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Croasdale (2008) reviews the opinions of various medical professionals regarding the advancement of legislature in 24 states to expand the scope of practice for Advance Practice Nurses.  Not surprisingly, individuals from the medical arena provided open opposition to the legislation, while nursing proponents supported it in full.  Croasdale (2008) outlines the legislature as addressing topics, including independence of practice, physician oversight, and prescriptive authority.  These expansions of practice are said to help address the issues related to primary care provider shortages.  Specific points of opposition by physicians have been aimed at the “limited diagnosing and prescribing skills” by APNs.  There has even been opposition to APN prescription of controlled substances to underserved areas; populations traditionally freely served by Nurse Practitioners.  Cyneetha Strong, MD, president of the Florida Academy of Family Physicians stated, “We need less narcotics out in the field, not more.”  Despite opposition, APN supporters see the legislation as a productive move toward the future.  These claims have been largely from the standpoint of consistency of practice and authority of APNs among the states.  Dr. Apold, RN, PhD, a former president of the American College of Nurse Practitioners questioned the allowance of APNs prescriptive authority in one state and not another, “Why?  What’s the evidence for that decision?”  She further argued that, if an APN can prescribe controlled substances in one state, every state should permit this authority.  States, which have recently passed legislature allowing expanded prescriptive authority for APNs, are said to have removed outdated language and provided opportunities for Nurse Practitioners to “do what most states already permit.”






Croasdale, M. (2008).  Advance-practice nurses seek wider scope in 24 states.  American Medical News.  Retrieved November 7, 2009 from http://www.ama-assn.org/amednews/2008/04/21/prl20421.htm.