By Antonia M. Villarruel and Jacqueline Dunbar-Jacob
In May we celebrate the vital contributions nurses make to the health and well-being of our community. We know the Commonwealth of Pennsylvania will join in thanking and celebrating the extraordinary efforts of nurses in all aspects of preventing the spread of the virus and treating those affected during the pandemic.
Every day, we are reminded of the impact of nurses. But how best to honor, and recognize nurses in Pennsylvania? Simply put: Let nurses do their jobs. But there is one critical state issue that stands in the way.
The National Academy of Medicine released The Future of Nursing 2020-2030 report this month, and one of its recommendations was to “enable nurses to practice to the full extent of their education and training by removing barriers that prevent them from more fully addressing social needs and social determinants of health and improving health care access, quality, and value.”
Yet, after nearly a decade of efforts, significant barriers to nursing practice and improved health remain.
Legislation (SB25) sponsored by Senator Camera Bartolotta, R-Washington, would accomplish this goal without requiring burdensome and expensive written collaboration agreement with not one, but two physicians.
This legislation has been introduced and passed by the Senate at least three times in the past five years. The current law mandates unnecessary oversight that does not improve care, limits access to care especially in rural areas, and needlessly increases cost.
Pennsylvania is falling behind on this front. Twenty-three states and the District of Columbia have passed such bills – with no adverse health or economic effects to patients – producing countless benefits, including increased access to care, increased productivity of the entire health care team, and reduced cost of care.
Republicans and Democrats, consumer organizations, and the business community – including Target, Verizon, Best Buy—and now Amazon—are actively supporting full scope of practice for nurse practitioners.
Changes in healthcare and the demand for access have been accelerated as a result of the COVID-19 pandemic. New models of care, such as tele-health, and pop-up and retail services, require changes in policy to support innovation and increased access to needed health services.
Baby steps won’t cut it. The Commonwealth did suspend some burdensome pre-approval requirements for collaborative agreements related to prescribing medications but did not go far enough in eliminating them. Last year, an alternate bill considered by the House would eliminate collaborative agreements for a select number of health-professional-shortage areas as a six-year pilot program.
This bill would have affected fewer than 50 NPs out of the 16,000 who practice in PA. A study conducted by the Leonard Davis Institute for Health Economics at the University of Pennsylvania, estimates that allowing NPs to practice to the full extent of their education and training would alleviate primary care shortages in 7 of 15 federally designated geographic health-professional-shortage areas in PA. Access to care in these areas – often rural and high poverty areas could be expanded.
We need full practice authority for all experienced NPs, right now. At a time when nurses are needed now more than ever, delays and impediments to providing care are no longer acceptable. The limitations placed on nursing practice by outdated and inefficient legislation harm not only nurses, but importantly, the individuals, families, and communities in the Commonwealth.
We implore our public officials and policymakers: LET NURSES DO THEIR JOBS!
Antonia M. Villarruel, PhD, is the Dean of the University of Pennsylvania School of Nursing. Jacqueline Dunbar-Jacob, PhD, is the Dean of the University of Pittsburgh School of Nursing.