Meet the New President of the AANP: Stephen A. Ferrara

Meet the New President of the AANP: Stephen A. Ferrara

The American Association of Nurse Practitioners (AANP) welcomed Stephen A. Ferrara, DNP, FNP-BC, FAANP, FAAN, as the organization’s new president, taking the reigns from former AANP President April Kapu, DNP, APRN, ACNP-BC, FAANP, FCCM, FAAN in late-June.

Ferrara is a busy man, wearing many hats.

meet-the-new-president-of-the-nurse-practitioners-stephen-ferrara

He’s an actively practicing NP in New York and a member of the senior leadership team at Columbia University’s School of Nursing, serving as the associate dean of clinical affairs and assistant professor responsible for overseeing the NP primary care faculty practice located in New York City and teaches health policy in the DNP program.

Ferrara is passionate about health information technology and integrating evidence-based practice into daily nursing practice. His doctoral work examined the impact of

group medical visits for patients with Type 2 diabetes and whether this intervention led to better health outcomes. He’s been honored with the AANP New York State Award for Clinical Excellence and inducted as a Fellow of AANP, as well as into the American Academy of Nursing and the New York Academy of Medicine.

 Meet Stephen Ferrara, the president of the AANP.

Congratulations on becoming the new president of AANP. What do you look forward to most at the helm of one of nursing’s most influential organizations?

It’s just great to be leading the largest NP organization that represents over 355,000 nurse practitioners across the U.S. I’m excited to continue to have nurse practitioners partner, care, and grow so we can build the NP workforce for the future. We do that through speaking with our policymakers and modernizing state and federal laws that will allow our patients greater access to NPs.

Talk about your early years in nursing and what inspired you to become a nurse.

I’ll start with what inspired me to become a nurse. I knew early on I wanted to be in a profession that helped people. I was unsure what that profession would be, but I always gravitated towards the help professions. I credit my aunt, a nurse, who all the while was saying consider nursing, and I did it. It took me a while to come to that decision on my own. Once I understood the role of nurses and patient advocacy, the ability to share health information and care for people and promote health and wellness, that was my epiphany.

Once that all came together, I said okay, this is what I want to do. So, I credit my aunt for putting me on the path to my career as a nurse practitioner. I knew I wanted to work as a nurse practitioner early on. I worked on a med-surg floor, which was a heavy orthopedic floor. And I give kudos to my colleagues who are on units in hospitals. But I knew that helped solidify that I did not want to be in that environment. I wanted to see patients on an ambulatory basis. And that’s where nurse practitioners became the natural fit for me. I’ve worked in some prior healthcare settings. I was associate director of student health services at Fordham University and loved working with college students. I also worked in retail health for a bit with MinuteClinic. Before joining the Columbia School of Nursing, I worked in occupational health. So, I was always connected to primary care. That’s where I wanted to be. That’s where I thought I could influence my patients and partner with them to reach our shared goals.

I’ve been incredibly fortunate to have these roles and fulfill what I wanted to do. Other than my presidency of AANP, I am the Associate Dean of Clinical Affairs at Columbia University School of Nursing. I oversee our primary care nurse practitioner practice as my everyday work, so I still do similar types of work, but more on a system scale than an individual patient basis. And I feel like I’m still contributing to the healthcare system through that NP lens.

When you were the executive director of the Nurse Practitioner Association of New York State (NPA), you were frustrated by arbitrary limitations” in your practicer and successfully advocated for full practice authority (FPA). Can you talk about that?

I enjoyed my time at the Nurse Practitioner Association of New York State as a member of that organization and then ultimately as executive director. I was frustrated by things such as not being able to sign most medical orders of life-sustaining treatment forms or not being able to sign, believe it or not, a barber who needs a physical to be cleared to get their barber license in New York State. As a nurse practitioner, the law at the time prohibited NPs from signing this form. I’ve been performing physicals for hundreds of patients across the spectrum, and organizations accept my signature, except for this barber form. Some of those examples drove me to get involved at the policy level. And I thought that all we need to do is change these laws, and then you could do it, but it’s not an easy task. It’s certainly empowering to feel part of it, and my frustrations were not just mine. Once you speak to colleagues, they have the same frustrations. So, working with people who want the same things, ultimately taking care of the patients in front of us without those barriers, was very empowering.

