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Advanced practice nurses include clinical nurse specialists, nurse practitioners, nurse anesthetists, and nurse-midwives. They have an excellent education as they have gone through rigorous training, including core competencies, and earned Masters and Doctorate degrees besides their licensure. Therefore, advanced practice nurses should be allowed to practice to the fullest of their education as they can ease the burden of the healthcare system by providing quality, cost-effective primary care. Advanced practice nurses face several challenges, including state and federal legislation, lack of physician’s knowledge of their scopes of practice and role, and organizations that employ them. However, there are several strategies that advanced practice nurses can utilize to remove these barriers, such as joining a nursing association, educating physicians, and communicating to organizations about their role and model of care.


Federal policies and state laws have slowed the progress of advanced practice nurses due to regulations that are in place. For example, not all states allow full practice or allow advanced practice nurses to practice to the full extent of their education, which prevents them from providing cost-effective and safe care to the American people. Therefore, not having uniformity in the APNs Consensus Model nationally can cause misunderstanding in other disciplines such as physicians and organizations. In addition, states laws and licensure allow APNs to evaluate, diagnose, treat, prescribe medications, and manage patients. However, removing  barriers can increase the workforce needed to meet the primary care needs of patients and provide highly skilled patient-centered care in the community (Altman et al., 2016).

The lack of physician knowledge of APNs’ scope of practice can create barriers, thereby preventing effective collaboration. The physician not knowing the role of the Advanced Practice Nurse can result in patients not receiving care from these skilled clinicians. Physicians should understand the scope of practice of Advanced Practice Nurses to share duties to manage patient care effectively (Clarin, 2014). When physicians know the role of Advanced Practice Nurses, it can foster more effective collaboration as they share the same goal, which is to improve patient outcomes.

Some organizations, such as hospitals, their policies can slow APN’s progress in providing care, which includes licensing laws, hospital privileging, insurance reimbursement, and prescribing controlled medications (Schirle et al., 2018).  As a result, patients/families can be denied of highly-skilled cost-effective care.

Strategies to Remove Barriers

Advanced Practice Nurses can use some strategies to remove the barriers that have slowed down their progress in providing quality, cost-effective, high-quality primary care to the American people. One approach is to join an organization such as the AANP and ANA, whether at the local or national level, and actively demonstrate our capabilities in providing excellent skilled care. In addition, joining an organization will create a more powerful voice to get the attention of lawmakers and legislators to remove barriers that restrict APNs’ scope of practice in the states.

The second strategy is to educate physicians on APNs’ roles and functions, fostering more effective collaboration. Besides, making APNs Consensus Model standardized in all states will help prevent misunderstandings by physicians and organizations about their roles in managing patients effectively. In addition, a standardized graduate curriculum and uniform education are essential in protecting public safety (Hamric et al., 2014).

Third and last strategy that APRNs can use to overcome barriers to practice. APRNs will have to communicate with organizations about their functions and roles to understand better what they do. Besides, to prove that they are responsible and capable of providing highly skilled care for patients by demonstrating competencies. In addition, to prove to organizations that they can provide highly skilled cost-effective care that improves patient outcomes. APRN’s practice includes more than just seeing patients and recognizing problems. Studies have proven that the holistic and patient-centered approach that APN use to provide care improves patient outcomes (Kirkman et al., 2018). Besides increasing accessibility and affordability.

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