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.

A Nurse Practitioner Keeps Communities Healthy

A Nurse Practitioner Keeps Communities Healthy

Operating with the highest level of autonomy, nurse practitioners are lifelines for many patients.

This week’s designation as National Nurse Practitioner Week (November 10-16) is an excellent time to examine the roles nurse practitioners (NPs) play in the nation’s healthcare system.

The American Association of Nurse Practitioners is a leading professional organization for NPs and also leads advocacy for issues relating to NPs. A nurse practitioner has achieved an educational path that brings them to Advanced Practice Registered Nurse (ARPN) designation. That gives them essential nursing knowledge and combines it with the ability to use it in a more comprehensive manner than a registered nurse (the first step to becoming an NP).

One of the biggest challenges facing NPs today is achieving full-practice authority (FPA) in all states. Because NPs have wide-ranging responsibilities that include examining and treating patients, diagnosing illness, and prescribing medications, they often work at the level of a physician. In some states, a nurse practitioner is not mandated to work under the supervision of a physician or required to have a physician sign off on some of their treatments. In states that don’t recognize the full practice authority of an NP, that additional layer of physician sign-off is required.

A nurse practitioner is able to “hang a shingle” and operate as a solo practice in any location. Many NPs choose to do so in remote areas where practicing physicians are hard to find or in urban areas where transportation to a medical office is a barrier to care. They are a vital cog in the healthcare wheel. They often assume many of the responsibilities of a primary care physician, developing relationships and providing preventive and long-term care. They see and treat patients with chronic diseases like asthma or diabetes and work in conjunction with a specialized care team as well.

If upping your career to a nurse practitioner level interests you, there are steps to get started. NPs require a master’s in nursing (with a focus on the population you intend to serve) and achieving a PhD in nursing is desirable for this role. After becoming a registered nurse, completing the BSN and MSN, you’ll need to earn your state-level advanced practice nursing license.

While NP authority is determined on the state level, there is progress toward achieving a national model. For now, some states participate in the APRN Contract, which allows a nurse holding an APRN license to essentially have authority to practice in several states. Not all states are part of the ARPN, so you’ll need to check to see where your own practice location, or intended location, fits in.

Career outlooks for NPs are stable. As the number of family practice physicians decline and the population increases, NPs are there to help patients on a high level. They are also able to work with communities that may not have had reliable medical care in years. The freedom to develop deep and lasting multigenerational relationships with patients and families is a routinely cited reason for working in this busy role.

If you’re an NP, National Nurse Practitioner Week is a good reminder to let people know of the training and skill set required of nurses in this area of nursing. And it’s a good time to give yourself a pat on the back for all you do.

Happy National NP Week!

Happy National NP Week!

This week, the American Association of Nurse Practitioners (AANP) leads the celebration of National Nurse Practitioners (NP) Week to mark the distinctive benefits of this career path.

According to the AANP, approximately 248,000 nurse practitioners hold an NP license in the United States. The career is especially appealing as NPs generally have more autonomy than other nurses. In some states, NPs are able to practice on their own without physician oversight, and, in doing so, can provide a full spectrum of care. They assess, diagnose, treat, and make a continual care plan for patients, so they are involved in each step of the patient’s care. Because of that, NPs often form close, long-lasting relationships with those they care for. NPs are able to prescribe medications across the US and almost half hold hospital privileges as well.

Nearly 98 percent of NPs hold graduate degrees and more than 8 in 10 hold some kind of primary care certification. For all the education NPs earn, the Bureau of Labor Statistics reports that they are rewarded with a salary that hovers around $111,000 annually. The job outlook is growing faster than average with a 31 percent growth predicted by 2026.

If you’re interested in this in-demand career path, you’ll need to obtain a master’s in nursing degree along with plenty of extra credentials like certifications. NPs often hold more than one certification and the credentials can be in related areas like neonatal care and pediatric care. You’ll need to pass an NP state licensing exam so you can be registered to practice in your state.

