Category Archives: Nurse practitioners
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A growing demand for acute care nurse practitioners (ACNPs) has created significant opportunity in this field, as well as a significant need for postgraduate residency programs, according to an article in the Journal for Nurse Practitioners.
Faced with issues such as the mandated reduction of work hours for residents, hospitals are turning to ACNPs to boost patient safety and satisfaction, writes Catherine Harris, PhD, MBA, CRNP, director of the ACNP program at Thomas Jefferson University in Philadelphia. Yet ACNP education emphasizes care across the life span instead of focusing on specialties—such as trauma, critical care, and cardiology—that hospital patients count on.
This is part of the June 2014 issue of Sharing Nursing’s Knowledge.
“A registered professional school nurse is the only person [who] has the education, the training, and the skill level to meet the needs of kids in the schools. It’s all about what the kids need and how can they attend schools, be healthy, and learn. Health and education go together: If a child is not healthy, he can’t learn.”
--Sue Buswell, RN, director, Montana Association of School Nurses, Philadelphia Tragedy Highlights Role of School Nurses, Education Week, June 2, 2014
“I quite frankly don’t understand how a school can function without a school nurse. They really are one of the most cost-effective, unrecognized resources in our country.”
--Anne Sheetz, MPH, RN, NEA-BC, director, school health services, Massachusetts Department of Public Health, School Nurses Save, Not Cost Money, New Study Says, Philadelphia Inquirer, May 29, 2014
“And lest we forget: a heartfelt thanks to all nurses, present and past, who are or have served in the military in any capacity, in some cases losing their lives as they tried to save other lives and heal the wounded. And to their families.”
--Jacob Molyneux, BA, MFA, senior editor and blog editor, American Journal of Nursing, Memorial Day Weekend: Thanks to the Nurses Who Served, May 23, 2014
For more than a decade, the percentage of newly licensed nurse practitioners who chose to work in primary care was on the decline. But that trend is changing, according to a survey released last month by the Health Resources and Services Administration (HRSA).
Fifty-nine percent of nurse practitioners (NPs) who graduated in 1992 or earlier went into primary care, and 42 percent of those who graduated between 2003 and 2007 did so, according to the survey. But 47 percent of the very newest NPs—those graduating between 2008 and 2012—opted to work in primary care, reversing the downward trend.
“We are encouraged by the national growth of primary care nurse practitioners, and HRSA is committed to continuing this trend to ensure an adequate supply and distribution of nurses for years to come,” HRSA Administrator Mary K. Wakefield, PhD, RN, said in a statement.
Susan Schrand, MSN, CRNP, a family nurse practitioner and executive director of the Pennsylvania Coalition for Nurse Practitioners, agreed. “We’re excited,” she said. “It’s good to hear that nurses, and especially new graduates, are staying in primary care.”
CDC Study: Nurses, Physician Assistants More Likely to Provide Education in Chronic Disease Management than Doctors
Proper patient management of chronic diseases is increasingly important to the nation’s health care system, as the Baby Boom generation reaches the stage of life where such conditions are common. From diabetes, arthritis, and asthma to obesity, hypertension, and depression, the health care system is looking to train patients to take steps mapped out for them in discussions with their health care providers. A new study from the Centers for Disease Control and Prevention (CDC), however, finds that a minority of patients with chronic conditions receive education in managing their problems, and that some practitioners—nurses and physician assistants (PAs), in particular—are considerably more likely to provide such education than others.
“Disease self-management is an essential component of care for patients with most chronic conditions,” writes a team of researchers led by Tamara S. Ritsema, MPH, MMSc, PA-C. “Patients cannot perform daily self-management tasks if they have poor understanding of the disease process, medications used, or the practical tasks they need to accomplish to care for themselves. Health education is, therefore, a vital preventive element in the patient visit.”
The researchers examined five years of CDC data, accounting for more than 136,000 patients who had been diagnosed with asthma, chronic obstructive pulmonary disease (COPD), depression, diabetes, hyperlipidemia, hypertension, ischemic heart disease, or obesity. The records indicated whether the patients’ doctors, nurse practitioners (NPs), or PAs had provided education to the patients in the self-management of their conditions during each visit.
One of the key recommendations in the landmark Institute of Medicine report on the future of nursing is to advance access to primary care by reducing barriers to practice for nurses. Implementation of this recommendation is now one step closer, thanks to a provision in President Obama’s budget proposal for fiscal year 2015, which was released this month.
Obama’s budget includes a provision that would extend an increase in Medicaid payments for primary care providers for one year at a cost of about $5.4 billion, according to an article in USA Today. The extension would, for the first time, apply to nurse practitioners (NPs) and physician assistants (PAs).
The Institute of Medicine recommended fixing this Medicaid “glitch” in its report on the future of nursing. The report is the foundation for the Future of Nursing: Campaign for Action, a national effort backed by the Robert Wood Johnson Foundation (RWJF) and AARP that is working to transform health care through nursing.
Obama’s budget proposal also calls for nearly $4 billion over six years to grow the National Health Services Corps (NHSC) from 8,900 primary care providers to at least 15,000 providers annually, starting in 2015, according to an analysis by the Campaign. Ten percent of the funding would be reserved for NPs and PAs.
