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Despite making considerable progress in the areas of nursing practice, nursing education, advocacy, policymaking, and expanding the influence of professional nursing organizations and associations, the nursing profession still has areas where the progress and development are not as significant as many professional nurses would like it to be. In particular, there are barriers limiting the progress of Advanced Practice Nursing and the contribution that Advanced Practice Nurses (APNs) can make to improving the health care system and access to care. Back in 2011, The Institute of Medicine (IOM) (2011) published a landmark report called “The Future of Nursing: Leading Change, Advancing Health”. In this report, IOM (2011) identified several barriers to undermining the ability of APNs to contribute to the health care delivery to the full extent of their training and education. The three of those barriers include (1) federal and state-level regulations limiting nurses’ scope of practice (SOP), including state laws, (2) institutional culture and practice, and (3) outdated reimbursement models (IOM, 2011).
SOP regulations present a considerable barrier to the progress of advanced practice nursing. For example, nearly half of the U.S. states have reduced or restricted SOP. In the states with reduced SOP, APNs do not have the author to engage in at least one element of advanced practice (Martin & Alexander, 2019). In those states, APNs are required to have a collaborative agreement with physicians to provide primary care, diagnose patients, and prescribe treatments including controlled substances. In the states with restricted SOP, APNs practice under supervision, perform delegated tasks or work as a part of the teams managed by the physicians (Martin & Alexander, 2019). In other words, SOP regulations limiting APNs’ professional autonomy and the ability to practice independently to the full extent of their education and training present a significant barrier to the progress of advanced nursing practice.
As was mentioned earlier, one more barrier is institutional culture and practice. For example, many health care organizations hire APNs that completed programs that equipped them with exceptional skills and educational background necessary to manage complex patients, work in fast-paced settings, perform complex monitoring, develop evidence-based treatment plans, and order and interpret diagnostic studies (Vanderbilt School of Nursing, n.d.). Moreover, many graduates of the MSN programs possess advanced expertise in clinical care, interprofessional collaboration, quality improvement, and organizational leadership (American Association of Colleges of Nursing, 2011). However, APNs may find it challenging to realize their full potential and make a greater contribution to their organizations when the latter have an organizational culture where the role of APNs is viewed as a managing or supervising type of position. Apparently, such organizational culture makes it more challenging for APNs to make a more valuable contribution to improving organizational outcomes.
Finally, an outdated reimbursement model for the services provided by nurses is another barrier slowing down the progress of advanced practice nursing. As Sarzynski & Barry (2019) explain, a revenue stream may need to be developed in order for the APN role to survive in different settings. However, APNs do not receive reimbursement equal to physicians for providing the same services (Sarzynski & Barry, 2019). Further disparities in reimbursement are exacerbated by the fact that ANpss are more likely to practice in rural settings and treat vulnerable populations and Medicaid beneficiaries compared with physicians (Sarzynski & Barry, 2019). Thus, reimbursement issues should be regulated to ensure that APNs can generate adequate revue for their organizations and in independent practice as well. Therefore, regulations limiting nurses’ SOP, organizational culture and practice, and outdated reimbursement models are the three barriers blocking the way to the progress of advanced nursing practice. Addressing these barriers through policy and practice change should be one of the priorities of nurses’ policymaking and policy advocacy efforts.
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Assignment: Case Study Read the case study, “Expanding Internationally at Suds Microbrewery,” on page 354 in Strategic Compensation, (10th ed.) Prepare a 4- to 6-page case analysis on the case study “Expanding Internationally at Suds Microbrewery” on page 354 in Strategic Compensation, 10th edition on the topic of global compensation strategy and why they are critical to the success of an organization in meeting its goals and mission. In your analysis, respond to the following question: What is the competitive global compensation strategy of the organizations and why is it critical to the success of an organization in meeting its goals and mission? Your analysis of this case and your written submission should reflect an understanding of the critical issues of the case, integrating the material covered in the text, and present concise and well-reasoned justifications for the stance you take. Case analysis criteria: Your case analysis should consist of: A brief analysis of the situation and pending decision problem, as presented in the case and as relevant to your answer. This should be exceptionally brief, and you should assume the person reading the assignment is familiar with the details of the case. Identification of the major issues surrounding the organization or individuals involved with the organization. Identification of alternate courses of action to address the issues identified. The decision or recommendation for action, with the appropriate supporting arguments.
Case Study “Expanding Internationally at Suds Microbrewery”
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Introduction
Suds Microbrewery is a well-known company for brewing several variations award-winning beers. The company has opened 20 new brewery locations across the United States within a span of 10 years. The first successful chain of Suds Microbrewery was opened in the Midwest. The company quickly expanded successfully into 20 major markets in the United States(Martocchio, 2020). Based on this successes, Ellie Gomes the Director of Human Resources seeks to expand internationally and the company has specifically identified Canada and the United Kingdom. The market research conducted by the company identified Toronto and London as the appropriate locations. Currently, Ellie has embarked on determining the staffing plan for each of the brewer in the identified locations.
The benefits packages in Canada and United Kingdom is different from that of the United States. Suds Microbrewery currently offer employees similar benefits packages in all the 20 locations across the United States(Martocchio, 2014). It is very imperative for the company to offer competitive benefits package to the local employees based on their local pay rate to make it possible to attract top talent as well as maintain the current workforce. In the United States locations, the company offer standard benefits to all full-time employees.
Among the benefits offered by Suds Microbrewery include company-paid health insurance option, which employees become eligible after working for one-year period with the company. In terms of retirement package, the company offers a 401(k) retirement plan with a match of employee contributions of up to 5 % of an employee’s annual pay(Steinberg, 2009). In addition, the employees of Suds Microbrewery are entitled to six paid vacation days plus seven paid holidays each year. Although these benefits packages are competitive in the United States, it is important for the company establish a benefits package that competitive with the benefits offered by the competitors in the two new locations.
