If you can’t attend, we’ve got you covered in advance as we sat down with Debbie Hatmaker, PhD, RN, FAAN, the Chief Nursing Officer at the American Nurses Association (ANA)Enterprise, to discuss the ANA’s role in addressing the nurse staffing crisis and how nurses can use the Magnet model to better their careers.
What follows is our interview, edited for length and clarity.
American Nurses Association (ANA) Chief Nursing Officer, Debbie Hatmaker, PhD, RN, FAAN
-Earlier this year, the ANA urged Congress to address the nurse staffing crisis and the work environment issues. Can you discuss the need for a national dialogue and ongoing collaboration between nurses, Congressional leaders, and other key stakeholders to support our nursing workforce, patients, and our nation’s health and well-being?
The nurse staffing crisis continues to demand a national dialogue with nurse-led approaches to help ease the enduring work environment challenges that nurses face across numerous specialties and healthcare settings. We support enforceable minimum nurse-to-patient ratios that reflect key factors such as patient acuity, intensity of the unit practice setting, and nurses’ competency, among other variables. And this is just one part of a larger solution to solve this.
We continue to work on addressing other challenges that have significantly made the nurse staffing issue worse, such as burnout, workplace violence, mandatory overtime, and barriers to full practice authority.
Nearly 400 ANA members convened at the U.S. Capitol, representing the nation’s more than 4 million registered nurses, to petition Congress to address the national nurse staffing crisis this summer. In addition to advocating, ANA is also advancing solutions from the 2022 Nurse Staffing Think Tank2022 in partnership with other leading organizations, which produced a series of actionable strategies that healthcare organizations could implement within 12 – 18 months.
We continue to advocate on behalf of nurses and remain a collaborative partner. Our goal is to empower nurses and position them for success. We continue calling on Congress to enact meaningful legislation and policies that improve nurse staffing and work environments.
–How can nurses use the Magnet Model to better their nursing leadership and shared decision-making?
The Magnet process fosters a collaborative culture that spurs shared decision-making. Magnet organizations are even provided with a multiyear framework for quality improvement and a structured way to engage staff in decision-making. This tool can help energize and motivate teams. In fact, team building, collaborating across disciplines, regular open community, and building staff engagement, while difficult to quantify, are often what happens during the Magnet process.
-What are some questions to ask before accepting a job at a Magnet hospital? Can you offer some tips for helping nurses choose which Magnet hospital to work in?
Each Magnet-recognized organization will have its own hiring standards, so each nurse should review those as they apply for or accept a position. But they should know that whatever role they fill, a Magnet organization will invest in them and their potential. At ANCC, we’ve created a free resource for nurses looking for select practice environments and interview questions to ask.
Magnet Recognition means education and development through every career stage, which leads to greater autonomy at the bedside. A Magnet organization supports opportunities for nurses to pursue new skills and professional development, champions them in those pursuits, and rewards them for advancing in their profession.
We’ll be at the 2023 ANCC National Magnet Conference® October 12-14 at the at the McCormick Place Convention Center in Chicago, Illinois. Stop by booth #918. We look forward to seeing you there!
Whether you know Nurse Blake (Blake Lynch) from his Facebook videos, podcasts, live comedy shows, or cruises, he’s proven that he’s a nursing force to be reckoned with using his humor to bring nurses together.
After graduating with a BSN from the University of Central Florida, Orlando, Florida, and working in trauma centers around the country, Nurse Blake started posting original comedy videos to cope with the stress of his nursing job. His lighthearted videos connect with nurses, nursing students, and healthcare workers worldwide, and he entertains almost four million followers on social media while lifting healthcare workers across the globe.
But Nurse Blake is more than comedy.
He’s the creative force behind NurseCon at Sea, one of the largest and most popular nursing conferences, and the NurseCon app, which provides free continuing nursing education courses.
