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AJN, American Journal of Nursing:
doi: 10.1097/01.NAJ.0000425737.68484.17
In the News

The Top Nursing News Story of 2012: Health Care Reform Goes Hand in Hand with Expanded Nursing Roles

Pfeifer, Gail M. MA, RN, News Director

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Despite the controversies surrounding the Patient Protection and Affordable Care Act (ACA) in 2012, including the Supreme Court decision confirming its legality, one thing is certain: health care reform is on a fast track and is unlikely to slow down. And the role nursing plays in our health care system—particularly in advanced practice—is expanding just as fast. This expansion, which is, of course, fueled, by the ACA, also has roots in the 2010 Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health. Here are highlights from the past year.

Figure. Family NP Te...
Figure. Family NP Te...
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* Although much needs to be done to remove legislative barriers to RN practice across state lines, some headway has been made: by the end of 2012, 24 states had joined the Nurse Licensure Compact, which allows nurses to practice with one multistate license. Six additional states had legislation pending in 2012, according to the National Council of State Boards of Nursing.

* Legislative hurdles remain for advanced practice nurses (APNs), too; however, the Consensus Model for APRN Regulation has gained momentum, and some experts are optimistic that the 2015 goal of standardization will be met. (See July 2012’s AJN Reports for more on the topic.)

* March 2012 enrollment data from the American Association of Colleges of Nursing showed a surge in applications to baccalaureate and graduate programs, and in August 2012 the Robert Wood Johnson Foundation awarded grants to nine states through a program aimed at creating a more highly educated, diverse nursing workforce.

* The news media paid more attention to the burgeoning role of APNs this year, boosting consumer understanding of the trend by explaining why it's important. The Atlantic, for example, ran a feature story in its May 7, 2012, issue, by physician John W. Rowe, who explained how expanding the role of nurses not only fills a gap in primary care but saves money as well. And the controversy surrounding the expansion of the nurse anesthetists’ role was addressed by the Wall Street Journal in October.

The first NP residency program in the country, established by the Community Health Center in Connecticut, is being replicated in seven other states, and four others are in the planning stages for implementation this year. An amendment to the ACA by U.S. senator Daniel Inouye (D-HI), which would provide for additional programs, awaits appropriation, according to Margaret Flinter, the center's senior vice president and clinical director.

Although the expansion of nursing roles continues to meet with resistance in some states, mostly from physicians, the Centers for Medicare and Medicaid Services has voiced its support, saying that increasing the ranks of APNs “is an important way to increase the base of primary care providers in this country.”—Gail M. Pfeifer, MA, RN, news director

© 2013 Lippincott Williams & Wilkins, Inc.

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