Nurse Practitioner Week: A Toolkit to Fight for Full Practice Authority

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NurseJournal.com Staff

December 7, 2021 , Modified on April 27, 2022 · 6 Min Read

To advance the fight for NP full practice authority nationwide, this toolkit includes Senator contact information and three sample scripts.

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It’s time to recognize nurse practitioners and their role in providing healthcare nationwide. The annual push for NP awareness is known as National Nurse Practitioner Week and is celebrated this year from Nov. 12 through Nov. 18. The week has a twofold purpose, according to the American Association of Nurse Practitioners (AANP): the first is to recognize the contributions of advanced practice nurses (including NPs) in their various fields, and the second is to bring attention to legislation affecting this community. This year, one of the most pressing issues is the fight for NP full practice authority (FPA) nationwide. This toolkit includes Senator contact information and three sample scripts to advance the cause.

In some states, nurse practitioners (NPs) cannot practice to the full extent of their education and credentialing. They may need an agreement with a 'collaborating' physician to prescribe even basic medications. This can create difficulties for patients, who may be forced to wait a long time to see a doctor; however, in FPA states, these patients can instead turn to NPs for their primary care needs. According to the AANP, full practice authority allows NPs to "evaluate patients, diagnose, order and interpret diagnostic tests, and initiate and manage treatments—including prescribing medications—under the exclusive licensure authority of the state board of nursing."

Why is NP service so important? Across the nation, wait times to see a doctor can be up to 20 days. In Boston, the average wait time to schedule an appointment with a family physician is 66 days. Why is there such a long wait? It boils down to a looming physician shortage. The Baby Boomer population is growing and needs more care as they age. In fact, the Association of American Medical Colleges (AAMC 2017) predicted that there would be a shortage of between 34,600 and 88,000 physicians in the U.S. by 2025.

Nurse practitioners can help relieve the demand for medical care. First, in addition to national credentialing, NPs have at least a master's degree and advanced training. And in upcoming years, NPs will be moving toward the widespread adoption of the DNP—the Doctor of Nursing Practice degree—which is becoming the new standard of education for NP practice. This is a move supported by the American Association of Colleges of Nursing (AACN).

Second, nurse practitioners specialize in different fields. From pediatric to elderly care and general practice to emergency care, NPs gain unique skills and clinical experiences in their area of expertise so that they are equipped to provide high-quality care to patients.

NursePractitionerSchools.com has interviewed more than 35 professors on NP practice authority. These professors are known as the site's "Heroes" and include the following:

Dr. Dianne Morrison-Beedy, a professor at the University of South Florida, specializing in women's healthcare

Dr. Linda Strickland, an assistant professor at the University of Indianapolis, with a background in neonatal care

Dr. Anne Derouin, an associate professor at Duke University, with experience in prenatal care

Dr. Jeffrey Kwong, an associate professor at Columbia University School of Nursing, with experience in adult and gerontology care

The vast majority of this site's Heroes advocate for FPA nationwide—not just for NPs in some states. Some of their recommendations for becoming involved in the cause include:

Seeking out NP professionals familiar with the FPA issue and working bedside them Donating to any APRN political action committee dedicated to the expansion of FPA for all NPs

How to Advocate for FPA

The American Association of Nurse Practitioners (AANP) reports that NPs already play a crucial role in the U.S. in healthcare. Consider that:

  • Two-thirds of Americans have been to an NP for primary-care needs
  • More than 916 million visits are made to nurse practitioners annually in the U.S.

More than 234,000 NPs are employed in the U.S., so why shouldn't they have the same type of practice authority in all 50 states? It is a question that many NPs and their advocates ask. More than 60 percent of NPs nationwide work in family care, yet NPs have full practice authority in fewer than 25 states. Instead, their authority is either 'reduced' or 'restricted.' The AANP describes these two categories as:

‘Reduced practice’: “State practice and licensure law reduces the ability of nurse practitioners to engage in at least one element of NP practice. State law requires a regulated collaborative agreement with an outside health discipline in order for the NP to provide patient care or limits the setting or scope of one or more elements of NP practice.” ‘Restricted practice’: “State practice and licensure law restricts the ability of a nurse practitioner to engage in at least one element of NP practice. State requires supervision, delegation, or team-management by an outside health discipline in order for the NP to provide patient care.”

As National NP Week approaches, it is time to advocate for greater authority for nurse practitioners everywhere. One way to do this is by writing letters to Senators asking them to support change. A list of 'reduced' and 'restricted' states is provided below with addresses for the U.S. Senators provided. Sample letter scripts follow.