Meet Nurse Blake, a nurse, creator, internationally touring comedian, healthcare advocate, keynote speaker, and creator of NurseCon at Sea.
Minority Nurse talked with Nurse Blake about running one of the most popular nursing conferences and his plans for NurseCon at Sea 2024 in Mexico.
Where did you go to nursing school, and what was the experience like for you?
I graduated from Seminole State College and the University of Central Florida in 2014. I was in a concurrent program. So, I got my ADN through Seminole State and my bachelor’s through the University of Central Florida.
Nursing school was hard, challenging, and not easy, and I had a lot of meltdowns, but I did it. And when I was about halfway through my program in 2013, I became president of the Florida Nursing Student Association. And that sheds light on gaps in education for nurses. I attended many nursing conferences; they were all so boring in these hideous corporate centers. So, I knew back in nursing school that I wanted to shake up the nursing conference world, but I didn’t know what that would look like. I thought about taking over one of the state nursing conferences, but zooming ahead to 2019, I decided to create my conference, NurseCon.
What was your inspiration to create one of the largest and most popular nursing conferences, and what goes into planning such a big event?
When people ask if I’m still a nurse at the bedside or in a hospital, I’m not anymore because I’m not only busy with my comedy tour, which takes me away multiple months out of the year, but I also manage and run NurseCon with a team of 90 people, including full-time and part-time employees and contractors. NurseCon is a massive team effort; I couldn’t do it alone. I have an office in Orlando, Florida, which is convenient because our cruises sail from Miami. So, in addition to the 1,000 staff members, we have a team of almost 100 NurseCon at Sea people trying to make this conference the best experience for our guests. So, we have educators and customer service, and we bring in our dancers, DJs, and production. So, if you look at our pictures from NurseCon at Sea and say, “Wow, that pool is so lit,” it’s because we bring our fog machines, lasers, and lighting. We have a huge production team and staff that helps elevate the regular cruise ship experience, which is already so amazing and epic, but we want to put the NurseCon at Sea touch to it.
Education is the most important. NurseCon at Sea isn’t a nursing conference without education. So, we are accredited by the American Nurses Credentialing Center (ANCC) and the California Board of Nursing. I have three DNPs that run and manage nurse candidacy education full time. We are super committed to it, and we’ll probably bring on 30 educators on our next sailing to deliver over 70 hours of CNEs. That number has gone up every year. Our first year, it was 20 hours of CNEs. Then it was 36. And now we’re jumping to almost 80, which is pretty impressive. And it’s all included in the price of the conference. We also specialize in continuing nursing education for nurse practitioners and the pharmacology track. CNEs are expensive, hard to find, and nurses need many hours. So, that’s also something we provide, and that’s included. We’ll probably have about 150 nurse practitioners in our pharmacology track on the cruise ship, which is incredible.
Do NurseCon participants request course offerings that you incorporate into the nursing conference?
Yes, we have education committees made up of some of our educators and also participants of NurseCon at Sea. This is their experience. We provide the venue, the CNEs, and the entertainment, but the guests make it an experience. So, we also always value our feedback and survey our guests after our cruise sails and even on the ship to make it the experience that nurses deserve and the experience they want. It’s such an inclusive, happy conference. And it’s all because of our guests. They make it such a safe space for everyone to be themselves and talk about the issues they’re facing, and to me, that’s the most extraordinary thing about NurseCon at Sea. We have nursing students that come on. We have retired nurses and nurses from around the world attending many specialties. Everyone in the nursing world can learn from each other even though you’re not from a specific specialty. And no matter your age or status. We’re all here to learn from each other. No matter how many degrees you have or certifications, no one’s better than anyone else.
Everyone attending NurseCon looks like they’re having a great time. Talk about what a nurse attending NurseCon can expect.
It’s epic. Vacations sometimes are once in a lifetime for people, and for them to connect with friends and family or coworkers is super special. We’ve done three cruises since we launched and had groups of nursing students who graduated together 20 years ago. Now it’s their annual trip, and they’ve been on all three. So, now it’s becoming a tradition for some people, and that’s special.
