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

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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

/checklist]

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:


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

    Doug Jones – (D – AL)

    326 Russell Senate Office Building Washington DC 20510

    (202) 224-4124

    Contact: www.jones.senate.gov/contact

    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

    Cindy Hyde-Smith – (R – MS)

    113 Dirksen Senate Office Building Washington DC 20510

    (202) 224-5054

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

    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/contact

    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]

    Copy Script #1 to Your Clipboard

    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]

    Copy Script #2 to Your Clipboard

    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]

    Copy Script #3 to Your Clipboard

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