Patient Perceptions, Professional Expectations Jayne believes that nurse practitioners hold clinical and non-clinical roles in the acute care setting. She explained that the responsibilities of a nurse practitioner are to perform physical assessment and screenings, to write prescriptions and to diagnose health conditions. By utilizing a holistic approach, she focuses on the patient’s physical needs as well as the emotional, psychological and environmental aspect of patients’ overall health. In addition, she educates her patients of ways to prevent diseases by choosing healthier lifestyles. Jayne finds that by giving patients autonomy, it yields a more positive response to their treatments. Her clinical role as a practitioner plays a very import part in providing a positive response to his patients. However, Jayne’s role also involves non-clinical duties and assumptions. The role of the nurse practitioners incorporates many non-clinical duties including consultation, professional leadership, research, management, education and advocacy (Raftery, 2015). Professional Barriers and Issues Some of the barriers she encountered to practice are ordering Home Health, being called a mid-level provider, and patients not wanting to see her because she is not a doctor. But for the most part, the barriers that she specifically identified are getting reimbursed less than a doctor because she is only a Nurse Practitioner, and the standardized procedures and not having a full practice authority in California. As Hamric, Hanson, Tracy, and O’Grady (2014) point out, today’s healthcare economic perspective presents a number of barriers to the inclusion of Advanced Practice Nurse (APN) in reimbursement strategies. The basic third-party payer reimbursement process was clearly explained that when patient receives care, APN then submits the claim to the payer and payer processes claims where payment is made to APN. However, when a claim is denied, the unpaid balance is written off as a loss (Hamric et al., 2014). In addition, Hamric et al. (2014) stated that although NPs have advance considerably over the past several years, erratic state by state regulatory issues create tremendous obstacles in allowing NPs to practice to the fullest extent of their scope and training and expanding the medical role of nurse practitioners. Only sixteen states have autonomy (Hamric et al,2014).


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