Nurse Practitioner Week 2017: A Toolkit to Fight for Full Practice Authority

Search For Schools

*sponsored

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:

  • Joining a state or national nursing association, including its advocacy branch
  • 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.

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

Alabama

Richard Shelby – (R – AL)

304 Russell Senate Office Building Washington DC 20510

(202) 224-5744

Contact: www.shelby.senate.gov/public/index.cfm/emailsenatorshelby

Luther Strange – (R – AL)

326 Russell Senate Office Building Washington DC 20510

(202) 224-4124

Contact: www.strange.senate.gov/content/contact-senator

Arkansas

John Boozman – (R – AR)

141 Hart Senate Office Building Washington DC 20510

(202) 224-4843

Contact: www.boozman.senate.gov/public/index.cfm/contact

Tom Cotton – (R – AR)

124 Russell Senate Office Building Washington DC 20510

(202) 224-2353

Contact: www.cotton.senate.gov/?p=contact

Delaware

Thomas Carper – (D – DE)

513 Hart Senate Office Building Washington DC 20510

(202) 224-2441

Contact: www.carper.senate.gov/public/index.cfm/email-senator-carper t

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

Richard Durbin – (D – IL)

711 Hart Senate Office Building Washington DC 20510

(202) 224-2152

Contact: www.durbin.senate.gov/contact/

Indiana

Joe Donnelly – (D – IN)

720 Hart Senate Office Building Washington DC 20510

(202) 224-4814

Contact: www.donnelly.senate.gov/contact/email-joe

Todd Young – (R – IN)

400 Russell Senate Office Building Washington DC 20510

(202) 224-5623

Contact: www.young.senate.gov/contact

Kansas

Jerry Moran – (R – KS)

521 Dirksen Senate Office Building Washington DC 20510

(202) 224-6521

Contact: www.moran.senate.gov/public/index.cfm/e-mail-jerry

Pat Roberts – (R – KS)

109 Hart Senate Office Building Washington DC 20510

(202) 224-4774

Contact: www.roberts.senate.gov/public/?p=EmailPat

Kentucky

Mitch McConnell – (R – KY)

317 Russell Senate Office Building Washington DC 20510

(202) 224-2541

Contact: www.mcconnell.senate.gov/public/index.cfm?p=contact

Rand Paul – (R – KY)

167 Russell Senate Office Building Washington DC 20510

(202) 224-4343

Contact: www.paul.senate.gov/connect/email-rand

Louisiana

Bill Cassidy – (R – LA)

520 Hart Senate Office Building Washington DC 20510

(202) 224-5824

Contact: www.cassidy.senate.gov/contact

John Kennedy- (R – LA)

383 Russell Senate Office Building Washington DC 20510

(202) 224-4623

Contact: www.kennedy.senate.gov/content/contact-senator

Michigan

Gary Peters – (D – MI)

724 Hart Senate Office Building Washington DC 20510

(202) 224-6221

Contact: www.peters.senate.gov/contact/email-gary

Debbie Stabenow – (D – MI)

731 Hart Senate Office Building Washington DC 20510

(202) 224-4822

Contact: www.stabenow.senate.gov/contact

Mississippi

Thad Cochran – (R – MS)

113 Dirksen Senate Office Building Washington DC 20510

(202) 224-5054

Contact: www.cochran.senate.gov/public/index.cfm/email-me

Roger Wicker – (R – MS)

555 Dirksen Senate Office Building Washington DC 20510

(202) 224-6253

Contact: www.wicker.senate.gov/public/index.cfm/contact

New Jersey

Cory Booker – (D – NJ)

359 Dirksen Senate Office Building Washington DC 20510

(202) 224-3224

Contact: www.booker.senate.gov/?p=contact

Robert Menendez – (D – NJ)

528 Hart Senate Office Building Washington DC 20510

(202) 224-4744

Contact: www.menendez.senate.gov/contact

New York

Kirsten Gillibrand – (D – NY)

478 Russell Senate Office Building Washington DC 20510

(202) 224-4451

Contact: www.gillibrand.senate.gov/contact/email-me

Charles Schumer – (D – NY)

322 Hart Senate Office Building Washington DC 20510

(202) 224-6542

Contact: www.schumer.senate.gov/contact/email-chuck

Ohio

Sherrod Brown (D – OH)

713 Hart Senate Office Building Washington DC 20510

(202) 224-2315

Contact: www.brown.senate.gov/contact/

Rob Portman – (R – OH)

448 Russell Senate Office Building Washington DC 20510

(202) 224-3353

Contact: www.portman.senate.gov/public/index.cfm/contact?p=contact…

Pennsylvania

Robert Casey – (D – PA)

393 Russell Senate Office Building Washington DC 20510

(202) 224-6324

Contact: www.casey.senate.gov/contact/

Patrick Toomey – (R – PA)

248 Russell Senate Office Building Washington DC 20510

(202) 224-4254

Contact: www.toomey.senate.gov/?p=contact

South Dakota

Mike Rounds – (R – SD)

502 Hart Senate Office Building Washington DC 20510

(202) 224-5842

Contact: www.rounds.senate.gov/contact/email-mike

John Thune – (R – SD)

