Titling the NP: Challenges and Misconceptions

N urse practitioners (NPs) have been practicing for nearly 50 years (American Association of Nurse Practitioners [AANP], 2014). So why is there still confusion over who we are and what we do? Why do we consistently get questions from patients such as " Are you my nurse? " or " Are you my doctor? " or " Are you the assis-tant? " And perhaps even more confounding, why is there still confusion about the NP role within the nursing and medical communities? There are likely many reasons for this confusion , which seems to be fairly consistent across institutions and private practices. Inconsistency in both messaging and scope of practice across states is a potential factor that comes to mind. While revising scope of practice is a mandate taken up by individual states and driven by individual NP organizations, it takes great effort , persistence, and time to navigate the legislative process. Currently, NPs have full practice authority in 19 states and the District of Columbia (AANP, 2014). For NPs in the remaining states, there is a varying degree of restrictive language with respect to their practice authority, creating a myriad of issues for patients and NPs alike. In 2010, the Institute of Medicine (IOM) published a report entitled, " The Future of Nursing: Leading Change, Advancing Health " (IOM, 2010). This report put forth 5 recommendations, number 1 of which was to remove scope-of-practice barriers. Many NPs face this hindrance today, which negatively impacts the patients in their care. Removing scope-of-practice barriers would legally allow advanced practice registered nurses (APRNs) to practice to the full extent of their education and training. Nearly in tandem, the National Council of State Boards of Nursing (NCSBN) established the APRN Consensus Model, which mirrors the philosophy of the IOM report in standardizing advanced practice nursing. The APRN Consensus Model was developed by 48 APRN nursing organizations that are committed to creating nationwide standards to unite all NPs (and all other advanced practice nurses) in their licensure, accreditation, certification, and education (NCSBN, 2010).