The Impact Scope-of-practice Laws Have on Urologic Care Outcomes

Raychael Noland, BSN, RN; Peggy Ward-Smith, PhD, RN


Urol Nurs. 2020;40(5):251-255. 

In This Article

Description and Role Functions of the Urology NP

The Society of Urologic Nurses and Associates (SUNA) (n.d.) provides specific competency training for advanced practice nurses (APRNs) who desire to expand their clinical functions. The SUNA scope of practice focuses on all APRNs; however, because NPs are the only advanced practice providers who can sustain a specialty practice in urology, this is the focus of this article (Quallich, 2011). Current data from SUNA indicate there are 537 SUNA members who are NPs; 235 of these individuals are certified (C. Page, personal communication, August 31, 2020). Survey data from 296 APRNs who were members of the AUA, the Urological Association of Physician Assistants (UAPA), or SUNA were obtained in 2017 (Langston et al., 2017). While results of this survey did not separate physician assistants (PAs) from NPs or other advanced practice nurses, the majority of the responses (62%) were from NPs. These data describe individuals who provide care primarily in ambulatory care settings (73.4%) and perform a variety of low-, medium-, and high-complexity procedures. In a commentary article, Doran and associates (2018) describe the various procedures and the increase in the number of procedures performed by PAs and NPs. Procedures include cystoscopy, transrectal prostate biopsy, complex indwelling catheter placement, urodynamic testing, and renal ultrasound.

Urology-specific workforce projections were reported by McKibben and colleagues (2016). This report describes a decrease in urologists over the upcoming decades, with urologist and advanced practice personnel unable to meet health demands. These authors predict that by 2035, the workforce shortage will range from 12% to 46%. Creative solutions to meet this impending workforce shortage are recommended.