Wider Acceptance of Autonomous Nurse Practitioners Could Help in Improving the Speed and Availability of Healthcare

By  //  October 6, 2019

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There have been multiple studies conducted in the last decade, and all of them point towards a growing shortage of physicians and healthcare professionals in the United States.

There have been multiple studies conducted in the last decade, and all of them point towards a growing shortage of physicians and healthcare professionals in the United States.

According to a study published on the NCBI website, by the time year 2025 comes around, America could be looking at a shortage of 124,000 – 160,000 doctors, which should already be a cause for alarm.

Unless sufficient measures are taken to counter this impending shortage, the consequences could be particularly worrisome for rural US.

There’s More to Worry about than Just a Shortage of Physicians

Medical assistants, lab technicians and every other department of assistive and allied healthcare is also experiencing shortages at the moment, which will further amplify in the coming years.

The aforementioned report clearly predicts a shortage of about half a million nursing professionals by the year 2025.

It is to be noted that allied healthcare professionals constitute roughly 60% of the total number of workers in the healthcare sector, in which nurses are not included, meaning that the estimated half a million is not even a part of the 60% workforce.

At this moment, it’s nearly impossible to even estimate how short the country’s healthcare sector will be in that department by 2025, especially in light of the fact that there has been a sharp decline in interest for becoming allied healthcare professionals among students.

Considering the present need for lab technicians alone, the deficit is in the hundreds of thousands, post a major retirement year in 2015.

Unless adequate measures are taken to improve the availability of allied healthcare professionals, the deficit is going to be felt even more severely in the coming years.

Compounded with the shortage of physicians, the report is predicting a very dim future for healthcare in the United States.

Nurse Practitioners Could Help the Impending Crisis from Being So Severe

Any registered nurse with an undergraduate degree and the necessary experience under their resume can join a BSN to MSN – FNP course. On completion of the program, they gain the qualifications necessary to sit for the Family Nurse Practitioner National Certification test.

Those that pass the test become some of the most respected nursing professionals in the industry, equipped with the knowledge to even diagnose and administer medication to patients on their own.

Nurse practitioners can be of immense importance in reducing the severity of the impacts estimated and brought to attention by the NCBI. NPs and FNPs are nursing professionals with sufficient knowledge, training and experience to take up leading, autonomous positions in a healthcare setting, especially when qualified physicians are not available.

While they are not allowed to practice with autonomy in about half the states, nurse practitioners possess the skills necessary to offer primary healthcare without a supervising physician, which is the main reason why they can be so instrumental in mitigating the deficit.

Combining the knowledge of a NP and the experience of a nurse, these healthcare professionals are the perfect link between doctors and nurses. In a rural community setting, where quality healthcare is not easily available, multiple families depend on a single-family nurse practitioner for the advice they need.

However, even such settings are not yet legal or available in every US state that needs it.

In more than 50% of US states, NPs and FNPs are not allowed to practice without physician supervision, which presents a big problem. One of the primary reasons why FNPs and NPs are needed is because they are the closest anyone can get to being a doctor, without actually going to medical school.

If that fact is not recognized by a state, then the role of a nurse practitioner becomes oversimplified and they cannot be as useful in fulfilling the demand vs supply gap as they can be in other states which have recognized their autonomy as health practitioners.

States that Allow Full Practice Authority (FPA) to Nurse Practitioners Have Seen Significant Improvements

In Alaska, Arizona, Colorado, Connecticut, Hawaii, Idaho, Iowa, Minnesota, Maine, Maryland, New Hampshire, Nevada, Nebraska, New Mexico, North Dakota, Oregon, Rhode Island, South Dakota, Vermont, Washington, Wyoming and the District of Columbia, experienced nurses who have completed their BSN – MSN degree in nurse practitionership can gain full practice authority (FPA).

The standards, requirements, and other specific criterions do differ quite a bit from state to state, but it is possible for an NP to gain an FPA in all of these regions.

This has, in fact, proven to be quite effective in improving the overall community health standards, in addition to the availability of educated healthcare services in these states, as compared to before. More states are trying to adopt similar policies for advanced medical professionals now.

It’s a move in the right direction, but not every state authority agrees to that conclusion and in some states, the doctors are vehemently against the decision to give FPA to APRNs.

Some physicians have expressed concerns that full practice authority would put nurses in a position that they are not equipped to handle, while others have argued against creating a new, competitive field among colleagues in healthcare.

NPs Could be Instrumental in Reducing Preventable Hospital Deaths as Well

The physicians themselves are often put under tremendous pressure in short-staffed facilities, as they have to diagnose, treat, write prescriptions, sign off on treatment procedures and check up on patients in a volume that could seem nearly impossible to handle, without risking errors in judgement.

