Full Practice, Full Potential: Policy and Innovation in Nursing Roles

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Similarities:

Differences:

APRNs possess deeper theoretical knowledge, advanced clinical skills, and are perceived as more autonomous

APRNs have independent diagnostic and prescribing authority (APRN)

RN's typically do not operate independently

Both play major roles in Patient advocacy , Health promotion, and education

Both roles work collaboratively with physicians and other care team members.

Equally accountable and responsible for patient care within their legal and institutional frameworks.

Both emphasize holistic, dignified, patient-centered care, advocacy, and follow similar laws, protocols, and regulations.

APRN and RN Differences and Similarities in Scope of Practice

Leadership in care management (APRN)

Full Practice, Full Potential: Policy and Innovation in Nursing Roles Hollin Macklin BSN, RN University of North Texas Health Science Center College of Nursing NURS. 6305 Health Policy and Leadership for Advanced Practice Nursing Cheryl A. Thaxton, DNP, APRN, CPNP, FNP-BC, CHPPN, FPCN, ACUE, FAANP, Associate Dean & Chair Graduate Education June 22, 2025

Full Practice, Full Potential: Policy and Innovation in Nursing Roles Central Topic: Full Practice, Full Potential: Policy and Innovation in Nursing Roles Subtopic 1: Registered Nurse (RN) Sub-subtopic: RN Scope of Practice Provides direct care under supervision of APRNs or physicians Administers medications, monitors vital signs, and offers emotional and educational support Cannot diagnose conditions or prescribe medications Education: Associate Degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN) Integral in patient care coordination and advocacy (Jersey College, 2025) Sub-subtopic: Differences and Similarities to APRNs RNs cannot diagnose or prescribe, unlike APRNs APRNs have advanced degrees and greater clinical autonomy Both RNs and APRNs serve as patient advocates and educators Sub-subtopic: Key Barriers to Full Practice (RN) Legal: Narrowly defined scope-of-practice laws Regulatory: Lack of national licensure standardization Institutional: Limited decision-making roles within clinical settings (Feringa et al., 2018; Kleinpell et al., 2022) Sub-subtopic: Strategies to Engage Stakeholders (RN) Share outcome data showcasing RN impact Develop partnerships with hospital leadership Advocate via state nursing associations for SOP updates (Zalon et al., 2024) Sub-subtopic: Addressing Rural & Underserved Needs (RN) Support nurse-led clinics and mobile health units Train RNs from rural communities through targeted scholarships Emphasize care coordination and chronic disease management (Yates et al., 2022) Sub-subtopic: Policy/Organizational Changes & Advocacy (RN) Promote uniform licensure and privilege expansion Campaigns led by ANA and local coalitions Develop rural RN advocacy fellowships and legislative internships Use data dashboards to highlight RN shortages and outcomes Subtopic 2: Advanced Practice Registered Nurse (APRN) Sub-subtopic: APRN Scope of Practice Includes NP, CNM, CRNA, CNS roles Can diagnose, prescribe, and independently manage care Authorized for independent practice in 26 states Requires a Master's or Doctoral degree (Boehning & Punsalan, 2023) Sub-subtopic: Key Barriers to Full Practice (APRN) Legal: Restrictive SOP laws, required physician oversight Regulatory: Lack of consistent credentialing frameworks Institutional: Denied privileges in hospital systems or limited EHR access (Hain & Fleck, 2014; Peterson, 2017) Sub-subtopic: Strategies to Engage Stakeholders (APRN) Leverage data showing APRN cost-effectiveness and quality outcomes Engage through national policy briefings and interprofessional forums Work with Future of Nursing Campaign and AANP (Mark, 2023) Sub-subtopic: Addressing Rural & Underserved Needs (APRN) Expand telehealth and remote prescribing services Launch APRN residency programs in rural FQHCs Build community trust through culturally responsive care (Tapp et al., 2025) Sub-subtopic: Policy/Organizational Changes & Advocacy (APRN) Advocate for APRN Consensus Model adoption Partner with FTC to counter anticompetitive supervision mandates Create storytelling-based campaigns showing APRN patient impact Expand CMS reimbursement rules and hospital privileging reforms (National Academies of Sciences, Engineering, and Medicine, 2016; FTC, 2014)