People make T-shirts, go all out on our theme nights, and are already getting their outfits ready. So, it’s a community within a community. And not even I am in all these special groups where they talk about what they’re going to do for next year. So, it’s so cool that it even lives outside of me, and NurseCon at Sea has become its own culture created by the guests.
Next year’s NurseCon event is in Mexico. Can you talk more about the courses and features?
Mexico’s going to be great. We always want to provide a new incredible location or port. So, people can get off the ship and choose whatever activities they want to participate in. We also have two full days at sea, so it’ll be our longest one yet. And that’s because people wanted it to be longer. And our theme nights are sports night and fairy tales. So, everyone will be super busy, and I can’t wait to see everyone’s outfits. I know the dancers are so excited and already rehearsing and working on the production. We meet every day about NurseCon at Sea, so as soon as the last one is over, we’re already preparing for the next one. I will be working on booking our 2025 cruise later this month.
The NurseCon at Sea app provides users with their continuing education for free. But it’s more than education. Please talk about your inspiration to create the app and its impact on nurses.
We have the NurseCon app; you can also access it on NurseCon.com. If you can’t attend the conference or need CNEs, we have a library where nurses can get them for free. I know a lot of other websites out there that say it’s free, but then you take the course, and then you have to pay for this certificate, or only one course is free. Ours is free, which is cool. I decided to launch this during the pandemic. I knew nurses were working so hard going through that, and I wanted to provide them with an education platform so they can get their courses for free. So, that stayed consistent. Once nurses attend our cruise, they can get their CNEs through that platform. And we will also be putting our courses from the cruise on that platform. If you can’t attend the event for whatever reason but are interested in those courses, you will take them and get the CNEs for free after the ship has sailed.
We like to talk about topics that many other conferences don’t necessarily talk about, and that’s so special. The coolest part is that you don’t have to be a nurse to attend. You have to be a guest of a nurse. And we were doing a course on pediatric trans health, and a nurse attended with her husband, who was just on as her guest. And he’s not in healthcare at all, but he sat through the course and came up to the educator afterward and cried. And they thanked the educator because their child is trans, and they learned so much from a non-healthcare perspective just from being on the ship and attending a CNE that the nurse didn’t have to attend. Knowing that it’s going to have a positive impact on their child’s life and their life as a family unit is what makes continuing education for nurses the most special.
What makes NurseCon at Sea different from other nursing conferences?
It’s the diversity on the ship. It’s incredible. I’ll look around a room, and this is what nursing is supposed to look like. This is what nursing is supposed to be, just like this in this positive environment with nurses of all ages and backgrounds coming together and learning from each other. That’s all the community. It gets back to all our guests, making it a safe space for everyone.
The annual recognition of Certified Nurses Day on March 19 honors the nurses who go the extra step to achieve certification in their specialties. But the day also helps raise awareness in the nursing community about the importance of certification and the benefits it brings to a nursing career.
Certification is an excellent career advancing move; after all gaining more knowledge and skills in your nursing specialty is only going to help you be a better nurse. But many nurses overlook another important result of gaining certification–the confidence boost it gives you and the new peer recognition of your advanced knowledge.
Clara Beaver, MSN, RN, ACNS-BC, AOCNS, and president of the Oncology Nursing Certification Corporation (ONCC) says certification brings better patient care, but also changes a nurses relationship with patients. “The best part [of nursing] is the buildup of trust with patients,” she says, “and having certification shows you have that commitment to oncology and that you have that knowledge. You both care about it and you know about it.”
Each certification is different, so look into one that that matches your specialty area. For example, ONCC offers five certifications: Oncology Certified Nurse, Certified Pediatric Hematology/Oncology Nurse, Certified Breast Care Nurse, Blood and Marrow Transplant Certified Nurse, and Advanced Oncology Certified Nurse Practitioner. Beaver says the bone marrow and breast care certifications are newer and were industry driven as a result of many nurses specializing in oncology subspecialties.
