![]() For example, 10 states with FPA have transition to practice requirements (Colorado, Connecticut, Massachusetts, Maryland, Maine, Minnesota, Nebraska, Nevada, South Dakota, Vermont), seven reduced or restricted practice states have transition to practice requirements (Arizona, California, Florida, Illinois, New York, Virginia, West Virginia), and 19 reduced or restricted practice states have no transition to practice requirements (Alabama, Georgia, Indiana, Kansas, Kentucky, Louisiana, Missouri, Michigan, Mississippi, North Carolina, New Jersey, Ohio, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, Utah, Wisconsin) ( Table 1įederal Regulatory Barriers to APRN Practice To add to practice confusion, the requirement for transition to practice varies by state regardless of APRN practice authority status. ![]() Similarly, the AANP cites national standards for APRN education, program accreditation, and board certification as evidence-based and decries the unnecessary barriers to patients and NPs, noting geographic health disparities, higher chronic disease burden, primary care shortages, higher cost of care, and lower health-status rankings in non-FPA states compared with FPA states ( AANP, 2022b). The ANA ( 2016) asserted that transition to practice requirements are “not based on evidence but are the result of political compromise” (p. All APRNs are educated to assume autonomous APRN practice according to competencies assessed by their respective accrediting bodies ( American Association of Colleges of Nursing, 2016). One of the four key messages of the initial Future of Nursing report is that nurses should practice to the full extent of their education ( Institute of Medicine, 2011). Transition to practice requirements are opposed by the Institute of Medicine (2011 now called the National Academy of Medicine), the American Association of Colleges of Nursing (2016), the AANP ( 2022a), and the ANA ( 2016). The transition phase duration varies from 750 hours to up to several years of supervised practice ( Green, 2022). The common denominator is the imposition of required supervision or mentorship by an experienced clinician, commonly a physician or APRN, for newly graduated APRNs. Such requirements vary considerably and are often not consistent with the APRN Consensus Model ( National Council of State Boards of Nursing, n.d.-c). Transition to practice requirements have become more common in recent years, in part to assuage concerns from FPA opponents in FPA-resistant, often conservative, states and despite a dearth of evidence about the need for or the efficacy of transition to practice requirements. Transition to practice regulations require newly graduated APRNs to practice under the supervision or mentorship of an experienced clinician ( Green, 2022).
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