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It’s 2016 and APRNs are still not recognized in all of the United States.  

In 2010, the Institute of Medicine released the report, The Future of Nursing, which outlined the need for advanced practice nurses (APRNs) to gain full practice authority in the United States.  This document, a collaboration of the Committee on the Robert Wood Johnson Initiative, set the policy agenda for APRNs to be given full practice authority in the majority of states that did not already have the legislation to support that practice. Full practice authority in every state is necessary to provide consistency in APRN practice, to provide access to healthcare for patients in greater numbers, to reduce healthcare costs and improve preventative health practices.  The IOM points out the disparities and waste in our current system, such as the ability of an APRN to have full practice authority in one state and go to a neighboring state and be unable to prescribe as much as a Tylenol without a physician’s oversight.  The Consensus Model for APRN Regulation, Licensure, Accreditation, Certification and Education set forth the structure in which states could base legislation of APRNs in the hopes to standardize practice.

 

The goal was to implement the model by 2015.Stethoscope-2

As of 2016, twelve states have fully implemented the full Consensus Model through legislation.  Many are close, but some are far from reaching full practice authority for APRNs.  I moved from Oregon, which has full practice authority, to Texas which limits APRN practice and requires burdensome physician oversight.  Instead of serving patients in my rural community, which suffers from disparities in healthcare services, I work in a nursing leader position, with a BSN requirement.   I am working with the state APRNs to advance legislation that will remove barriers to practice, but there is a lot of opposition from another special interest group, physicians.  Some physicians view APRNs as competitors, instead of partners in expanding healthcare services.

Political victories are happening.

West Virginia is on the cusp of expanding APRN practice authority and are waiting for their governor to sign the bill into legislation. Amy Summers, a member of the West Virginia legislature, was the lead sponsor of HB 4334 which expanded APRN authority to practice independently and to expand prescriptive authority.

Summers stated in defense of the bill, “This is not a new idea, this isn’t something that needs studied further. Iowa has allowed full practice authority for 33 years, Alaska 28 years, New Mexico 20 years.  No state has ever repealed full practice authority once it was given.”

I hope that Texas, and the many states that have yet to adopt the Consensus Model, will move towards joining forward thinking states.  States like Oregon, Idaho, Iowa, Utah, Montana, Maine, Nevada, New Mexico, North Dakota, Vermont, Colorado and Hawaii, all of which have given full practice authority to all APRNs.

How does your state measure up? Click here to find out!

 

 

 

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Joy Who?

The internet was in an uproar. Miss Colorado, Kelley Johnson, delivered a monologue about her experience of being “just a nurse” for the talent portion of the Miss America pageant. I watched it on YouTube the night of the contest. Like many nurses, I felt all the warm, fuzzy, nurse feelings and even got a little misty eyed. By Tuesday morning, the news reached my Facebook nursing groups. Joy Behar and Michelle Collins had mocked Miss Colorado on The View. Ms. Collins thought it would be a good laugh to poke fun at the heartfelt monologue delivered by Nurse Kelley. Ms Behar chimed in with the question, “why does she have a doctor’s stethoscope around her neck?”

A doctor’s stethoscope! Behar poked a sleeping bear with those words. Nurses roared into action as the disparaging remarks reached nurses across the globe. Hashtags like #nursesshareyourstethoscopes, #nursesrock, #nursesmatter, #notacostume, #mytalentisnursing, #nursesunite and #notjustanurse began trending on social media. I wish that Ms. Behar and Ms. Collins had supported Nurse Kelley, not only as a healthcare professional, but as a woman. It was disturbing to watch an all-woman-panel mock another woman for sharing her talent, the art of nursing.

The backlash from three million nurses was swift and strong. Pictures of nurses wearing stethoscopes flooded my news feeds. I spent time retweeting every one of my fellow nurses posts about the scandal. I was caught up in the collective outrage and for a few days I felt united with my sister and brother nurses.

Weeks later, the nurse hashtags have stopped trending and the conversation has changed to other hot topics. All of the nurse empowerment energy has evaporated.

Have we once again become stethescope#justnurses?

Joy Behar’s comment was careless. It was a throw away thing to say to fill up space and to seem like she had something intelligent to add to the conversation. I don’t believe that she meant it maliciously, she was being thoughtless. Her thoughtlessness united nurses in a way that I have not seen since nurses jumped on planes and busses to help in the aftermath of Hurricane Katrina. The energy on social media was exciting. It was gratifying to read supportive comments and see nurses being given positive attention. I loved seeing all the stethoscopes and reading nursing stories about where those stethoscopes have been. For a few days it has felt like nurses were united and a part of a large community. United in their outrage of being publicly mocked.
It is now clear that nurses have the ability to direct national conversations. Where have all the hashtags gone? Why aren’t there trending hashtags like #endhealthdisparity, #decreasepatientratios, #stoplateralviolence, #nurseautonomy, or #APRNsIncreaseAccessToHealthcare? Healthcare policy and laws are influenced by a handful of lobbyists and legislators. These lobbyists and legislators number far fewer than three million nurses, but their decisions affect the entire nation. Can you envision a healthcare system being directed by our modern day Florence Nightingales and Clara Bartons, with the support of the national nursing community?
The best thing that could result from this stethoscope spectacle would be for nurses to finally find their voice.

We have power to influence, educate and advocate for the healthcare changes that we know we need. We can command a national stage whenever we choose to unite behind a cause. Its time to come together to influence issues that affect our friends, neighbors and families. Nurses are never just nurses, it is time to prove it.

To take action start here: American Nurses Association

 

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