Some nursing specialties are starting to require certification as the advanced and most current skills are required for patient care. Many Magnet hospitals require certification for some nurses as do many cancer centers.
“We’re always trying to find the value in increasing knowledge and commitment,” says Beaver. “Certification says to the community that those nurses are staying up-to-date on what’s going on and their skills may be higher.” Beaver says when she became certified it made her think about patient care differently. “I looked at my patient differently because I had increased knowledge,” she says. :I looked at the entire background and not just at the task in front of me.” With certification, Beaver says she understood more of how things worked and could explain what was going on to the patient a little more.
Nurses who are certified are proud to show their certification, says Beaver, because it is instant recognition that you’ve gone above and beyond what’s required. “I feel like certification takes you up a little higher and they become like the informal leaders. They have raised confidence.” And their success with becoming certified shows other nurses that they can also achieve the same thing.
Nurses do find one of the biggest roadblocks to certification is test anxiety. “Nothing is as bad as the NCLEX,” says Beaver with a laugh. Before each of her three certification exams, Beaver says she had to overcome major test anxiety, so she understands why it can be a deterrent. “I just had to remember this is what I do every day,” she says. “Test taking is scary.”
Before each exam, she studied the test blueprints. She also pulled all the resources that were referenced to study those as well. That’s what the questions are based on, she says, so review all that information carefully. “Pull the statistics and the references,” she says and find out your weakest areas so you can focus on those places intensely. Reading information out loud helped Beaver retain the information, and she encourages nurses to find a method that works best for them.
When you sit for the test, Beaver suggests that you read the entire question, then read all the answers, and then go back and read the question over again. This will help you slow down and comprehend exactly what is being asked.
If paying for the exam is a barrier, see if your organization will help pay for it or if a professional organization will help.
“Certification is an important part of our job as nurses,” Beaver says. “And it’s attainable. It expands your knowledge base and your skill set. And it shows a commitment to what you are doing.”
Critical Care Transport Nurses Day on February 18 brings attention to the vital work done by nurses in this specialty. Working on a flight or ground vehicle adds complexity to this fast-paced career, and the nursing industry is helping these nurses stay informed and educated throughout their careers.
Critical care transport nurses provide medical care to ill or injured patients as they are transported by flight or ground to facilities where they will receive additional care. The distinct environments require different training and certifications to meet the needs of transport nurses. This July will mark the 30th anniversary of the Certified Flight Registered Nurse (CFRN). Ground transport nurses began taking the Certified Transport Registered Nurse (CTRN) certification when it was introduced in 2006.
“This is a rigorous, scientific process done in consultation with a panel of ground and flight transport RN experts,” says Schumaker. “This process ensures the exams reflect current practice and roles for nurses in each specialty. So everything on the CFRN exam content outline is flight specific and everything on the CTRN exam content outline is ground specific. And now there are separate test item banks, too.”
The recent BCEN survey showed how critical care ground transport nurses work within incredibly complex environments and that they take great pride in their capabilities. What surprised you most about the findings (or perhaps reinforced what you already knew)?
The responses to [the survey] really underscored ground transport nurses’ pride and sense of accomplishment in being board certified in their specialty—and rightly so—and the significant ways certification contributes to their ability to be the best nurse they can be. Chief among these is how CTRN certification contributes to their critical thinking, confidence, clinical knowledge, and ability to provide expert care for their patients in the very dynamic and highly technical ground transport setting.
Ground transport nurses and their clinical partner, typically a paramedic, care for high acuity critically ill patients, sometimes over long distances, relying on their joint expertise and experiences and what’s in their specially-equipped truck until they get to their destination. They have to be at the top of their clinical game and prepared to provide life-sustaining and even life-saving care, and also know how to keep their patient and their team safe—all while they are on the move.