In those ten years, nurse practitioners can now sign most forms in New York State, and we can sign the barber physicals. In April of 2022, New York Governor Kathy Hochul signed legislation that nurse practitioners with more than 3600 hours of clinical experience have full practice authority and are no longer mandated to have any contract with physicians to practice. So, what this means is increased access for patients. It means a more equitable healthcare system. We are improving those dynamics around us. I advocate for everyone to get involved in health policy because it affects us all personally or professionally. So, NPs have a crucial role in advocating. Nurses are the most trusted profession in the Gallup poll every year. And we need to continue using our voices outside patient rooms with our policymakers and lawmakers. So they need to hear the stories of the challenges we face that impact patients in their constituents and districts and then work together to solve them. I want to leave this profession better than when I found it. And it requires not just nurses and nurse practitioners to talk about these things, but collectively, we need to use our voices to escalate these issues. And we know as nurses, we’re leaders, we have no problem advocating for our patients. I would love to see us continue that advocacy beyond and to our lawmakers and policymakers.

You’ve worked with several national organizations. Can you talk about who they are, what motivated you to join them, and how nurses can become more involved? 

I’ll use AANP as the first national organization. People need to join their membership organizations. They don’t necessarily consider joining an organization because information is out there, but our national organizations advocate for the profession. And they are looking out for us in ways we cannot do alone. So, join your national organization and your state organization. Sometimes, they’re not the same organization. And that’s somewhat confusing. So you have to be a member first and foremost. I recognize, and I’ve been through the ups and downs of a career, and sometimes you want to reach out to your organization and say, “I’m a volunteer, and I want to help you. I want to lend my talent.” And sometimes you are so busy with your work and personal life that you can’t possibly volunteer any more time, and that’s okay. But we want you to be a member. We want you to lend your time and talent and be part of the membership. That’s how we can band together and use our collective voices. Hopefully, that’s a loud voice with more people supporting the cause.

The other organization I’ve been involved with for two years is Jonas Nursing and Veterans Healthcare. I led that organization as executive director, and that was a fantastic opportunity to support nurses returning to school for their doctoral education in the form of scholarships. So, it was empowering to hear the stories of the applicants and what they wanted to do with their advanced education and plans. In every instance, it was about bringing increased access to care to their communities or studying underserved communities historically passed over. It was inspiring to me. It gives me hope for the profession’s future, knowing that such passionate people are in the pipeline and looking to finish their education to do the work they feel most impactful for their patients and their communities. So it’s been great.

You’ve worked in several nursing leadership positions. What advice do you have for nurses seeking leadership positions?

First, you need some experience. People should volunteer, whether volunteering their time or being a mentee, reaching out to individuals who might be out there who could help them. I support and endorse the idea of a mentor-and-mentee relationship. Finding the right mentor takes time. Sometimes, that mentor may not be available to you based on what’s going on in their lives. So there needs to be a plan, and you need to have a few people on your list that you identify that you can say, hey, I’m going reach out to them to see if they’ll give me some words of advice. I think that’s quite powerful.

The other thing to say to people is that once you have some experience, go ahead and apply for the job. You may not get that role, but going through the steps of submitting an application for interviews is always good. And it allows you to interview that organization as much as they’re interviewing you. That’s a key. As people mature in their careers and roles, I remember being in love with a job before it was offered. I’m like, “Oh, this would be the perfect job for me.” And then you go on the interviews, speak with people, and do your diligence. You’ve concluded that maybe that role is not the best for me. And I think that takes just having some experience, speaking with people, and making the best decision for yourself. Sometimes, we forget about that when we go on job interviews. We see a job description on paper, and it looks perfect. But the reality is no job is perfect. You have to look at the full pros and cons of any situation. Certainly, there are lots of opportunities for people to get involved. Nurses make great leaders, and I encourage people to seek those leadership positions.

Speaking of leadership, what was your motivation to run for president of the AANP?

I wanted to give back to my profession. I wanted to support the profession in ways I felt supported in the 20-plus years I’ve been a nurse practitioner. So I like working with people. I like making changes at the system level. And being the AANP President would allow me to continue doing those things at a national level. And so far, I am just still a few months into this. I officially became president at the end of June, but it’s been fun. It’s been so rewarding to me. Hearing and speaking with our members invigorates me and gives me the passion to continue creating positive change.

You are particularly interested in health information technology and integrating evidence-based practice into daily practice. How do you plan to make that a focus of nursing?

From a healthcare technology perspective, I think there’s a huge potential to allow us to care for patients better. The example I like to use is the electronic health record, which is sometimes challenging because it’s very structured and takes more time. But what we have accessible to us that we didn’t have before is just reams and reams of data. And it’s a lot of data points, and no human can look at all these data points and make sense out of them. And this is where I see the potential of artificial intelligence to look at information and summarize it. We have wearable technology like the Fitbit and Apple watches and things like that. We can get EKG readings every hour that can go to anyone. But that information isn’t helpful if it’s just recorded as a point in time. And that’s where technology can help us make better sense of the information and determine if this information that we’re getting is good and if it’s actionable. And that’s where a clinician’s expertise comes in to say yes; this is good information that I can make an educated decision for my patients. So that’s critically important.

