APRN board of nursing regulations vary from state to state. The full scope of practice for Nurse Practitioners (NPs) cannot be properly executed and it is very limiting to certain states. Experts predict that there will be a significant shortage of primary care providers in the United States in the next few years. An increase in the number of nurse practitioners working in the field may alleviate this problem. However, restrictions imposed by state NP regulations may make primary care less accessible (Neff et al., 2018).
Michigan has one of the most limiting practices for NPs. Under restrictive legislation, nurse practitioners are permitted to practice in Michigan. They lack the authority to practice on their own; Instead, a licensed physician must oversee them. Michigan NPs need physician oversight to prescribe, diagnose and treat patients. An example of a full practice authority state is Arizona. In full practice states, NPs can prescribe, diagnose, and treat patients without a physician overseeing them (Juda, 2021). For example, in the state of Arizona, an NP can prescribe a patient medication that is schedule 2-5, excluding schedule 2 opioids except opioids that are for medication assisted treatment for substance use disorders, without supervision of a physician nor the physician’s DEA registration number. In Michigan, an NP can prescribe medication that is a non-scheduled prescription drug without physician delegation and controlled substances that are scheduled 2 to 5 under a delegated act of a physician (NCSL, 2023).
A growing field in aesthetics is taking place today. A newly introduced bill in Michigan regarding injections of filler and Botox has been introduced. Senate Bill 1068 currently states that Botox and dermal fillers may only be administered by a physician, physicianâs assistant or nurse practitioner (MLive, 2022). Currently the law states that a registered nurse can administer these procedures. However, an NP cannot own and operate their own medical spa unless under the supervision and partnership of a physician. In Arizona, medical aesthetic procedures can be performed by any trained medical professional and NPs are free to practice independently owning their own medical spas (American Med Spa Association, 2022).
It is crucial to know what your practice regulations are as an advanced practice nurse state to state. Making sure you are following regulations can ensure proper practice and execution of patient care. The future made lead to more full practice states due to the growing needs in healthcare and the medical spa fields. Leaders in the medical and nursing professions agree that NP independence should be discussed more frequently. Although both sides agree that the NP role is essential to the nation’s health and medical care delivery, neither side can agree on the best approach (Juda, 2021).
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Fourthly, Vittola questions upon whose authority can demand a declaration of war, where he implies any commonwealth can go to war, but more importantly, âthe princeâ where he has âthe natural orderâ according to Augustine, and all authority is given to him. This is further supported by Aristotleâs Politics ((1996), Page 28): âa king is the natural superior of his subjects.â However, he does later emphasise to put all faith in the prince is wrong and has consequences; a thorough examination of the cause of war is required along with the willingness to negotiate rival party (Begby et al (2006b), Page 312& 318). This is supported by the actions of Hitler are deemed unjustly. Also, in todayâs world, wars are no longer fought only by states but also non-state actors like Al-Queda and ISIS, showing Vittolaâs normative claim on authority is outdated. This is further supported by Froweâs claim that the leader needs to represent the peopleâs interests, under legitimate authority, which links on to the fourth condition: Public declaration of war. Agreed with many, there must be an official announcement on a declaration of war (Frowe (2011), Page 59-60&63). Finally, the most controversial condition is that wars should have a reasonable chance of success. As Vittola reiterated, the aim of war is to establish peace and security; securing the public good. If this canât be achieved, Frowe argues it would be better to surrender to the enemy. This can be justified because the costs of war would have been bigger (Frowe (2011), Page 56-7). Consequently, jus ad bellum comprises several conditions but most importantly: just cause and proportionality. This gives people a guide whether itâs lawful to enter a war or not. However, this is only one part of the theory of the just war. Nevertheless, it can be seen above that jus ad bellum can be debated throughout, showing that there is no definitive theory of a just war, as it is normatively theorised.>
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Fourthly, Vittola questions upon whose authority can demand a declaration of war, where he implies any commonwealth can go to war, but more importantly, âthe princeâ where he has âthe natural orderâ according to Augustine, and all authority is given to him. This is further supported by Aristotleâs Politics ((1996), Page 28): âa king is the natural superior of his subjects.â However, he does later emphasise to put all faith in the prince is wrong and has consequences; a thorough examination of the cause of war is required along with the willingness to negotiate rival party (Begby et al (2006b), Page 312& 318). This is supported by the actions of Hitler are deemed unjustly. Also, in todayâs world, wars are no longer fought only by states but also non-state actors like Al-Queda and ISIS, showing Vittolaâs normative claim on authority is outdated. This is further supported by Froweâs claim that the leader needs to represent the peopleâs interests, under legitimate authority, which links on to the fourth condition: Public declaration of war. Agreed with many, there must be an official announcement on a declaration of war (Frowe (2011), Page 59-60&63). Finally, the most controversial condition is that wars should have a reasonable chance of success. As Vittola reiterated, the aim of war is to establish peace and security; securing the public good. If this canât be achieved, Frowe argues it would be better to surrender to the enemy. This can be justified because the costs of war would have been bigger (Frowe (2011), Page 56-7). Consequently, jus ad bellum comprises several conditions but most importantly: just cause and proportionality. This gives people a guide whether itâs lawful to enter a war or not. However, this is only one part of the theory of the just war. Nevertheless, it can be seen above that jus ad bellum can be debated throughout, showing that there is no definitive theory of a just war, as it is normatively theorised.>
