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