Many nurses find the NP role helps them make a positive impact when access to healthcare is essential and sometimes not in easy supply. NPs can make big inroads into the health of communities as they are able to care for patients in a variety of settings and situations. Nurse practitioners who want to practice autonomously need to have the extra information to know how to do that while protecting themselves and their patients.

NPs can and should connect with peers and colleagues to share the challenges of the role and talk about the satisfaction of this role. Networking will help their professional development and the information learned will often improve their patient care as well.

Dr. Scharmaine Baker Honors National Nurse Practitioner Week

Dr. Scharmaine Baker Honors National Nurse Practitioner Week

This week, the American Association of Nurse Practitioners is highlighting all the work nurse practitioners (NPs) do with National Nurse Practitioner Week.

The week kicks off today and runs through November 18 and honors the work NPs do both on the job and as ambassadors for the nursing profession.

Minority Nurse caught up with Dr. Scharmaine L. Baker, FNP, FAANP, FAAN, CEO at Advanced Clinical Consultants, to talk about the role of a nurse practitioner. After Hurricane Katrina, Baker’s New Orleans patient caseload swelled from 100 to 500 in three months. With a critical shortage of health care facilities and providers, Baker’s skills as an NP not only saved her patients, but also clearly showed how invaluable her thorough NP training is.

National Nurse Practitioner Week, says Baker, is a way to give nurse practitioners the recognition they often don’t receive. “National Nurse Practitioner Week gives us the positive spotlight that we deserve,” she says.

This kind of national attention to the nurse practitioner’s work shows the devotion nurses have to caring for a patient, and also helps clear up any misunderstandings about the role and how an NP works within a health care team. “Nurse practitioners don’t just prescribe a medicine and send you out of the door,” says Baker. “We take the time to listen to the patient stories about their children, spouses, pets, and job promotions. These stories often solve the complicated puzzle of making an accurate diagnosis. It’s called holistic care of the total man.”

When prospective nursing students are deciding on a career path, Baker urges them to consider a few things. Top in their minds should be the honest assessment of their commitment to making this career decision. Taking the time to complete the challenging NP studies isn’t easy, she says. “Once they have decided that this is indeed the right time to pursue an Advanced Practice Nursing degree,” she adds, “then the necessary preparations as far as letting family and friends know that they will be somewhat unavailable for the next three to four years because the schooling demands all of your time for successful completion.”

But when the degree completion and training are done, the potential for a lifelong career that challenges you, uses all your skills, and lets you connect with and help people is gratifying on many levels. As a nurse practitioner, you’ll be diagnosing, assessing, and treating medical conditions. You’ll also look at the whole patient. NPs take into account the interplay between a patient’s physical and emotional well-being as well as the environment they live in. By doing so, they can help treat every part of a patient’s condition.

“I get to hear the stories that make my patients happy or sad,” says Baker. “Then, I get to connect those stories to their physical state. They are always related. I enjoy providing health care on this advanced level. I get to take care of the whole patient.”

Baker also points out that while NPs continue to earn recognition and some states are allowing them to practice on their own, there is still work to be done. “The most challenging and frustrating part of advanced practice nursing is the many restrictive laws that prevent us from practicing to the full extent of our scope,” she says. “It’s downright ridiculous! I long for the day when all states will actively have full practice authority.”

Currently, nearly two dozen states allow nurses to have full practice authority where they practice without physician oversight. Baker continues to advocate for full practice authority among all nurse practitioners. She also urges NPs and the nursing profession to continue to honor the nurses who worked so hard to get all nurses where they are today.

“Many have fought for us to be where we are,” says Baker. “Every time we show up and provide stellar care, we make our founding nurses beam with joy. We must never forget their sacrifices.”

Celebrate National Nurse Practitioner Week this week and spread the word about these highly skilled professionals. Use #NPWeek to share photos and tags on your social media posts to help others see just what satisfaction a career as an NP can bring.

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