My doctoral work focused on evidence-based practice to critically appraise data and ensure we’re doing things in healthcare because they are based on evidence and not just how we always did that. It’s vital for credibility; it’s essential to new treatments, and as we learn more about disease processes, it’s critical to keep incorporating these aspects into our daily practice. And then there’s the research piece. There are so many opportunities for research for nurse practitioners. At Columbia University, we’re working with our researchers on nurse practitioner and patient outcomes, but not just that. We’re also looking at nurse practitioner-led interventions and different studies aimed at taking better care of patients.

What is your vision for AANP under your tenure? 

It will be working with our stakeholders and lawmakers at the federal and state levels. We want to remove barriers to practice that impede nurse practitioners from delivering healthcare to our patients. There are many outdated laws or policies, particularly Medicare and Medicaid. Medicaid is also legislated at the federal level, and there’s an opportunity there for us to make historic changes within those programs that will increase access to care. One of the items in the current bill in Congress, both in the House and in the Senate, is the ICAN Act, which aims to improve care and access to nurse practitioners. This bill will make many improvements and modernizations to laws, including a nurse practitioner’s ability to prescribe diabetic shoes for patients with Medicare insurance for cardiac rehab, inpatient cardiac rehab, and medical nutrition therapy. There’s a whole host of priorities that are included in this legislation. I was looking this up, and we only have 14 co-sponsors in the House right now for the ICAN legislation out of a possible 435 districts. On the Senate side, there is just one Senate co-sponsor. So, we have a lot of work to bring awareness to this bill and not have it lost in our society’s political discourse today. This means patients are prohibited from getting the care and access they need. The other thing we need to do is on the state level. We have 27 states that are full practice authority. We need to work with those 23 states that are not full practice authority. And we know that full practice authority leads to better outcomes. Most of the healthiest states in the nation are full practice authority states for nurse practitioners.

And conversely, the ones that are not healthy restrict NP practice. So there’s a lot of work to do. And it’s no one person’s responsibility to do all that work. But it’s truly working together and getting our lawmakers to listen to some of these challenges and hear the stories that everybody’s encountering on a daily basis.

You have a lot on your plate. What do you enjoy doing when you’re not working hard to elevate the role of NPs?

I put my family first and foremost. I enjoy being a father to my three children and a husband to my wife. My kids are involved in various sports and activities, so you’ll find me at the soccer or the football fields. I listen to music and exercise and try to have some sense of balance in my life. I also love things like sports and cars. I try to find a good mix of balancing everything, but sometimes it’s easier said than done.

Sweet Service: Nursing Diabetic Patients

Sweet Service: Nursing Diabetic Patients

According to the Centers for Disease Control, more than 100 million Americans have diabetes or pre-diabetes, making it the seventh leading cause of death in the U.S. as of 2015. As a result, a number of nurses work with patients who have this disease.

Joyce M. Knestrick, PhD, APRN, CFNP, FAANP, president of the American Association of Nurse Practitioners (AANP), says that one of the most alarming and interesting factors is that many patients who come to see their nurse practitioners (NP) have no idea that they have the disease. “Roughly a third of Americans with the disease do not know it, and every 21 seconds, another person is diagnosed. And it is for this reason that diabetes is called the ‘silent killer,’” explains Knestrick.

What can nurses do to help these patients? “As NPs, we discuss things like obesity, poor eating, and bad exercise habits as risk factors that drastically increase patients’ chances of becoming pre-diabetic or diabetic. That’s really what we do on a daily basis—examine patients for warning signs; get to know them by discussing their history, their lifestyles, and their families; and, if need be, order various tests to help us gain more information that allows us to put patients on a proper track towards better health,” explains Knestrick. “As NPs, the key is threefold: active listening to your patients, adaptability to each patient’s unique set of needs, and the flexibility to lead or assist a care team all the way through the patient’s care continuum. So it is really NPs who are on the front lines, so to speak, with the patients battling this disease, and we work very closely with organizations who are working hard to raise awareness about diabetes and how it can be prevented, mitigated, and treated.”

Diabetes, Knestrick says, has devastating effects on patients’ bodies. “NPs have a daily responsibility to understand the risk factors and work with patients to mitigate those risks before they become diabetic. Like with so many diseases, NPs help patients focus intensely on prevention efforts and ways to take better control of their daily health,” she says.

In addition to what diabetes can do to people’s bodies and affect their overall health, Knestrick also points out that there are also astronomical economic costs associated with this disease. “A lack of overall awareness had led to over $322 billion spent annually treating diabetes. This means that health care costs are almost two-and-a-half times higher for someone with diabetes, and that is largely because of additional and devastating complications that result,” she says. “That is why we cannot emphasize enough that it is not just about people with diabetes, but that everyone has a responsibility to elevate awareness so we can avoid the human and economic costs of this terrible disease.”

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