Nurses gave feedback about having wanting more specific CE content and BCEN responded by creating the BCEN Learn CE platform. Why is this so important for transport nurses’ ability to keep their certifications current?
CTRN- and CFRN-certified transport nurses, like all nationally board-certified nurses, make a commitment to know and stay abreast of the latest trends, advances, and best practices across their specialties. And that is no small feat.
Emergency, trauma, and transport nurses had been telling BCEN for some time that they wanted and needed more advanced and specialty-specific continuing education content to support their commitment to lifelong learning and help meet their certification renewal requirements. In response, we developed and launched the online (and now, award-winning) BCEN Learn platform in 2020 and offered our first regional, in-person CE conference, BCEN Learn Live, in 2022. The 2023 conferences will be held in Dallas in May and Charlotte, NC in November.
There are now 90 high-interactivity CE courses designed by and for nurses practicing across the emergency spectrum including in transport settings on the BCEN Learn platform. There are also more than two dozen free CE webinars, with a new title debuting each month.
Nurses interested in or practicing in transport settings can earn one free contact hour by listening to these free transport-specific webinars:
The shift in separating the credentialing exam content outlines and test item banks into ground- and flight-specific shows how dynamic critical care transport nursing really is and how important it is for nurses’ continuing education opportunities to keep pace. What is the biggest factor in the changing landscape for critical care transport nurses?
New clinical knowledge, new techniques and technologies, new equipment, evolving professional issues, and public health challenges are all influencing factors. The separate CFRN and CTRN exam content outlines and separate test item banks, underline the distinctions between the ground and air transport settings.
While board exam questions are updated and new ones are added on a rolling basis, BCEN conducts a highly scientific role delineation study (RDS) every five years to make sure the content and relative emphasis in our credentialing exams are accurate, current, and relevant with respect to the roles and responsibilities of nurses in a given specialty. Our most recent transport nursing RDS took place in 2019, and I fully expect the new knowledge, advances, and experiences that came about during the coronavirus pandemic will be apparent as we go through the 2024 transport nursing RDS.
In addition to transport-mode specific updates to major sections of the now separate CFRN and CTRN exam content outlines, mental health was added as a category of the CTRN certification because mental health issues are becoming more common in the ground transport environment, for example. In the CFRN certification program, the emphasis on resuscitation and “special populations” were both increased due to greater volumes of high acuity patients transported by air and to adequately address essential knowledge regarding the special needs of obstetrical, neonatal/pediatric, geriatric, and bariatric populations.
The increase in critical care transport certifications over the last three years is impressive. What factors influenced that increase, and what does that tell you about transport nurses’ commitment?
It is! The number of CTRN-certified nurses surged 19 percent in 2020, 29 percent in 2021, and 24 percent in 2022. We think several factors may have contributed including a growing recognition of the knowledge, skills, and abilities that are unique to the ground transport environment and the volume of patients being transferred to facilities offering a higher level of care or specialty care (a trend seen long before the pandemic).
A solid 50 percent of the CTRNs surveyed reported doing more ground transports during the pandemic. Certain patients with COVID-19 needed to be transported by ground and not air and patients needed to be transferred to hospitals with available beds when local facilities were full.
Additionally, nearly two-thirds said having the CTRN credential contributed to their ability “to deliver the best possible care” for their patients with COVID-19. And that really speaks to a third, and maybe the biggest driver, which is a deeper appreciation of the benefits of nursing specialty certification to nurses, healthcare teams, and, above all, patients and their families.
What we know for certain is that CFRNs and CTRNs are highly committed to critical care transport nursing and their patients, and we couldn’t be more proud of their remarkable contributions.
For nurses who enjoy both nursing and business, occupational health nursing is a career that combines both interests. While the majority of nurses work in medical care facilities or settings, occupational health nurses work in an office setting and care for employees of a company.