511 Dirksen Senate Office Building Washington DC 20510

(202) 224-2321

Contact: www.thune.senate.gov/public/index.cfm/contact

Utah

Orrin Hatch – (R – UT)

104 Hart Senate Office Building Washington DC 20510

(202) 224-5251

Contact: www.hatch.senate.gov/public/index.cfm/contact?p=Email-Orrin

Mike Lee – (R – UT)

361A Russell Senate Office Building Washington DC 20510

(202) 224-5444

Contact: www.lee.senate.gov/public/index.cfm/contact

West Virginia

Shelley Moore Capito – (R – WV)

172 Russell Senate Office Building Washington DC 20510

(202) 224-6472

Contact: www.capito.senate.gov/contact/contact-shelley

Joe Manchin III – (D – WV)

306 Hart Senate Office Building Washington DC 20510

(202) 224-3954

Contact: www.manchin.senate.gov/public/index.cfm/contact-form

Wisconsin

Tammy Baldwin – (D – WI)

709 Hart Senate Office Building Washington DC 20510

(202) 224-5653

Contact: www.baldwin.senate.gov/feedback

Ron Johnson – (R – WI)

328 Hart Senate Office Building Washington DC 20510

(202) 224-5323

Contact: www.ronjohnson.senate.gov/public/index.cfm/email-the-sena…

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

California

Dianne Feinstein – (D – CA)

331 Hart Senate Office Building Washington DC 20510

(202) 224-3841

Contact: www.feinstein.senate.gov/public/index.cfm/e-mail-me

Kamala Harris – (D – CA)

112 Hart Senate Office Building Washington DC 20510

(202) 224-3553

Contact: www.harris.senate.gov/content/contact-senator

Florida

Bill Nelson – (D – FL)

716 Hart Senate Office Building Washington DC 20510

(202) 224-5274

Contact: www.billnelson.senate.gov/contact-bill

Marco Rubio – (R – FL)

284 Russell Senate Office Building Washington DC 20510

(202) 224-3041

Contact: www.rubio.senate.gov/public/index.cfm/contact

Georgia

Johnny Isakson – (R – GA)

131 Russell Senate Office Building Washington DC 20510

(202) 224-3643

Contact: www.isakson.senate.gov/public/index.cfm/email-me

David Perdue – (R – GA)

455 Russell Senate Office Building Washington DC 20510

(202) 224-3521

Contact: www.perdue.senate.gov/connect/email

Massachusetts

Edward Markey – (D – MA)

255 Dirksen Senate Office Building Washington DC 20510

(202) 224-2742

Contact: www.markey.senate.gov/contact

Elizabeth Warren – (D – MA)

317 Hart Senate Office Building Washington DC 20510

(202) 224-4543

Contact: www.warren.senate.gov/?p=email_senator

Missouri

Roy Blunt – (R – MO)

260 Russell Senate Office Building Washington DC 20510

(202) 224-5721

Contact: www.blunt.senate.gov/public/index.cfm/contact-roy

Claire McCaskill – (D – MO)

503 Hart Senate Office Building Washington DC 20510

(202) 224-6154

Contact: www.mccaskill.senate.gov/contact

North Carolina

Richard Burr – (R – NC)

217 Russell Senate Office Building Washington DC 20510

(202) 224-3154

Contact: www.burr.senate.gov/contact/email

Thom Tillis – (R – NC)

185 Dirksen Senate Office Building Washington DC 20510

(202) 224-6342

Contact: www.tillis.senate.gov/public/index.cfm/email-me

Oklahoma

James Inhofe – (R – OK)

205 Russell Senate Office Building Washington DC 20510

(202) 224-4721

Contact: www.inhofe.senate.gov/contact

James Lankford – (R – OK)

316 Hart Senate Office Building Washington DC 20510

(202) 224-5754

Contact: www.lankford.senate.gov/contact/email

South Carolina

Lindsey Graham – (R – SC)

290 Russell Senate Office Building Washington DC 20510

(202) 224-5972

Contact: http://www.lgraham.senate.gov/public/index.cfm/e-mail-senator-graham

Tim Scott – (R – SC)

717 Hart Senate Office Building Washington DC 20510

(202) 224-6121

Contact: www.scott.senate.gov/contact/email-me

Tennessee

Lamar Alexander – (R – TN)

455 Dirksen Senate Office Building Washington DC 20510

(202) 224-4944

Contact: www.alexander.senate.gov/public/index.cfm?p=Email

Bob Corker – (R – TN)

425 Dirksen Senate Office Building Washington DC 20510

(202) 224-3344

Contact: www.corker.senate.gov/public/index.cfm/emailme

Texas

John Cornyn – (R – TX)

517 Hart Senate Office Building Washington DC 20510

(202) 224-2934

Contact: www.cornyn.senate.gov/contact

Ted Cruz – (R – TX)

404 Russell Senate Office Building Washington DC 20510

(202) 224-5922

Contact: www.cruz.senate.gov/?p=form&id=16

Virginia

Tim Kaine – (D – VA)

231 Russell Senate Office Building Washington DC 20510

(202) 224-4024

Contact: www.kaine.senate.gov/contact

Mark Warner – (D – VA)

703 Hart Senate Office Building Washington DC 20510

(202) 224-2023

Contact: www.warner.senate.gov/public/index.cfm?p=Contact

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]