Instructions: Response must be at 300 words written in current APA format with at least two academic references cited. References must be within the last five years. Response must refute/correct, or add additional nuance.

Although there has been progress for the advanced practice nurse (APN) profession in recent years, there remain opportunities for improvement in the advocacy of APNs. Numerous barriers still exist in the workforce culture that prevent APNs from contributing to their fullest capacity to improve healthcare.  
Significant barriers to the advancement of the profession are outdated policies and laws and a lack of uniformity across states. The Future of Nursing Report, published in 2010 by the Institute of Medicine declared that states must eliminate outdated regulations and organizational and cultural barriers that limit the ability of nurses to practice to the full extent of their education, training, and competence (Sofer, 2018). To overcome outdated and restrictive legislation requires APNs across the nation to come together to advocate for the necessary changes. Despite the immense need for more advocation for the profession, there are too few APNs who engage in legislative action. APNs’ hesitancy to get involved with policy development is contributing to continued disparities across state lines. Studies conducted to assess the reasoning behind the gap in the nursing profession being involved in policy have identified that a lack of awareness of policy implications, misunderstanding of their role in change, and a lack of training on how to communicate with policymakers are all contributing factors (Jurns, 2019). To improve workplace culture there must be more education provided to APNs on their role and opportunities available in advocacy. Informational sessions offered to enhance their knowledge on the topic will give them more confidence and the ability to appropriately communicate with lawmakers. Because nurses are among the most trusted profession and have firsthand knowledge of patient needs, it is crucial they have a strong voice in the policy arena (Jurns, 2019).
Another cause for persisting challenges for APNs in the workforce is the continued opposition by some physicians. To promote the expansion of their profession requires that physicians stand behind APNs, but this is not always the case. When physicians do not appear to back APNs as fully functioning and safe primary care provides it can cause patients to distrust APNs to fully handle their care. In 2015, the American Medical Association (AMA) released a report saying that nurses cannot take the place of a fully trained physician and opposed decisions by the Department of Veterans Affairs that allowed APNs to practice independently at their centers. Even as recent as 2017, the AMA adopted Resolution 214 that opposes the APN Compact (Sofer, 2018). The APN Compact which allows an APN to hold a multistate license in states that belong to it is highly beneficial to bridge the gap in primary care shortages. By physicians not supporting the APN compact, the continued shortage will exist. A broader education campaign for physicians needs to be initiated to demonstrate to them how data reflects APNs provide patients with just as much quality and safe care as they do. This opposition further leads to a divide among the medical community and there should be cohesive and smooth collaboration instead of opposition. More strategies must be developed to unite the professions and bridge the gap in understanding. 

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