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California remains to be one of the states that have reduced practice for an advanced nurse practitioner (ANP). Peterson (2017) defines reduce practice as ANP as being able to care for the patient by providing at least one responsibility as a Nurse Practitioner (NP) such as prescribing medication under the supervision of a primary care physician. NPs in California are accountable for the care of patients and still have to report to doctors.There are many barriers to ANPs which stream from cultural barriers to structural ones. Federal regulations make reimbursement for NPs a barrier as well as a competitive factor (Peterson, 2017). This makes it equally tough for NPs to provide care without compensating appropriately for the services. This also means that if a NP is not able to get reimbursement for services, it could lead to budget shortfalls leading to layoffs.After many years of fighting to grant NPs the ability to practice without doctor supervision, Senator John Moorlach (Republican-Costa Mesa) and many other Californian lawmakers recently has proposed a measure on Governor Gavin Newson’s desk for consideration. The bill will lift the stipulations on NPs allowing them to practice using his/her own autonomy independently. Currently under the AB-890 Scope of Practice for NPs has the ability to prescribe level II-V drugs, administer medications, diagnose, referral, and care of patients all under a doctor’s supervision (https://www.ca.gov/serp/?q=nurse+practitioner (Links to an external site.)). Interest groups that influence APN policy are American Nursing Association (ANA), American Advanced Nurse Practitioner (AANP) along local state board and the federal government have the ability to change the scope of practice for NPs. These groups advocate and keep NPs up to date with the regulations and policies within their state. With the shortage of primary care physicians and increasing chronic illnesses of patients, California will have to make a decision soon about allowing NPs to practice to their full scope with supervision.There are many methods to influence change that an NP can be involved in. For example, it is important for NPs to advocate for health policies by conducting projects which focus on improving the quality of care and how essential NPs are to the healthcare team. The results can be implemented into policies at their workplace and community. Another way is writing letters to legislators and helping lawmakers work on amending the current health policy bill. NPs have the clinical and educational background and can give validity to changing policies at a local, state, and federal levels. Lastly, joining nationals organizations to lobby on healthcare issues will help bring the benefit of change. Barnes (2015), stated that being able to transition from the registered nurse (RN) role to the NP role is essential for change to happen. NPs are leaders within the healthcare team.Barnes H. (2015). Exploring the Factors that Influence Nurse Practitioner Role Transition. The journal for nurse practitioners : JNP, 11(2), 178–183. https://doi.org/10.1016/j.nurpra.2014.11.004Peterson M. E. (2017). Barriers to Practice and the Impact on Health Care: A Nurse Practitioner Focus. Journal of the advanced practitioner in oncology, 8(1), 74–81.https://www.ca.gov/serp/?q=nurse+practitioner

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