Department: Editor's Memo
We at the journal are ringing in the New Year with a celebration! For the last 25 years, The Nurse Practitioner's Annual Legislative Update has reported the challenges and successes of the nation's nurse practitioners (NPs) in their efforts to attain full scope of practice. Readers enthusiastically await the January issue every year knowing they will find reliable information that highlights the previous year's legislative activities.
Since becoming editor-in-chief of the journal, I have been acutely aware of the amount of work that goes into producing a report like this. The Annual Legislative Update does not just appear! Many individuals contribute in innumerable ways to make it happen, and I thank them all. I also want to congratulate the author and coordinator of the report, Susanne Phillips, MSN, FNP-BC, for her painstaking efforts to compile this enormous amount of information. This year's update emphasizes the evidence that supports full authority to practice for NPs and other advanced practice registered nurses (APRNs).
NPs as primary care providers
Less than 3 months ago, an article in The New York Times by Tina Rosenberg presented a positive assessment of NPs' capability to serve as primary care providers. In the article, “The Family Doctor, Minus the M.D.” (October 24, 2012),1 Rosenberg noted that a review of data from 118 published studies over an 18-year period demonstrated comparable health outcomes and patient satisfaction at physician- and NP-led clinics. Nurses actually rated more favorably in several areas and did not score worse in any evaluated parameter.
Rosenberg interviewed directors of nurse-managed clinics who stressed the holistic approach nurses take when providing healthcare. She also mentioned the worsening shortage of primary care providers, NPs' advanced training in diagnosing and treating disease, and the cost-effectiveness of using NPs. The essential value of nurse-managed clinics, especially those in underserved and rural areas as well as those that have attained status as a federally qualified community health clinic, is without question. The article concludes by saying, “In some ways, the nurse practitioner-managed clinic is a throwback to the small-town family practice…Among the many changes needed in how America values and reimburses health care, it's important to encourage and support these clinics.”1
Cultivating a model of change
In 2010, the Affordable Care Act authorized $320 million to expand the primary care workforce. To date, 10 nurse-managed centers have been given $15 million to improve access to primary care services for underserved populations. This is a major step in the right direction. These 10 centers serve as examples of one model for change in the current system, and NPs are well-prepared to meet the opportunity.
Gaining full practice authority
Not unlike the small town family practice, the NP legislative movement started through grassroots efforts with small groups of NP pioneers getting together to discuss issues and challenge existing laws and regulations. Professional nursing organizations representing licensure, accreditation, certification, and education (LACE) in partnership with interprofessional partners have been working together to advance these humble beginnings and advocate for full practice authority for NPs and other APRNs in all 50 states and the District of Columbia. Imagine the day when all the states on the Collaboration/Supervisory Language in State Practice Acts & Regulations for Nurse Practitioners map of the United States maintained by the American Academy of Nurse Practitioner are dark blue! However, this reality will represent only one success. Read the Annual Legislative Update to help celebrate 25 years of keeping NPs informed. And remember to contact your nursing organization's Political Action Committee to find out how you can become involved.
Jamesetta Newland, PhD, RN, FNP-BC, FAANP, FNAP