Health Management with an APRN

A common question I get from patients is:

Can you take care of me by yourself, without a doctor?

The answer is YES!

In the state of Arkansas, if an APRN has practiced under the direction of a collaborating physician for 6,240 hours (approximately 3 years), he/she can apply for a Full Independent Practice License. The state board of nursing reviews the application and determines if he/she meets the criteria to practice safely without physician oversight. I am fortunate to have been granted a Full Independent Practice License!

There are a couple of limitations to this that still require a physician’s involvement:

1. Chronic pain medication with Hydrocodone requires a physician to see the patient every 3 months. This can be achieved by referring to pain management or another provider.

2. Prescribing stimulants for ADHD requires that a physician start the prescription. An APRN can refill the medication at the same dose as the physician has prescribed it. The patient still must see the physician every 6 months for follow-up. This can be achieved with referral to behavioral health or another provider.

   
   

So, for the basic healthcare management of everyday common issues like hypertension, diabetes, hyperlipidemia, well-woman exams, wellness visits/yearly physicals, well-child visits, and acute visits like sudden illness or injuries, APRNs with Full Independent Practice are capable of caring for you without physician oversight. In fact, many of us have a license to do so!

I hope this clears up any confusion about what an APRN is legally allowed to do. We didn’t become APRNs because we couldn’t handle med school. We wanted to be nurses! At the heart of it all, we were nurses first. This means we were trained to monitor and identify the smallest, most subtle changes in a patient’s behavior, demeanor, or baseline functioning as we spend most of the time at the bedside. This is where I feel APRNs really shine. We know our patients well and can usually sense when something is not right, even if it looks right on paper.

I want to be sure to give a heartfelt thank you to physicians in this whole process. They have ALWAYS been willing to assist me when I’ve had questions. No physician has EVER made me feel stupid or “less than” when I’ve requested advice in developing treatment plans for my patients. There have been times when I have decided that it was best for a patient to be managed by a physician due to the complexity of their illness. At the end of the day, we all want the same thing. We want the highest quality of care for each patient, individualized to their own specific needs. It’s not an ego contest. It’s an ethical and moral obligation to do the right thing by the patient.

We are all on the same team!