APRN Legislative/Policy Issues: Nurse practitioners are the answer to the primary care shortage

Nurse practitioner faculty need to ensure that students are involved in local and federal legislative issues early in their educational program so they understand reimbursement, barriers to credentialing, and patient-centered medical home roles.  Besides role modeling and having students attend professional meetings and legislative sessions, faculty need alternatives for fulfilling this objective.  While states are preparing to meet the need for primary care for millions of previously uninsured people, NPs should be prominent in local/state efforts to accommodate the newly insured.  Faculty need to immerse students in these experiences as.  At the University School of Nursing (SON), faculty noticed that many legislators and policy-makers are unfamiliar with the roles of APRNs.  So, to begin the process of educating both groups, the faculty invited state legislators, agency chiefs, department of health officials and policy-makers to attend an event designed to highlight the roles of APRNs as primary care providers. 

The SON dean and university president provided opening remarks and thirty attendees were educated about APRNs.  While sitting in a lecture hall filled with poster-size photos of NP faculty in their practice sites, the audience “played” the roles of actual APRN students, listening first to a brief lecture that illustrated the interrelated “three Ps” with hypertension as the example.  They participated in clinical simulation labs where they practiced CPR, maintained an airway, defibrillated, and started IV access.  Next, they participated in standardized patient scenarios designed to highlight complex clinical decision-making that NPs engage in:   assessment of lead levels in a hyperactive child, polypharmacy problems with elderly patient, asthma exacerbation in a woman without medications/inhalers, diabetes and hyperlipidemia management, and post-traumatic stress disorder assessment. 

After “debriefing sessions” at the close of the program, the evaluations were so positive that the decision was made to repeat it to ensure that APRN education is understood by all and that legislators continue to plan health care reform measures with NPs assuming a prominent role as medical home leaders.  The connections made were invaluable as lead faculty members were later appointed to the governor’s coordinating council for health care reform in Maryland.