Robin Knobel, PhD, RN, is an associate professor at the Duke University School of Nursing and a Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholar (2010-2013). The University of Carolina at Chapel Hill (UNC-CH) School of Nursing recently recognized her with its Distinguished Alumna award.
Human Capital Blog: Congratulations on the award! What does it mean for you and for your research?
Robin Knobel: I was truly honored to receive this award from UNC-CH because it recognizes my achievement thus far in my career in my area of research around improving thermal stability with premature infants. I was given great support as a doctoral student at UNC-CH through mentorship in research from faculty who are leaders as nurse scientists. To be recognized by alumni and faculty of the UNC-CH School of Nursing is a tremendous honor.
HCB: You received the award for your research into physiologic processes related to thermoregulation and perfusion in extremely premature infants. Can you explain what this means in lay terms?
Knobel: Yes. Premature infants are born too early to be able to keep themselves warm through the normal methods of heat production. Normally, infants up to one year of age do this through a metabolic production of heat, instead of shivering. Premature infants lack necessary components to accomplish efficient production of heat and consequently can become very cold if exposed to cold air after birth and through stabilization in the neonatal unit. They often experience hypothermic body temperatures during the early weeks after birth, which can lead to instability and possible lasting insults such as brain hemorrhage, infection, or even death. My research is studying the mechanisms around thermal stability in premature infants and ways to prevent bad outcomes from hypothermia.
Have you signed up to receive Sharing Nursing’s Knowledge? The monthly Robert Wood Johnson Foundation (RWJF) e-newsletter will keep you up to date on the work of the Foundation’s nursing programs, and the latest news, research, and trends relating to academic progression, leadership, and other essential nursing issues. Following are some of the stories in the February issue.
Preparing Nurses for Leadership in Public Policy
Many nurse education programs, including those that confer doctoral degrees, fall short in educating nurses about public policy, leaving them unprepared to maximize their expertise in policy arenas. To help change that, the RWJF Nursing and Health Policy Collaborative at the University of New Mexico hosted a recent conference that brought together leading nurse educators, public policy experts, social scientists, and others. The goal was to identify and share effective ways to prepare students in doctoral (PhD and DNP) nursing programs to be health policy leaders. Talking to lawmakers is “high-stakes communication,” one speaker said, and nurses need to know how to do it.
Nurse Leader Urges Nurses to Study Political Science, Too
Nancy Ridenour, PhD, APRN, FAAN, has combined a lifelong passion for policy with a drive to improve public health. Throughout her career, she has fought state laws that prevented Nurse Practitioners from practicing to the top of their education and training, and spoken out on health policies affecting access to care for patients in rural communities. “Policy is a tool to foster social change. Leadership and expertise in health policy ensure that nursing expertise is used to improve the health of the nation,” Ridenour says.
Have you signed up to receive Sharing Nursing’s Knowledge? The monthly Robert Wood Johnson Foundation (RWJF) e-newsletter will keep you up to date on the work of the foundation’s nursing programs, and the latest news, research, and trends relating to academic progression, leadership, and other essential nursing issues. These are some of the stories in the January issue:
Patients Slowly Gaining Access to Care Provided by Advanced Practice Registered Nurses
In recent years, several states have taken steps to ease restrictions on advanced practice registered nurses (APRNs), indicating that efforts to empower them and improve patient access to care are picking up steam. However, many consumers still lack unfettered access to care provided by APRNs because two-thirds of states do not allow them to practice without physician supervision—and even in states that do, APRNs aren’t always able to practice independently.
Stronger Primary Care System Is Goal of RWJF Scholar
RWJF Executive Nurse Fellow Margaret Flinter, PhD, APRN, has been at the center of three movements: community-oriented primary care, the growth of the community health center movement, and the growth of nurse practitioners as primary care providers. She founded the country’s first formal post-graduate residency training program for new nurse practitioners, and co-directs The Primary Care Team: Learning from Effective Ambulatory Practices, a national project supported by RWJF that is working to help health care organizations develop and accelerate innovations.
Efforts to expand the role of nurse practitioners (NPs) to help address the country’s shortage of primary care providers have been bolstered by legislation in several states. But laws expanding scope of practice may not do all they could to relieve the nation’s primary care crisis, according to a new study by researchers at the Columbia University School of Nursing, which suggests that the culture in health care settings can impede full utilization of NPs.
The study, published in the Journal of Professional Nursing, was conducted in Massachusetts, where state health reform increased demand for primary care and legislation recognized NPs as primary care providers. Researchers found that gains made by government can be neutralized by formal and informal practices at health care organizations. For example, the study cited instances where NPs were not allowed to conduct physical assessments or see new patients.
“Organizational policies can often trump governmental policies, keeping the contribution of the nurse practitioner unrecognized and preventing them from making the fullest contribution possible to effective patient care,” lead researcher Lusine Poghosyan, PhD, RN, an assistant professor of nursing at Columbia and a Robert Wood Johnson Foundation Nurse Faculty Scholar, said in a news release.