Nursing, says Sanisidro, was a calling she recognized from an early age. “When I was young, every time someone was hurt, I was the first to go to the rescue,” she says. After considering a premed path, Sanisidro says nursing offered her something she knew would be essential to her own career satisfaction–high patient contact.
“But I had no idea occupational health nursing was even an option,” she says. She was disillusioned by her current nursing role and didn’t feel like she was able to make the impact she wanted or expected. When a professional contact mentioned a job at a large corporation and noted that Sanisidro’s nursing background and bilingual skills were ideal for the role, she applied. With her strong medical base and her understanding of workplace safety and preventative care, Sanisidro says she realized the role would allow her to flourish, and she accepted the role when it was offered.
With that introduction to occupational health nursing, Sanisidro never looked back and appreciates the variety of her work and the relationships with the people she cares for. “You never know what will walk in the door,” she says. “I have to stay on top of my game. I felt like I hit the Disneyland of occupations.”
The job also offers opportunities for nurses to gain essential business skills they might not have in traditional medical settings. As a liaison to the leadership, occupational health nurses are relied on to give concise presentations and gather and report on data. For those reasons, Sanisidro says advanced degrees will benefit nurses. Even if an advanced degree isn’t required, she encourages nurses to pursue them. Certification in occupational health nursing is also valuable, and certification for this niche is for entry-level skills, so new nurses are able to take the exam. “The most important attributes in an occupational health setting are those that can’t necessarily be taught,” Sanisidro says. “It’s having that desire, care, and compassion. You can’t teach that.”
Unlike many medical centers, save for long-term care options, employees are generally with a company for a long time. And nurses gain deep knowledge of the business aspects of a company so they become experts at about compliance and keep detailed records about visits. Although occupational health nurses have specific daily, weekly, and monthly tasks to track, the day-to-day work is unpredictable. “There’s no typical week,” she says. “And that’s the exciting part of it.”
As a nurse within a corporate setting, occupational health nurses’ duties are broad. They can be counted on to give hearing conservation testing, eye exams, and preventative programs including biometric testing, health coaching, and nutritional counseling. There will be biosafety questionnaires and follow up exams. Nurses in this role can also see emergencies like a cardiac event, seizures, or anaphylaxis or less traumatic problems of something in an eye, a rolled ankle, an abrasion, or checking an unusual mole or suspicious skin lesion.
Occupational health nursing is sometimes confused with occupational therapy, which is distinctly different. But many people aren’t familiar with occupational health nursing–even many nurses. “It’s not a specialty reviewed in most nursing programs,” says Sanisidro. “But once nurses find the niche, they stay for a long time.”
Another difference that many occupational health nurses find is that there is funding in the specialty. Corporations that have occupational nursing staff are making a purposeful, direct investment in the employees’ health and well-being. “We may not generate revenue, but we can demonstrate what was utilized this month and if visits were for personal medical or occupational reasons,” she says. “You have to get comfortable with public speaking, PowerPoint presentations, and speaking the lingo of business, because businesses listen to dollar signs.” Occupational health nurses are also advocates for employees, so they are comfortable alerting the company to a workplace safety issue or a strange odor before it becomes a larger problem.
Employees, in turn, appreciate the convenience of health care in the workplace with someone they recognize and trust. “You develop a rapport and trust with them,” says Sanisidro. “They can just pop in and say hello.”
If occupational health nursing interests you, Sanisidro recommends reaching out to an occupational nurse for a conversation, shadowing a nurse to see what the role is like, or even picking up some per diem jobs through an agency to get a feel for the position. “If they love helping others and are caring and compassionate nurses,” she says, “everything else can be taught.”
In the long struggle to gain full practice authority (FPA), nurse practitioners (NPs) can point to notable advances in the last few years. Now, patients in more than half of the states, the District of Columbia, and two U.S. territories have full, direct healthcare access from NPs.
