The Impact of State Healthcare Policies on Nursing Roles and Responsibilities

Nursing is a dynamic field that has changed a lot over the years, even just in the last few decades. Opportunities for nurses to specialize and gain more autonomy have grown considerably and are likely to expand even further in the future. Those entering the field now have options and can follow their interests or earn more money by choosing these different paths.

With that said, the healthcare industry is partially regulated at the state level, and not every state has the same policies about nurse responsibilities. Where a nurse lives and works will dictate how much autonomy they have and what their options are. It can even influence the work environment and the hours they can work.

So, how are these diverse policies affecting nurses? And what do they mean for patients in the short and long term? Here’s how state healthcare policies are shaping the American healthcare system.

Modern Nursing Roles in the United States

The word “nurse” usually brings to mind a person in scrubs who helps patients recover in a hospital setting. While these nurses do form the backbone of the nursing profession, the scope of the field is expanding and there are more roles than ever.

Here are some of the most common modern nursing roles in the United States:

Registered Nurse (RN)

An RN is often the stereotypical nurse. These healthcare professionals provide direct patient care in a variety of settings, but most frequently in hospitals. They help patients with daily activities, provide medications that have been prescribed by a doctor, take vital signs, monitor patients’ conditions, and more. RNs also work in clinics, schools, correctional facilities, and other settings where patient care is needed.

Advanced Practice Registered Nurse (APRN)

A nurse who gets additional education through a master’s degree and specializes in some aspect of patient care or a specific population. APRNs can specialize in midwifery (Certified Nurse-Midwife), anesthesia (Certified Registered Nurse Anesthetist), or become a Clinical Nurse Specialist. Some APRNs also become nurse practitioners.

Nurse Practitioner (NP)

A nurse practitioner is an advanced practice registered nurse (APRN) with additional rigorous training in diagnosis and treatment. NPs are typically qualified to provide a wide variety of healthcare services for basic health needs. As the current number of primary care physicians often cannot reasonably meet demand, NPs are stepping in to ensure that everyone has access to quality healthcare and medical advice.

Other Nursing Roles

Lower-level nursing jobs are critical for supporting RNs and APRNs. These professionals, including Licensed Practical Nurses (LPNs) and Certified Nursing Assistants (CNAs), assist with patient care.

Other nursing roles are those that might not involve direct patient care. Nurse researchers, managers, and educators also play an important role in the healthcare field.

The Landscape of State Healthcare Policies

State healthcare policies are designed to protect patients and improve outcomes in the field. While that’s the aim, some of these policies support these goals better than others.

For instance, in many states, nurse practitioners (NPs) do not have full practice authority and must provide care under the supervision of a licensed physician. While this is intended to help ensure that patients are receiving expert care, it reduces the autonomy of highly-trained medical providers and reduces access for patients at a time when demand is growing significantly.

Policies in different states can vary considerably, from the licensing procedures to the scope of practice to the hours that nurses can work. Some states regulate staffing ratios, some require nurses to complete continuing education throughout their careers, and even the educational requirements can be different from state to state.

Now that it is becoming more popular among patients, some states are also instituting policies surrounding telehealth.

How State Policies Influence Nursing

So, how do these policies affect nurses working in the field, or those hoping to enter it? It begins with education. Each state has its own standards for curriculum and clinical training standards. While this might not matter to nursing students, it does affect the role of nurse educators.

Differing licensing and credentialing requirements can also affect nurses. While it is important to have high standards for nurses in the field, stricter requirements can limit the pool of available nurses and affect staffing levels.

On the job, the scope of practice that nurses can have will affect daily work considerably. In states where APRNs have full practice authority, they can essentially act as primary care providers, even prescribing medication. In states where the scope of practice is smaller, NPs can only provide support for doctors and have less autonomy.
In states where staffing ratios and workloads are regulated, it can help to provide a better work environment and better care for patients. However, these ratios can be challenging for healthcare organizations that are struggling with a shortage of qualified nurses who are licensed in the state.

Policies Affect Care and Work Environments

Right now is a great time to become a nurse as the demand for medical professionals is high and there are lots of opportunities. Those who are interested in becoming nurses should consider the policies in the state where they would like to work and consider becoming licensed in another state if they aren’t happy with what they find. Although policies do change over time, the process is slow.

Becoming a nurse is an investment of time and money. Choosing the right nursing role and state where you want to live and practice can take time— don’t make a snap decision about your career. If you choose your path wisely, you will find a fulfilling career that allows you to help others and make a comfortable living.