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This study compares the labor and delivery outcomes of certified nurse-midwives (CNMs) and physicians. For care processes, (e.g., epidural, labor induction, episiotomy), CNMs were found to have lower rates of application/use. For infant outcomes, (e.g., low Apgar, low birth weight, neonatal intensive care unit admission), there were no differences between physicians and CNMs. Perineal lacerations were lower and breastfeeding rates were higher among women cared for by CNMs compared with physicians.

Nurse practice laws and regulations are specific to each state. Check out AANP's quick reference guide below for licensure and regulatory requirements, as well as practice environment details, for all 50 states and the U.S. Territories. Download State Regulatory Map Members get more! Log in for access to State Policy Fact Sheets.

This article discusses the Pros and Cons of using APRNs in both outpatient and inpatient settings. One of the positives is that there are more jobs for the APRN and now APRN's can specialize much like physicians. The downside to that is that there are not as many NPs doing primary care, which is leaving a gap.

This article addresses how Iowa APRNs in a state-sanctioned task force identified barriers for practicing at the top of their licensure in a full practice authority state including defending the right to control the scope of nursing practice in court.

Spoelstra, S. L., & Robbins, L. B. (2010). A qualitative study of role transition from RN to APN. International Journal of Nursing Education Scholarship, 7(1).

I found this article very interesting. It talks about the current challenges in midwifery in regards to legislation, reimbursement, physician restrictions, and many other restricting factors. It also discusses the challenges of the education required to become an APRN.

Connects efforts for full practice authority for NPs to the ratification of the Equal Rights Amendment by various states. States that ratified the ERA and therefore have a more egalitarian view of women are more likely to have full scope of practice laws for NPs, CNMs, and CRNAs

A very interesting article going in detail on the expansion of the role of advanced nurse practitioners and the potential rewards and risks associated with it. There is a shortage of primary care providers. Pondering upon the topic of role expansion brings about the important consideration of liability but also has a positive side that includes being able to provide primary care to more people. This article brings up great discussion points.

In reproductive endocrinology, there is no clear role for a CNM. I feel like this article has an undertone that doesn't seem to invite the CNM to the table for collaboration, though I still found it interesting.

This article describes the thought behind, process and goal of the Consensus Model for APRN Regulation, which aims to clarify and unify regulations for APRN licensure, accreditation, certification and education (LACE). This model was created in response to inconsistencies in APRN education and practice caused by a need for APRNs.

History and Benefits to having the role of ENPs

Everything an AGPCNP needs to know about certification exams thru ANCC

This article presents the development of APRN in the recent 20 years. Really a giant step regarding to scope of practice and license issue.

This article provides a brief history of the APRN role and how it has evolved over time. There are many links provided within the article that are intersting to better understand th initial thoughs about APRNs and how the role has changed and evolved over a relatively breif period of time.

This article is a great resource for learning a little more about the history of APRNs. It provides some history about the use of certification exams for licensure.

Here's a JONA article discussing the CNO and Leadership's role in encouraging APRN Fellowships and new grad NP educational opportunities, along with the positive outcomes associated with employing these practices. J Nurs Adm. 2014 Dec;44(12):625-7. doi: 10.1097/NNA.0000000000000138.

Helpful forms to look at

28 Brach's jelly beans instead of glucose beverage use.

This resource goes into details on the role of the NNP and shows the progression of how the profession has come to be established and known as a provider.

Practice research serves as the certification framework for validating advanced practice roles and updating national qualifying examinations. This national study describes the current practice of the acute care pediatric nurse practitioner (AC PNP) to inform an update of the Certified Pediatric Nurse Practitioner-Acute Care (CPNP-AC) examination content outline.

This article goes over how nurse practitioners were able to obtain provider status. The audience, however, is for pharmacists. Thought it was an interesting perspective

Nice overview of how NP became primary care providers

History of NP since it was started in 1965

Recently published article in NEJM that pulls together some of the exciting things coming for NPs and RNs in continuing expanded roles to meet primary care needs in our health care system.