’s regulations. Classes on topics such as specific types of medication and Medicare guidelines are frequently required to work as an NP.

Now that Covid has calmed down, the following are some hot topics for continuing education about current issues confronting nurse practitioners:
• Addiction and substance abuse • Opioid prescribing • Medical Marijuana • Health disparities

The American Association of Nurse Practitioners, in collaboration with the American Nurses Association, provides numerous options for NP CEUS to meet state requirements.

ISSUE #21: Need for Bilingual NPs One of the current issues confronting nurse practitioners is the need for bilingual NPs, which is increasing in demand due to record numbers of immigrants and non-US-born people arriving in the US on a daily basis. According to the US Census Bureau, about 8.3% of those in the US speak English “less than very well”. This means that NPs who speak more than one language can help patients who would otherwise miss important information about their condition or risk misinterpretation between the provider and the patient.

NPs who are bilingual in Spanish are in high demand because Spanish is the second most common language in the United States, with over 41 million people speaking it at home.

ISSUE #22: Online education is becoming more popular.
Most people will agree that online education is beneficial. The flexibility provided by online programs can only add to the appeal for prospective NP students.

Some NPs in the field, however, are concerned that certain aspects of this trend will “water down” the hands-on experience gained in a traditional NP program. Will the next generation of nurse practitioners be as well-prepared as those who came before them, as more nurse practitioner programs offer online classes?

We can be confident that NP programs are rigorous and well-planned. Time will tell how new grad nurse practitioners who use online education compare to those who choose the traditional educational model for their training.

ISSUE #23: The Transition to Value-Based Care
Models of value-based health care (VBHC) are being proposed as a solution to improve patient health while lowering overall costs to the patient and medical system.

With the Centers for Medicare and Medicaid Services planning to fully implement value-based care in the United States by 2030, this is one of the most pressing issues confronting nurse practitioners today. The AANP emphasizes that NPs, now more than ever, require education and support to develop new care management strategies in order to effectively embrace value-based care.

ISSUE #24: Disparities in reimbursement
There is currently a gap in the reimbursement system between physicians and nurse practitioners from third-party payers/insurance companies. Nurse practitioners receive only 85% of the physician rate in Medicare reimbursement. There is no logical reason why payment parity should be unequal when NPs provide the same service at appointments as MDs.

Incentives are required for NPs to fill a shortage in primary care, and disparities in reimbursement exacerbate the problem. Furthermore, as more states grant full practice authority, NPs who practice independently deserve to be reimbursed at the same rate as physicians for comparable services.

ISSUE #25: Advocacy role required
All of the current issues confronting nurse practitioners mentioned in this article (along with many others) necessitate NPs’ ongoing and diligent advocacy. Nurse practitioners must continue to broaden their role in order to reach our most vulnerable populations and provide affordable care options. Furthermore, we can advocate for safer working conditions for both our patients and ourselves. The 2018 Massachusetts Nurses Association proposal to establish reasonable nurse-to-patient ratios is an example of what a grassroots effort can do to be a catalyst for positive change in our healthcare system.
The purpose of this assignment is for students to identify potential legal risks providers face in the current health care environment.

1. Please identify and discuss existing or potential areas of legal/litigation risk for a new graduate (support with at least 2 references).

2. Discuss ways the new graduate APRN can avoid these pitfalls.

Needs to be two pages and in APA format.

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