Catherine Grant: Please, let nurse practitioners serve patients
I own and manage a small health center in Slickville, population 372. I was the very first nurse practitioner (NP) to own a health center in Pennsylvania. I established my office because I saw a huge need in towns and rural areas. I’ve dedicated 25 years of my life to make sure families have access to health care, because it can be a matter of life and death.
A 2-year-old boy was sick on a Sunday morning a few years ago. His mother called me to say he didn’t seem himself. I told her to come to my office right away. The minute I saw him, I knew something was seriously wrong. He was vomiting. His heart rate went to 200 and he became lethargic. I recognized the symptoms of intussusception, a potentially fatal bowel condition. I called an ambulance immediately, and he was Life-Flighted to Children’s Hospital. This saved his life.
Thank God his mom called. Thank God she didn’t have to wait for an appointment or drive an hour away to see someone. Sometimes I wonder, what if they had lived in another town?
Living in rural Pennsylvania means being an underdog, and I embrace it. But, our state law works against rural NPs by requiring that we obtain a business contract with a physician in order to practice. I am fortunate to know a physician who is willing to sign because he sees the value of using NPs to provide care. Other NPs are not as fortunate.
Lawmakers in Harrisburg have introduced an answer to this problem called Full Practice Authority. The legislation is endorsed by AARP, the Pennsylvania Rural Health Association and many respected community organizations. The initiative is sponsored by Republicans and supported by Democrats.
Full Practice Authority for NPs would increase access to care, improve quality and lower costs. Twenty-two states already have this policy, and NPs in those states are more likely to see patients in rural areas. Seniors and patients with chronic conditions are more likely to receive regular care. The bill would protect patient safety by requiring every NP to have a bachelor’s degree, an R.N. license, a masters or doctorate, be nationally certified, work three years in a clinical setting, and be overseen permanently by the State Board of Nursing.
Unfortunately, medical trade associations have blocked this reform for years. In the op-ed “Pending bills could impact patient care in Pa.” (Oct. 3, TribLIVE), Dr. Gene Battistella of the Pennsylvania Osteopathic Medical Association wrote that training differences between physicians and NPs justify the mandatory contracts. He is incorrect on both counts. The National Academy of Medicine concluded NPs provide safe, quality care.
NPs in Pennsylvania and nationwide will always work with physicians. Not because of a government mandate, but because that’s what’s best for our patients. But, there is a great and growing need for all clinicians at every level of health care. When government empowers NPs, it helps patients. It’s common sense: Fewer barriers for NPs means more NPs will practice, which means more patients have access, which means healthier patients.
This Sunday, a mom or dad somewhere in our state will wake up to find their child is very ill. We owe it to them to make sure someone can answer their call.
Catherine Grant, DNP, FNP-C, is the owner and manager of Associates in Family Health in Slickville and an assistant professor at the University of Pittsburgh School of Nursing.