Dr. Judith Chamberlain's 2013 SLC presentation for the Scope of Practice panel on Advanced Practice Nurses in Maine.

1. Independent practice

2. 
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Assessing clients
Synthesizing & analyzing data, understanding & applying nursing
principles at an advanced level
Providing expert teaching & guidance
Working effectively with clients, families, health care team
Managing clients’ physical & psycho-social health-illness
Utilizing research skills
Analyzing multiple sources of data, differential diagnosis, selecting
appropriate treatment
Independent decisions in solving complex client care problems
Diagnosing, prescribing, administering & dispensing therapeutic
measures
Recognizing limits of knowledge & experience, planning
for situations beyond expertise, consulting with or
referring to other health care providers as appropriate

3. 
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NPs earned the right to practice independent
of physicians in ME in the mid-1990s
NP must complete at least 24 months of
supervised work
NPs can now be credentialed as participating
providers
NPs can be primary care providers in
managed care organizations
A new grad can be supervised by another NP
who is independently licensed.

5. Physician supervision required
Physician supervision not required

6. 
1088 NPs in ME in 2012
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Most are independently licensed
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Fewer than 50 practice independently

7. 
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Distribution of NPs and primary care similar
Majority of NPs in ME in Primary Care
From the ME NP Association web site:
◦ Overall 25% of NPs in rural areas of ME
◦ In primary care about 40% rural (most in FM)
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Rural distribution of NPs almost identical to
FPs
NPs, PAs and Physicians are all leaving
primary care at about the same rate (AHRQ
and Robert Graham Center data)

9. 120000
100000
80000
52%
TOTAL
0
NPs
IN PRIMARY CARE
30,402
43%
70,383
20000
55,625
40000
106,073
60000
PAs
Data from 2010 National Provider Identifier File