Community Health Nursing

CommunityHealth Nursing

CommunityHealth Nursing

Nursingpractices are regulated by the laws that seek to protect patients orenhance efficiency of delivering health care. The Nurse PractitionersModernization Act (NPMA) is among the newest laws in the U.S. thatseeks to expand the autonomy and the scope of work done by registerednurses. The act as sponsored by the New York senate representative,Catharine Young, enacted in 2014, and became effective on January2015 (Ferrara, 2015). NPMA holds that nurses who have been workingunder the guidance of registered physicians for a period of at least3,600 hours will be allowed to practice without requiring a writtenagreement or direct instructions of a physician (Ferrara, 2015).

Thenew legislation is based on the assumption that 3,600 hours ofpractice are sufficient to give a nurse adequate experience andskills to practice independent of supervision or guidance fromphysicians. The spirit of the act is to break or reduce the practicebarriers that prevent registered nurses from maximizing theirknowledge, practicing autonomously in their profession, anddelivering care in an efficient way. However, the act maintains thatnurses should retain a collaborative relationship with physicians inorder to ensure that serious cases are reviewed by physicians.Provisions of the NPMA are consistent with the initiative that hasalready been taken by more than 17 states, which seeks to remove awritten agreement between the doctor and a physician as a criticalcondition that determines the practice of experiences nurses(Ferrara, 2015). However, the law maintains that nurses with aworking experience of less than 3,600 hours should still be guided byphysicians, which implies that the act seeks to enhance efficiencywhile maintaining the quality of care and the safety of all patients.

Membersof the public, nurses, and other professionals have expressed theirsatisfaction with the new law. The act has a direct impact on thepractice of community health nurses. Community nurses provide supportto patients at home and offer treatment, injections, wound dressing,and medication monitoring services (Kulbok, Thatcher, Mark, E. &ampMeszaros, 2012). The nature of their work shows that they may nothave an immediate contact with physicians, which implies that the oldlaws that required them to have a written agreement with a doctorbefore providing treatment for serious cases prevented them fromaddressing cases of emergency. With the new act, experiencedcommunity nurses will be able to treat serious illness and addresscases of emergency that may occur in the absence of physicians,especially in the patient’s home, even before obtaining a writtenagreement from the doctor.

Althoughthe older version of the act the regulated the practice of nursesaimed at ensuring that patient safety is maintained, it is now clearthat the law subjected patients to some risks and reduced efficiencyof nurses. The new law will remove these bottlenecks and givecommunity health nurses the autonomy to offer a wide range of healthservices without the direct supervision of doctors.

Inconclusion, laws are made and amended to enhance the workingenvironment of the health care providers and help patients receivequality care. The NPMA act will enhance the practice of communityhealth nurses by giving them the author to serve their clientswithout the need for a written agreement with a physician. The acthas also helped clients receive care in time since experiencedcommunity nurses do not have to wait for authorization of physicians.


Ferrara,S. (2015). Nurse Practitioners Modernization Act becomes law.ColumbiaUniversity.Retrieved November 18, 2015, from

Kulbok,A., Thatcher, E., Mark, E. &amp Meszaros, S. (2012). Evolving publichealth nursing roles: Focus on community participatory healthpromotion and prevention. EvolvingPublic Health Nursing Roles,17, 1-10.