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NPs: Continue to Educate and Demand Respect

Published June 18, 2014 9:35 AM by Renee Dahring
A funny thing happened on the way to full practice authority...

We have been working hard for years on passage of a bill to update the nurse practice act and free APRNs of outdated and restrictive practice agreements. In fact we have been focused for so long on achieving our goal that we haven't really thought much past - well, achieving our goal. We put a great deal of effort into winning hearts and minds and last month our hard work paid off: the governor signed the APRN bill and our dreams of full practice authority were realized. On January 1st, 2015 the new law will go into effect and mission accomplished, right?

Not so quick. Our arguments may have won over the legislators and a good portion of the public, but we are learning that it may be a bit premature to declare victory. Our opponents didn't get what they wanted at the Capitol, but that doesn't mean it's over for them.

It seemed so promising when we reached an agreement, but perhaps it was only the battlefield that changed and not the battle. While we were pursuing our goal on the house and senate floors, organized medicine had already turned their attention to the workplace.

I don't think it's a coincidence that many large healthcare organizations have been quietly altering the job descriptions for their NPs. Practices are being restructured so that NPs no longer have their own patient panel and are now required to "share" a panel of patients with an MD. Recent job ads describe the NP as working under the "supervision" of an MD. It's looking suspiciously like what the docs were unable to put into statute they are now putting into work rules.

And yes, they can do it. It's perfectly legal for an employer to be MORE restrictive than the law.

But we don't have to like it. And we don't have to work for them. We must continue to educate and demand respect. If you are one of the folks out looking for a position, you need to let employers know that these terms are not acceptable to you. I know it's a little scary when you really need a job but if we allow our roles to be diminished now it will set a precedent. It's much harder to undo rules than to make them.

This is where I make a plea again for you to get involved with your local and national professional organizations. We cannot let this become the accepted culture. Remember, the price of freedom is eternal vigilance.

2 comments

Congrats!  What state?

Have you ever tried to put yourself into the shoes of a physician? 2-3 times the amount of school, 4-8 times the cost, most importantly, international recognition of their qualifications, Doctor, to be a healer.

Most NP's and PA's have no idea of how to run their own practice.  They have neither the financial or work experience to take on the responsibilities of ownership.  Interestingly, in Washington state very few NP's have become owners and they have had autonomy for years.

Instead of focusing on the small issues and problems that will crop up in your state, concentrate on organizing NP's to develop group practices, relocating to areas with a need for providers as opposed to trying to compete with physicians in areas that are well represented with physicians and start an organization that will support NP's that want to take the plunge.

NP's will NEVER compete with physicians....and they shouldn't.  Ultimately politicians will be on our side when we make health care more accessible not when we are threatening a long standing source of contributions-the AMA and statewide Medical Organizations. I am even willing to wager that physicians will support us if we help America also!

matt Freitas, FP - FNP-C July 15, 2014 5:25 PM
modesto CA

The laws of supply and demand make it more difficult for the NP to practice in an area with a high density of MD's. Many MD's are not collegial with NP's. As reimbursement rates fall the MD's have become more difficult as they view NP's as a real threat.

helen haley, pain - NP June 23, 2014 6:17 AM
new york NY

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    Occupation: Nurse Practitioners and NP Recruiters
    Setting: correctional healthcare/career consulting/teaching
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