Autonomous Nurse Practitioner Practice: A Position Paper and Action Plan for Change

Autonomy in nurse practitioner practice has been a dominant professional issue. Professional autonomy means allowing professionals to have substantial control over professional practice, including the ability to independently exercise their judgment. Nurse Practitioners working in restrictive practice environments such as managed care systems perceive themselves as less autonomous due to legal and organizational restrictions that limit their scope of practice and ability to freely exercise independent judgment. Many researchers have addressed autonomy in the context of organizational influences, prescribing patterns, decision-making, role implementation, patient satisfaction and health outcomes of nurse practitioner versus physician care. National organizations such as the Institute of Medicine and The Robert Wood Johnson Foundation are urging policy makers to restructure the healthcare system to allow nurse practitioners to practice to the full extent of their education and training, thereby providing timely and more efficient care to healthcare consumers. The purpose of this project is to develop an evidence-based legislative model to increase autonomy for nurse practitioners and enhance their ability to use their education and training to the fullest extent without organizational or legislative restrictions. Concepts/Key words: Autonomy, nurse practitioner access to care, legislation Major Professor: Stephanie Burgess, PhD, APRN, B