Advanced Practice Registered Nurse (APRN)

Policy/Organizational Changes & Advocacy (APRN) (National Academies, 2016; Kleinpell et al., 2023; Mark, 2023)

Empower APRN students through policy fellowships and media training

Expand CMS reimbursement rules and hospital privileging reforms

Use FTC and CMS data to advocate for removal of anticompetitive policies

Promote standardization via the APRN Consensus Model

Push for APRN Compact legislation for multi-state practice

Addressing Rural & Underserved Needs (APRN) (Tapp et al., 2025; Taylor, 2023)

Build community trust and retention through culturally responsive care

Launch APRN residency programs in rural FQHCs

Expand telehealth and remote prescribing services

Strategies to Engage Stakeholders (APRN) (Mark, 2023; Zalon et al., 2024)

Leverage AANP, ANA, and interdisciplinary coalitions

Engage through national policy briefings and interprofessional forums

Leverage data showing APRN cost-effectiveness and quality outcomes

Key Barriers to Full Practice (APRN)

Institutional: Restrictions on prescriptive authority, hospital admitting, and billing (Kleinpell et al., 2022; Barton et al., 2021)

Regulatory: Inconsistent certification, privileging, and transition-to-practice mandates (Feringa et al., 2018; Kleinpell et al., 2023)

Legal: SOP laws require physician collaboration in many states (Peterson, 2017; Hain & Fleck, 2014)

APRN Scope of Practice (Boehning & Punsalan, 2023)

Emphasizes evidence-based practice, leadership, health policy, and systems-level care

Requires a Master's or Doctoral degree

Authorized for independent practice in 26 states

Can diagnose, prescribe, and can independently manage care

Includes 4 Main Roles

Clinical Nurse Specialist (CNS)

Certified Registered Nurse Anesthetist (CRNA)

Certified Nurse-Midwife (CNM)

Nurse Practitioner (NP)

Registered Nurse (RN)

Policy/Organizational Changes & Advocacy (RN) (Chiu, Cummings, Thorne, & Schick-Makaroff, 2021; Rash, 2024; Sutor & Painter, 2020; Ferguson, 1998)

Expand BSN-preparation mandates and create RN residency programs

Launch storytelling campaigns through the Campaign for Action

Use data dashboards to highlight RN shortages and outcomes

Develop rural RN advocacy fellowships and legislative internships

Addressing Rural & Underserved Needs (RN) (Yates et al., 2022)

Support legislation recognizing RN clinical decision-making authority

Emphasize care coordination and chronic disease management

Train RNs from rural communities through targeted pipeline programs and scholarships

Empower nurse-led clinics and home visit models

Strategies to Engage Stakeholders (RN) (Zalon et al., 2024; Morris, 2024)

Use ANA’s Healthy Nurse Healthy Nation and Future of Nursing framework as leverage

Collaborate with hospital boards and quality councils

Present patient safety and quality metrics tied to RN-led interventions

Key Barriers to Full Practice (RN)

Institutional: Hospital policies limit RN protocol use and nurse-initiated care pathways (Kleinpell et al., 2022)

Regulatory: Inconsistent national licensure and lack of privileging policies (Feringa et al., 2018)

Legal: Scope-of-practice statutes limit autonomous roles (Baker & Williams, 2016)

RN Scope of Practice (Jersey College, 2025)

Integral in patient care coordination and advocacy

Requires: ADN or BSN

Cannot diagnose conditions or prescribe medications

Administers medications, monitors vital signs, and offers emotional and educational support

Provides direct care under supervision of APRNs or physicians