Consideration of the emergency nurse practitioner as a population within the APRN Consensus Model: A SWOT analysis

Abstract

After adoption of the 2008 Consensus Model for Advanced Practice Registered Nurse (APRN) Regulation, evolution of the nurse practitioner (NP) role and emergency NP (ENP) specialty has outpaced regulatory standards. Lack of uniformity among regulators, health insurance providers, and employers in acknowledging the ENP specialty has created barriers to practice and access to care. This article serves to identify potential outcomes if the ENP specialty was transitioned to a population within the Consensus Model of Regulation. A strengths, weaknesses, opportunities, and threats (SWOT) analysis methodology was used to assess ENP specialty current state, specifically focusing on the licensure, accreditation, certification, and education model for APRN regulation. The data were collected from peerreviewed literature, clinical subject-matter experts, and academic and advanced practice executive leaders. Variances in ENP licensure, recognition, and acknowledgment among State Boards of Nursing leave the ENP specialty in a precarious position. For each of the strengths and opportunities that could exist in recognizing the ENP at the population level of the Consensus Model, there are abundant weaknesses and threats. Although full acknowledgment of the ENP specialty is lacking, regulatory implications are highly variable, and employers' understanding of the APRN educational model is limited, our findings reveal that the ENP specialty is an evolving role that deserves regulatory legitimization. Although ideal placement for the ENP within the Consensus Model remains to be determined, challenges and opportunities exist with both specialty and population options.

An evaluation of nurse practitioner and physician assistant hiring patterns after implementation of the advanced practice registered nurse consensus model

“…We found no evidence that implementation of hiring practices to align with the APRN Consensus Model was associated with preferential hiring of PAs over NPs. Although there are concerns that the APRN Consensus model may make it cumbersome to hire NPs (Kaplan & Klein, 2021; Schumann & Tyler, 2018; Wilbeck et al, 2022), possibly shifting hiring preferences toward PAs, our findings suggest the opposite. In the years immediately after Consensus Model implementation, we find there was a greater proportion of NPs hired than PAs compared with the years before model adoption.…”

“…Klein, 2021;Schumann & Tyler, 2018;Wilbeck et al, 2022), possibly shifting hiring preferences toward PAs, our findings suggest the opposite. In the years immediately after Consensus Model implementation, we find there was a greater proportion of NPs hired than PAs compared with the years before model adoption.…”

“…There are several organizations that have not yet aligned hiring practices with the APRN Consensus Model (Hudspeth & Klein, 2019; Klein et al, 2020). When developing institutional policies, it is important to consider how specific specialties fit within the model, such as emergency NPs (Schumann & Tyler, 2018; Wilbeck et al, 2022). Furthermore, having a plan in place for NPs that currently work within the system who are not yet certified for the role they are currently serving in will prevent abrupt displacement of this workforce (Kaplan & Klein, 2021).…”

“…Furthermore, the APRN Consensus Model provides direction but is not a legislative document; hence, there is variation in uptake and implementation among institutions (Goudreau & Smolenski, 2022). There are also concerns that the model may place unnecessary constraints on hiring NPs into select roles, reducing the workforce available to fill needed roles in care delivery, especially in areas with the greatest access needs (Kaplan & Klein, 2021; Schumann & Tyler, 2018; Wilbeck et al, 2022). If the model makes it cumbersome for organizations to hire NPs, it is possible that institutional implementation may inadvertently lead to preferential hire of PAs over NPs because both are advanced practice providers with overlap in the types of roles they can fill.…”

Guest Editorial: Is It Time for a New NP Population

“…Despite the Consensus Model's purpose of standardizing APRN regulation, many states have not adopted its recommendations. In contrast, others have only adopted certain elements (Wilbeck, Schumann, Comer, & Davis, 2022).…”