Peer response
In nursing practice, there are clear professional and legal differences between the Registered Nurse (RN) and the Advanced Practice Registered Nurse (APRN). An RN in Florida provides direct patient care, conducts assessments, implements and evaluates care plans, administers medications, and promotes health and wellness based on orders from providers. However, RNs do not have the legal authority to make medical diagnoses, independently prescribe medications, or order diagnostic tests; they are responsible for nursing judgment within the scope of their license and must practice under supervisory Florida Statutes. Practicing outside of this legal scope can result in disciplinary action from the board of nursing, fines, or loss of licensure. In contrast, APRNs have advanced graduate education (MSN or DNP) and national certification that expands their scope of practice to include comprehensive assessments, diagnoses, treatment planning, ordering/interpreting diagnostics, and prescribing medications within legal limits. In Florida, APRNs must meet educational, certification, and practice requirements to obtain prescriptive authority and may be subject to collaborative practice agreements if they do not have an autonomous practice license or if they practice in a specialty that requires oversight by an MD or DO.
Legally and ethically, APRNs are expected to address societal health concerns such as epidemics, mental health needs, substance use disorders, and health disparities through evidence‑based, culturally competent care and advocacy. Advanced Practice Registered Nurses play a vital role in improving health equity and access, especially in underserved and vulnerable populations, by providing preventive services, health education, and treatment interventions aimed at reducing disparities in care and outcomes. Expanding access to APRN care for mental health and substance use disorders can help address workforce shortages and disparities in treatment access, according to a recent policy analysis. This is both an ethical requirement and part of APRNs’ public health responsibilities. Also noteworthy, are the negative perceptions by other providers regarding the competency of the APRN to provide medical care. APRN’s have a shared responsibility to practice within their scope and prescribe safely especially when it comes to opioids. It is the APRN’s responsibility to know when to refer a patient to seek specialized care. When it comes to mental health and substance abuse there are limitations for Family Nurse Practitioners (FNP’s). FNP’s must recognize when patients need specialized care and collaborate with the specialists for the patient’s safety and best interests.
In addition, APRNs have a professional and moral duty to push for changes at the system level that make it easier for people to get care, improve social determinants of health, and support public health initiatives. These changes should be based on beneficence, justice, and respect for patient autonomy. Evidence indicates that APRNs play a crucial role in promoting health equity by enhancing access to care, particularly in underserved regions, and by employing advanced assessment and treatment skills to facilitate holistic, patient-centered practice.
Bae, K. (2024). Advanced Practice Registered Nurse full practice authority: The untapped potential of the nurse practitioner workforce in reducing health disparities. Journal of Nursing Regulation. https://doi.org/10.1177/15271544231212155
Duyilemi, F. E., & Mabunda, N. F. (2025). Nurses’ perceptions on the role of advanced psychiatric nurses in mental healthcare: An integrative review. International Journal of Environmental Research and Public Health, 22(4), 626. https://doi.org/10.3390/ijerph22040626
Tierney, M., Schimmels, J., Delaney, K., Mumba, M., Glymph, D., Handrup, C., & Phoenix, B. (2025). Policy priorities to improve access to advanced practice nursing care for mental health and substance use problems: An American Academy of Nursing manuscript. Nursing Outlook. https://doi.org/10.1016/j.outlook.2024.102342
Adams, S. (2024). Integrating nurse practitioners into primary healthcare to deliver equitable care: A framework for practice. Journal of Advanced Nursing. https://doi.org/10.1111/jan.16093
Chapman, S. A., Fraimow‑Wong, L., Phoenix, B. J., & Tierney, M. (2024). Perspectives on APRN prescribing of medications for opioid use disorder: Key barriers remain. Journal of Substance Use and Addiction Treatment. https://doi.org/10.1016/j.josat.2023.209215