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States With Reduced NP Practice Authority and U.S. Senator Contact Information

Alabama

Arkansas

Delaware

  • Christopher Coons – (D – DE)
  • 127A Russell Senate Office Building Washington DC 20510
  • (202) 224-5042
  • Contact: www.coons.senate.gov/contact

Illinois

  • Christopher Coons – (D – DE)
  • 127A Russell Senate Office Building Washington DC 20510
  • (202) 224-5042
  • Contact: www.coons.senate.gov/contact

Indiana

Kansas

Kentucky

Louisiana

Michigan

Mississippi

New Jersey

New York

Ohio

Pennsylvania

South Dakota

Utah

West Virginia

Wisconsin

States With Restricted NP Practice Authority and U.S. Senator Contact Information

California

Florida

Georgia

Massachusetts

Missouri

North Carolina

Oklahoma

South Carolina

Tennessee

Texas

Virginia

Sample Letter Scripts for Reaching out to U.S. Senators

Anyone can write to their U.S. Senator and advocate for NP full practice authority. Below are sample letters for NPs, students studying nursing, and civilians. The AANP suggests that letters be concise and to-the-point. Please note that the scripts below are adapted from the AANP's National Nurse Practitioner Week Resource Guide.

Script 1 – NPs

Dear [Senator's name]:

National Nurse Practitioner Week is November 12-18. Did you know there are more than 234,000 solutions to the physician healthcare shortage facing the United States? These are the country's nurse practitioners who are already licensed and working in all 50 states.

In our state, NPs work under [reduced/restricted] practice, meaning that they cannot provide healthcare services to the full extent of their education and training. Despite the overwhelming evidence that NPs provide safe, high-quality, and cost-effective healthcare, they’re still unable to practice to the full extent of their graduate education and clinical training in [state]. Please support the expansion of their practice to include evaluating patients; diagnosing; ordering and interpreting tests; and initiating and managing treatments, including prescribing medication, under the exclusive authority of our state board of nursing.

Thank you.

[Your signature]

Script 2 – Nursing Students

Dear [Senator's name]:

There is no time like the present to acknowledge the 230,000+ nurse practitioners who work in this country. In fact, National NP Week is November 12-18. I’m advocating for full practice authority for NPs in [state]. I am currently an NP student at [name of school, if desired]. As a student, I am specializing in the [name of field] and completing [number] of clinical hours in this specialty.

We have a looming physician shortage in this country, and many people need to wait for weeks to see a primary care physician or specialist. Nurse practitioners are already working to provide needed care, but they have [reduced/restricted] practice authority in this state. Despite the overwhelming evidence that NPs provide safe, high-quality, and cost-effective healthcare, they’re still unable to practice to the full extent of their graduate education and clinical training in [state]. As a future NP, I ask you to support full practice authority for NPs in [name of state] and to acknowledge nurse practitioners during National NP Week.

Thank you.

[Your signature]

Script 3 – Civilians

Dear [Senator's name]:

National Nurse Practitioner Week is November 12-18. I am grateful for the many nurse practitioners that serve our state. There are more than 230,000 nurse practitioners across the country, providing excellent healthcare and helping to offset the looming physician shortage. NPs have full practice authority in more than 20 other states, but not in ours.

Many states allow nurse practitioners to fully evaluate patients; order and interpret tests; initiate and manage treatment; and prescribe medication under the authority of their state board of nursing. This is not true in [state], where NPs practice under a [reduced/restricted] setting. Despite the overwhelming evidence that NPs provide safe, high-quality, and cost-effective healthcare, they’re still unable to work to the full extent of their graduate education and clinical training. Please support change in our state and be sure to thank all of these invaluable healthcare providers during National NP Week.

Thank you.

[Your signature]

Related Posts

A lack of access to primary care in the United States is one of the key reasons why the Commonwealth Fund ranks the U.S. as having the worst healthcare system in the affluent world. Looking to the future, the impending primary care provider shortage indicates that this problem is only to going to intensify, particularly in the South and Midwest. Given the overwhelming evidence that NPs provide cost-effective, safe healthcare for their patients, it’s time for Oklahoma to disabuse itself of unnecessary practice restrictions so that NPs can help alleviate the looming primary care provider shortage. Primary care, when accessible and publicized in communities, has been proven to diminish health disparities between social classes. The future of healthcare in the Northwest and all over the country is dependent on the reform insurance systems, policy, and education, among other aspects. As a shortage of primary care providers looms on our collective horizon, lack of access to primary care has the potential to get much worse. And, unfortunately, the South is going to be the most heavily impacted. Nursing has always been a female-driven profession, and male nurses are often the butt of jokes on television and in movies, from Meet the Parents to Friends. That said, the gender roles are softening and there has been a recent upswing in the number of men joining this high-growth career field. Primary care is vital to a healthy, thriving population, and essential to a healthcare system that hopes to deliver efficient, cost-effective, and high-quality care to all. The Commonwealth Fund ranks the United States healthcare system last out of those of ten other high-income countries in the world. Nurse practitioners play an important role in healthcare. These licensed clinicians have furthered their education and skills to provide specialized care to their patients. Some nurse practitioners have a particular interest in working with vulnerable populations and have gone above and beyond to serve these groups.

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