In April 2022, New York and Kansas granted FPA to NPs. That brings to 26 the number of states where NPs can practice to the top of their license without restriction. In this article, we’ll look at how that progress was made, the impact of COVID, and how newly proposed federal legislation would strengthen NP practice. But first, let’s have a look at what FPA means.
“Full practice authority is essentially that the nurse practitioner can practice to the full extent of their education and training,” says April N. Kapu, DNP, APRN, ACNP-BC, FAANP, FCCM, FAAN, president of the American Association of Nurse Practitioners (AANP). “Nurse practitioners are trained to evaluate patients, make diagnoses, order and interpret tests, prescribe medications, coordinate care, and educate. We are educated and trained to do these things,” says Kapu.
In the past few years, the pace has “really picked up as we have seen more and more states move to full practice authority,” according to Kapu. She notes that four states moved to full practice authority through the pandemic: Delaware and Massachusetts in 2021 and New York and Kansas in 2022. “It’s because we demonstrate our commitment to quality and equitable care and ensuring care is provided in all communities.”
In states that have moved to full practice authority, “we’ve seen improved patient care outcomes. We’ve seen an increase in the workforce. We’ve seen an increase in nurse practitioners working in historically underserved urban and rural areas,” Kapu says.
FPA, COVID and Care
While devastating, COVID helped bring to light the high-quality care that NPs provide and boosted efforts to gain FPA. In some states where NPs worked under less than full practice authority, the governors signed executive orders waiving various restrictions, notes Kapu.
“That’s where we saw the opportunity for nurse practitioners to continue providing care. They provided very high-quality care. They were able to provide more accessible care. As you saw throughout the pandemic, they were in communities and churches, going door to door, seeing patients in their homes, and doing everything they did in the hospital and the ICUs. So we demonstrated that continued quality of care. And that is what quickened the momentum during the pandemic; the executive orders provided that opportunity,” Kapu says.
In Ohio, a reduced practice state, an emergency authorization during COVID allowed NPs to deliver care via telehealth, notes Evelyn Duffy, DNP, AGPCNP-BC, APRN-NP. However, she notes that NPs can still practice via telehealth, and that ability is no longer contingent on the emergency authorization. Based in Cleveland, Duffy is an NP in the University Hospitals Geriatric Medical Group and a professor at the Frances Payne Bolton School of Nursing.
An NP since 1981, Duffy notes that “we’ve come a long way in Ohio. We got full prescriptive authority at the end of the 1990s.”
However, like all Ohio NPs, Duffy needs a collaborative agreement with a doctor. “Ohio is in the reduced practice category,” she notes. “Not a lot obstructs me from doing what I want. The only thing that gets in the way is having to make that collaborative arrangement.”
Kapu stresses the need to get out the message that laws limiting NP practice need to be revised. Laws need to be updated to “allow NPs to practice to the extent of their education and training, not beyond that, but to the extent of their education and training, as they are very capable of doing and have decades and decades of evidence demonstrating their quality-of-care outcomes. So it’s getting that message out that all we have to do is update those laws. It’s no cost or delay and can be put into place, and you would see much-increased access.”
Kapu points to Arizona as an example of what may happen for states that grant FPA. Arizona, she notes, moved to FPA in 2001. Five years later, the NP workforce doubled, and rural areas saw a 70% increase in NPs.
FPA Federal Legislation
On the federal level, new legislation, the Improving Care and Access to Nurses (ICAN) Act, was introduced in September in the House of Representatives. Supported by the AANP and other major nursing organizations, the act would update Medicare and Medicaid to enable advanced practice nurses to practice to the top of their education and clinical training, according to a press release from the American Nurses Association.
Although getting FPA in all states has taken a little longer than wanted, “we have momentum,” says Kapu. “I believe we’ll get there, especially with the increasing access to care needs that we’re seeing in the United States today.”