While it was time consuming, I loved doing the April Alphabet Challenge A to Z. It got me writing new stories, released memories I had forgotten and expanded my writing skills. Going forward with my Blog, I will intersperse more personal tales.
This is a timely decision since nurses are getting greater attention being on the forefront of the pandemic. Look what nurses do, shout the headlines. Plus, nurses are writing their own stories in essays, news media and books in greater numbers. This is just fantastic. I feel more comfortable cutting a back bit on my emphasis to show how nurses make a difference.
Also, there seems to be a national movement to grant nurse practitioners the legal authority to practice independently. That is, to practice without physician oversight. While I was busy constructing a daily post for the month of April, a friend emailed me an article about nurse practitioners titled: We trusted nurse practitioners to handle a pandemic. Why not regular care? (Lusine Poghosyan, The Niskanen Center Newsletter, March 9, 2021). Before COVID-19, only 22 states allowed NPs to practice independently. Since then, governors of 23 states have signed executive orders to permit NPs to practice without physician agreements.
Sadly, it took a pandemic to unearth the truth that nurses and NPs do improve patient care and make a difference in the health care system.
In the April 2019 AARP Bulletin there is an article discussing the restrictive laws in North Carolina that control Advanced Practice Registered Nurses.*
North Carolina is where I now live. While I no longer practice as a nurse practitioner, I’m always on the lookout for the latest restrictions or advances in APRN practice. And I am saddened with this particular write-up. Why? Because the story shows that the years of research proving that APRN’s give the same level of safe, quality care as physicians in similar settings is totally disregarded. Therefore, limiting the use of APRN’s has caused the following:
Many rural North Carolina counties face severe provider shortages. Three have no primary care doctors, 26 counties have no OB-GYN, and 32 are without a psychiatrist, . . . .
Ranked 35th for overall health care
Ranked 41st for infant mortality
56% of low-income children don’t have a doctor
(Michelle Crouch, Bridging the Health Care Gap, AARP Bulletin/Real Possibilities, April 2019. p 44.
In 2017, a bill to expand APRNs practice was defeated. Both the NC Medical Society and the NC Academy of Family Physicians opposed this bill, in spite of the fact that “moving restrictions on APRNs could save the state $400 million to $4.3 billion in health care costs annually” and, could increase the number of APRNs to correct the health care shortage.
I have almost 40 years’ experience in watching the struggle to limit APRNs practice. I know many physicians who work alongside nurse practitioners, nurse midwives, and mental health nurses who promote their role in keeping our communities healthy. From my viewpoint, it’s the efforts of organized medicine that disregards putting patients first and values only its own economic growth.
A new bill to remove barriers to APRN practices is expected to be introduced this year. I will be following this closely. It is my dream that in the near future, all states will give APRN’s full practice authority.
What a pleasant surprise to read that nurses save lives (italics mine) in a news article yesterday, September 21. Unfortunately, the story was not a happy one. The Raleigh, NC News & Observer detailed the memorial service for the crew of a Duke Life Flight Air Ambulance that crashed on September 8 killing all aboard: pilot, patient and two flight nurses.
“Like all medical personnel at Duke, Life Flight’s Crew ‘have a strong desire to save lives (italics mine),’” said Irene Borghese, program director. She goes on to say “what sets this group apart is their desire to do so (save lives) while putting themselves in harm’s way and without the safety net of an entire health care team . . . They simply depend on each other.”
What she is saying is that the nurses can rely on their own knowledge and expertise when they deal with difficult patient problems on a flight mission and not have to follow doctor’s orders, although there probably are protocols when needed.
The nurses who died, Crystal Sollinger and Kris Harrison, had worked together on a flight “that wound up saving the life (italics mine) of an infant . . .that baby is now 3 years old, and her family brought her to” the service.
We all know that in most instance nurses are not recognized for the intelligent, caring and competent health care providers that they are.
In a post I wrote in February 2013, Businessweek reporters gave doctors credit for caring for Hillary Clinton while she was admitted to the hospital when she had a blood clot. Nurses were never mentioned. I can’t imagine a doctor was around to do vital signs on the night shift.
Thank you to Ray Gronberg and Tammy Grubb, the authors of N & O piece, for giving credit to Crystal and Kris for doing what they really do: save lives.
In preparation for moving I discover the darndest things as I unpack dusty boxes stored in the attic untouched for years. This time it’s a mercury sphygmomanometer, packed in its original carton along with a “limited warranty” card that should have been filled out within ten days of purchase. Looks like I didn’t even open the box but put the blood pressure machine away for the day I would open my independent practice.
That would have been in the early 80s after I became a gerontological NP
after I worked in Chicago with inner city, underserved elderly
after I became frustrated with the lack of resources and left to become an administrator of an HMO
after I knew I didn’t want to be in administration
after going back to work as a nurse practitioner once again