Ethics and legal regulatory statutes

Week 5 Discussion
In my future role of a family nurse practitioner, there are many current trends and modern issues that play into my role as a nurse practitioner. The top three issues/trends that apply most to me are COVID-19, nurse practitioner autonomy, and Medicare reimbursements.

The first issue to address is the most prevalent and most vital in this moment; COVID-19. This devastating pandemic has altered the realm of healthcare and how we operate within the constraints of a mandated “shut down” nationwide. One of the biggest changes for family nurse practitioners is how they interact with patients and schedule appointments. Many physicians are strictly performing telemedicine visits with their patients, reducing the exposure and risks for infection from this virus. The effects of this may have a long-term outcome in a higher number of “out of office” Telemed visits for less severe medical problems. For us, as FNP’s, this can be a lucrative system, but also a journey of care that lacks the personal interaction and can decrease patient outcomes long term. The ability to truly assess and diagnose a patient in person is an essential part of our process and over a FaceTime call, this just does not seem 100% feasible. We cannot listen to one’s heart, lungs and GI system over facetime and until that becomes part of practice, the only place for telemedicine is for work/school sick notes and common cold diagnoses. Without the ability to diagnose our patients correctly, we cannot properly treat them and could essentially leave their concerns untreated and their outcome poor. I am a strong believer in the personal communication that occurs in a professional healthcare setting and the ability we have as providers to not only physically assess our patients, but to provide them with the comfort and dignity they deserve in this setting. Many times there are things we are able to find out in an office, that we could not be told over the phone. There are many physicians who refuse to prescribe anything high-risk over telemedicine and for good reason, as we lose control over our patient outcomes when we cannot define the whole story in person and confirm a need for said medical interventions (Karim & Bajwa, 2011).

Medicare. In general, this does not seem to be a large issue as we are still being compensated,

but when we look at the logistics of the care provided, it is unjust to declare our process and

option and contract option. Both sides ultimately limit the income of a nurse practitioner, but as

a family physician our duty is to serve our communities in terms of health and access to care,

Hamric, A.B., Hanson, C.M., Tracy, M. F. & O’Grady, E. T. (2014). Advanced practice nursing: An integrative approach (5th ed.). Retrieved from
https://digitalbookshelf.southuniversity.edu/#/books/9781455739806/cfi/6/34!/4/2@0:0 Medicare Payment Advisory Commission. (2019). Improving Medicare’s payment policies for Advanced Practice Registered Nurses and Physician Assistants. MedPAC Blog. Retrieved from http://medpac. gov/-blog-/the-commission-recommends-aprns-and-pas-bill- medicare-directly-/2019/02/15/improving-medicare% 27s-payment-policies-for-aprns- and-pas.

Karim, S., & Bajwa, I. S. (2011, August). Clinical decision support system based virtual telemedicine. In 2011 Third International Conference on Intelligent Human-Machine Systems and Cybernetics (Vol. 1, pp. 16-21). IEEE.