It is important for all NPs to stay informed about pending legislation that might impact our field, especially if that legislation is aimed at restricting NP practice. The number of letters, emails, faxes, or other correspondence that legislators receive matters; legislators listen to their constituents.
Making Headway
Of course, NPs are not the only advanced practice nurses (APNs) who have struggled to gain the regulatory and legislative authority that accurately reflects their education, training, and capability, permitting them to practice as autonomously as intended for the role.
Each role shares a common thread-providing quality (and appropriate) care by qualified (and appropriate) healthcare professionals to individuals in need of care.
In this month's 20th Annual Legislative Update, Susanne Phillips presents several milestones from 2007 that impacted one or more of the four recognized APN roles: the NP, the clinical nurse specialist, the certified nurse midwife, and the certified registered nurse anesthetist.
For example, Texas APNs defeated legislation to limit ability to perform sports physical exams and South Carolina defeated a bill sponsored by the Board of Medicine to amend the medical practice act to limit CRNA practice and limit the title of "Dr." to physicians only. A separate bill was defeated that sought to grant authorization of surgical technicians to obtain licensure as first assistants.
In addition, Arizona passed legislation giving NPs statutory authority to provide a variety of services, and California passed two laws authorizing NPs and CNMs to provide consent for blood transfusions and to perform specified Department of Motor Vehicles physical exams.
Ongoing Education
We know that APNs carry numerous degrees, licensing titles, and credentials that vary between educational institutions, states, and certifying organizations. It is no surprise that confusion still exists among lay persons about who we are and what we are able to do. Discussion continues even among ourselves. The initials do not tell the story.
An ongoing component of any advocacy and/or legislative effort is the education and reeducation of the public/consumers, nursing and other colleagues (proponents and opponents), and legislators about who we are and what we are able to do. We become weary and frustrated repeating the same thing over and over. What is so difficult to understand? Aren't we clear in our explanations?
Fortunately, we do not have to repeatedly convince our patients that we are advanced nursing professionals who are highly qualified to perform the services we provide. Patients experience firsthand the benefits of the unique set of skills APNs bring to the healthcare arena; to them, the resistance is a mystery.
Are We in Action?
The results of a large, organized political effort may be highly visible, may receive broad media coverage, and may appear to exert great power, but it is the participation of individuals that fuels and facilitates this bigger push. How many of us immediately respond when we receive a request to send a letter to our legislators? How much individual effort and time is required to personalize a letter that has already been written and formatted for us? Do we say, "Not again" when we receive a second or third pleading message from our professional organizations? Why not just jump in and respond?
The actions of individuals are important in bringing about change. And let us not forget our patients, sometimes our strongest allies, who, through appropriate venues, can tell their stories that in due course help to fortify our voices.
Jamesetta Newland, APRN, BC, FNP, FAANP, FNAP, PhD
Editor-in-Chief