Discussion reply post. Must use citation

1. To practice as an advanced practice nurse (APN) in the state of Illinois, you must hold a registered nursing license, earn a graduate degree, and acquire a national certification. The APN must earn a post-master certificate or a graduate degree from a graduate program for clinical advanced practice registered nursing specialty that is appropriate for national certification. According to The National Council for State Boards of Nursing, Illinois is a state with a pending nurse compact legislature, but one must hold the RN license (“Illinois Scope of Practice Policy – State Profile”, 2020). This allows an RN that has graduated the advance practice program to apply for a temporary permit to practice while waiting to take the national certification examination. The date of the pending exam will need to be provided to the licensing agency. To apply for the APRN license, the application is located on the Illinois Department of Financial and Professional Regulation (IDPR) website. There is a $125 application fee and submission of official transcripts and copy of the certification. The applicant must apply in writing justifying to the department that there have been no violations to the rules under the act.

The APRN scope of practice includes the ability to assess and diagnosis, order procedures, diagnostic and therapeutic test, interpret laboratory and diagnostic tests, prescribe medication and medical equipment, provide end-of-life and palliative care, educate, council, and be a patient advocate. The state of Illinois is considered a full practice authority and an APRN may be granted privileges without a written collaboration agreement, however this does not include operative surgery. An NP can practice autonomously with a physician supervising periodically. To apply for full practice the APRN will need to submit a request by completing a form indicating that all requirements have been met, including 4,000 practice hours, an active, current, and unrestricted license. In addition to the other stated requirements the APRN must have completed a minimum of 250 hours of training and continuing education and sign a notarized attestation (Illinois Department of Financial and Professional Regulation, 2020). The administrative code can be located under Title 68: Section 1300.465.

The APRN does have the option to have a written collaboration agreement and practice and prescribe under a supervising physician. The written agreement must outline the full practice authority and the NP and physician must meet monthly to discuss all patients that have been prescribed opioids or benzodiazepine. APRN’s also can apply for prescriptive authority that includes schedules III-V controlled substances. Schedule II controlled substances can be prescribed if it has been declared part of the agreement with the supervising physician. To prescribe controlled substances the APN must complete an additional 45 contact hours of graduate pharmacology and complete 5 hours in pharmacology annually. Prescriptions cannot exceed a thirty day supply. APRN’s are considered primary care providers under the state’s policy which also includes maternal and child health.

2.

On September 17,2020 Governor Bruce Rauner signed the Nurse Practice Act making Illinois a full practice state. However in week 1, we outlined the barriers nurse practitioners continue to face and some of the difficulties in applying for full practice authority. Even though there are many options for healthcare in and around Chicago, the ED is still used for primary care needs on many occasions creating long wait times and overcrowding. Nurse practitioners are high in demand in Chicago and the surrounding suburbs with 194 jobs listed on Indeed alone today. Nurse practitioner’s practice at the many walk-in immediate care centers and minute clinics available through Walgreens and CVS in Chicago and the surrounding suburbs. In addition to the immediate care centers, there are many private practice physicians available with nurse practitioners employed to help fill the gap . In Illinois nurse practitioners have tripled since the passed bill and many NP’s have gone into practice independently improving access to care and lower cost of service. With many registered nurses pursuing further education by the year 2025 nurse practitioners will increase 93% since 2013 (“National and Regional Projections of Supply and Demand for Primary Care Practitioners: 2013-2025”, 2016). This is critical to have the ability to provide care to the rapidly growing aging population in Illinois. By 2030 over 20% of our population will be 60 or older It has been shown that a higher percentage of NP’s are entering primary care than physicians acknowledging the shortage of physicians (“Illinois Department of Public Health Disparities Report”, 2017). In 2025 it is projected that we will have a shortage of 5320 primary care physicians in the Midwest (“National and Regional Projections of Supply and Demand for Primary Care Practitioners: 2013-2025”, 2016). When I think about access to care from my home in Chicago, an immediate care center employed by nurse practitioners is a five minute walk and I have 3 hospitals and several other care options within a 10-15 minute drive.

3.

The minority population in Illinois continues to grow and out of the 12.8 million citizens 38% are minorities (“Illinois Department of Public Health Disparities Report”, 2017). It was reported that in Illinois 43 percent of African American children live below the poverty level creating adverse health outcomes (“Illinois Department of Public Health Disparities Report”, 2017). Access to care in high crime, inner city neighborhoods is challenging, and many families need to use public transportation to access quality health care. Historically, minorities have higher incidence of morbidity and mortality and by addressing disparities with effective utilization of nurse practitioners and physician assistant’s regional disparities and access to care can be improved (“National and Regional Projections of Supply and Demand for Primary Care Practitioners: 2013-2025”, 2016). It has been shown that having access to quality trained NP’s lead to fewer emergency room visits and more office based visits and scheduled checkups (E. Peterson, MS, APRN, AOCNP, 2017). Even though Illinois NP’s can practice independently, to receive 100% reimbursement for services they cannot be independent creating further barriers to care (E. Peterson, MS, APRN, AOCNP, 2017). The Chicago Tribune wrote an interesting article in February of 2020 mentioning that Illinois has more than 12,000 nurse practitioners with 400 NP’s practice independently. I could not find a source to verify the article or the numbers, but I found it interesting and will provide the link just for the read. Even though we have come a long way in Illinois we still have quite a way to go when only 400 out of 12,000 nurse practitioners are independent.

References

Illinois Department of Financial and Professional Regulation. (2020). Advanced Practice Registered Nurse. Retrieved from https://www.idfpr.com.profs/Nursing.asp# (Links to an external site.)

llinois Department of Public Health Disparities Report. (2017). Retrieved 5 October 2020, from http://dph.illinois.gov/sites/default/files/public…

Illinois Scope of Practice Policy-State Profile. (2020). Retrieved 5 October 2020, from http://scopeof (Links to an external site.) practicepolicy.org/states/il/#

National and Regional Projections of Supply and Demand for Primary Care Practitioners: 2013-2025. (2016). Retrieved 5 October 2020, from https://bhw.hrsa.gov/sites/default/files/bhw/healt…

Peterson, MS, APRN, AOCNP, M. (2017). Barriers to Practice and the Impact on Health Care: A Nurse Practitioner Focus. Journal of The Advanced Practitioner In Oncology, 8(1). doi: 10.6004/jadpro.2017.8.1.6, L. (2020).

Nurse practitioners have nearly tripled in Illinois, where they can now practice independently. Some even use the title ‘doctor.’ Should you be worried? Chicago Tribune. Retrieved from https://www.chicagotribune.com/business/ct-biz-nur…