Heroism in Nursing Practice: Spotlight on Adult-Gerontology and Acute Care NPs

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The important message is to optimize everyone’s scope so that we have enough healthcare providers to take care of aging Americans.
Dr. Barbara Resnick, University of Maryland

According to the American Association of Nurse Practitioners (AANP 2016), 28.5 percent of all NPs specialize in acute care, adult care, or adult-gerontology.

Through a mix of academic work and hands-on clinical preceptorships, NPs are prepared to diagnose health conditions, create treatment plans, manage acute and chronic health problems, prescribe medications, and work as part of healthcare teams. With more than 220,000 NPs across the country, these advanced practice nurses help fill a growing demand for healthcare services across the US, but it hasn’t been easy.

Despite the abundant 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 many states. Due to differing local legislation, NP practice authority falls short in many regions, presenting undue barriers for these healthcare providers (e.g., reduced prescriptive privileges); these limitations are not only unwarranted, but they’re putting the future of American healthcare at risk.

In fact, there’s a looming healthcare provider deficit across the country. The Association of American Medical Colleges (2016) projected a shortage of between 14,900 and 35,600 primary care physicians by 2025; NPs are well-poised to help fill this need since eighty-nine percent of them are prepared to work in primary care with various populations (e.g., adult, family, pediatric, women’s health). This is especially pertinent in underserved rural areas, where many doctors choose not to settle in order to work in better-paying facilities.

Underscoring the imminent demand for healthcare providers, Dr. Barbara Resnick of the University of Maryland recommended a study titled Caring for an Aging America (2010-11). This paper was published in the Journal of the American Society of Aging and stated that between 2011 and 2031, the number of American adults 65 and over would double; simultaneously, the population 85 and older would increase five-fold. These aging adults will require considerably more acute, primary, and long-term care than younger Americans. Therefore, investments in the eldercare workforce—including adult-gerontology and acute care nurse practitioners—will be paramount in coming years.

This article aims to draw attention to the contributions of three prestigious adult-gerontology and acute care NP professors. In highlighting the invaluable work of these clinicians and educators, it is hoped that all states will come to embrace an expanded practice environment for all NPs, thereby empowering these professionals to work to the full extent of their training and credentialing.

Interviews with Three Exceptional Professors

Advancing Toward Full Practice Authority for NPs

As nurse practitioners, we’re sometimes not recognized for our skillset, knowledge, and competency as clinicians.
Dr. Jeffrey Kwong, Columbia University

While it’s clear that NPs play an important role in healthcare teams and can help address the looming shortage of medical providers, they’re still clinically disenfranchised across several US states despite their expertise and advanced credentialing. As illustrated above, highly skilled NPs may be denied the ability to prescribe basic medications, to order lab tests, or to decide when patient resuscitation is futile and may lead to suffering; the limitations on NP practice are not only unjust, costly, and bureaucratically inefficient, but they also severely impair the ability of qualified healthcare professionals to help others.

This wasteful system is begging for change and countless prominent organizations have taken note. Here’s an incomplete list of the national organizations which support granting full practice authority to NPs across all specializations:

  • Institute of Medicine
  • American Association of Retired Persons (AARP)
  • Department of Veterans Affairs (VA)
  • American Association of Nurse Practitioners (AANP)
  • National Governors Association (NGA)
  • Bipartisan Policy Center (BPC)
  • National Conference of State Legislatures

The main opponents to granting NPs full practice authority are physicians’ groups. Doctors must realize that NPs share their primary goal: creating cost-effective, quality-assured, resource-efficient, and patient-centered healthcare delivery across the country. Allowing NPs to fulfill their professional potential will help accomplish this objective and mitigate the impending healthcare shortage across the United States. The question is: are physicians’ groups ready to do what’s best for patients?

Jocelyn Blore

Jocelyn Blore

Editor

Jocelyn Blore is the Managing Editor of NursePractitionerSchools.com. After graduating from UC Berkeley, Jocelyn traveled the world for five years as freelance writer and English teacher. After stints in Japan, Brazil, Nepal, and Argentina, she took an 11-month road trip across the US, finally settling into lovely Eugene, OR. When Jocelyn isn’t writing about college programs or interviewing professors, she satirizes global politics and other absurdities at Blore’s Razor (Instagram: @bloresrazor). Thank you for being interested.