Given that physicians are also held responsible for every patient they are in charge of, malpractice lawsuits because of such errors are not rare either.

When full practice authority is given to qualified NPs in a state, they can treat more patients on their own in any healthcare setting, which would take some of the pressure off from overworked physicians. This also speeds up the treatment process naturally, as well as reducing the chances of errors and preventable deaths.

Conversely, in states where even nurse practitioners with years of experience are not allowed to take fast, independent actions for treating patients, everything becomes slower, which affects the quality of healthcare and overburdens physicians unnecessarily.

It could and often does lead to preventable deaths as well, on account of the fact that nurse practitioners in some states do not have the authority to prescribe medication in time, which they know would help the patients.

By the time the physician consultation and approval get through, it could be too late for the treatment to be of any use to the patient. This is particularly true in rural and suburban areas, where doctors are far and few in between.

If a family nurse practitioner is all a community has, and he/she is not allowed to prescribe medicine in a state, the choice left to the rural, lower-income groups without health insurance is no choice at all. 

Nurse Practitioners with FPA are Improving Veteran Healthcare in Texas 

Back in December 2016, the U.S. Department of Veterans Affairs took a positive step and made it official that all healthcare facilities operating under them now have the ability to grant FPA to nurse practitioners.

Charlene Seale became the first NP in Texas to gain full practice authority under the new law, and there have been quite a few independent NPs in the state since then. Unfortunately, the same has not been adopted by the state in general, nor has Texas allowed these NPs and FNPs to exercise their full practice authority outside the veteran healthcare facilities.

Given that there is a very large rural community in Texas, as well as considering the fact that veteran healthcare in the state has since managed to fill up at least some of its deficits, the decision to keep full practice authority for nurse practitioners limited to veteran healthcare is somewhat baffling to many.

The Texas nursing association expects things to change in the near future, but no plans of the sort have so far been revealed by the state government to do so.

PAs and APRNs are Likely to Gain FPA in Florida Soon

In the state of Florida, physician assistants (PA) and advanced practice registered nurses (APRN) could soon gain the independent authority necessary to diagnose and treat patients without physician supervision. As nurse practitioners are among the most qualified APRNs, they will have to take up the most responsibility, provided that the bill is passed by the Senate as well.

It is to be noted that while the Florida House Bill 821 has been passed already without any issue, the Senate Bill 972 has met a roadblock at the House. Therefore, we will have to wait until mid-2020 before finding out whether or not the Florida Senate decides to pass the bill for granting autonomy to physician assistants and advanced practice registered nurses next year.

The opinions are divided regarding this in the Senate, but there is little doubt about the fact that this move will help in improving the ability of state and private healthcare facilities in Florida to handle more patients with better efficiency, especially in the most remote locations.

The Deficit Has Presented Experienced Nurses with Both Pressure and Opportunity

The shortfalls are being felt already in various US states and the estimated crisis is beginning to ring a lot of alarm bells. However, all of this also indicates a huge growth in demand and opportunity for APRNs, as well as other advanced, assistive medical professionals, who have years of experience with working in medical care.

Although the supply deficit, in proportion to the demand has obviously made healthcare a much more pressurized sector to work in for everyone in recent years, the same has also increased the average pay and employment rates in all states for primary and assistive healthcare professionals.

On the other hand, new nurses starting out, or experienced nurses who are willing to take up a new, higher role have huge opportunities ahead of them, simply because the industry doesn’t have enough people to fill up all the positions that need to be filled up. 

Online Education Could be Healthcare’s Biggest Hope

Technology is playing a huge role in enabling nursing professionals to complete the education they need in order to become nurse practitioners.

Earlier, it would have been impossible for a full-time nurse to complete their BSN to MSN without taking time off work or shifting to part-time duty only. This was a problem on multiple fronts.

Either of the two choices meant that a full-time nurse would have to stop working or reduce their working hours significantly in order to make time for the BSN to MSN program.

As nursing staff are in short supply almost all the time, the absence of an experienced, working asset would further increase the shortage. On the flipside, trying to complete a Master’s degree and hold down a job at the same time due to financial reasons, more often than not, resulted in burnouts.

The availability of highly advanced, online BSN to MSN programs from CCNE Accredited institutions has changed all that. The flexible nature of these courses is designed to let even the full-time nursing professionals complete their duties and education simultaneously.

As an added advantage, the working nurses are now able to continue earning their experience, while studying online at the same time.

This naturally makes for a much stronger resume, in addition to giving nurses the chance for honing their practical skills for helping patients, by adding more clinic hours to their experience.

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