Nurse practitioners in Nebraska may soon be able to practice independently, thanks to a bill recently advanced in the Nebraska State Legislature. According to an article in Tuesday’s Omaha World-Herald, Legislative Bill 916 would eliminate a requirement in Nebraska’s current law that nurse practitioners have practice agreements with physicians.
The bill was introduced by State Sen. Sue Crawford of Bellevue, who said Nebraska’s current law is adding to a shortage of primary care in the state’s rural areas. According to Crawford, 70 percent of nurse practitioners trained in Nebraska leave for other states. Iowa, Colorado and 16 other states allow nurse practitioners to practice independently without physicians agreements.
The issue at the heart of the bill is that Nebraska’s physician numbers in rural areas are dwindling at the same time that demand is increasing from aging populations and those newly insured under the Affordable Care Act. However, nurse practitioners are trained to fill those primary care roles, and research has shown that they are able to do so effectively. Two state review panels overseen by the Nebraska Department of Health and Human Services have endorsed LB 916.
To learn more about the need for nurse practitioners in Nebraska to have greater independence, read “Midlands Voices: Nurse practitioners critically important,” an opinion article by Dr. Dennis Joslin, President and CEO of Nebraska Methodist College, published in the Omaha World-Herald in December 2013.
Research conducted by a group of Nebraska Methodist College students was recently featured in American Nursing Today, the official journal of the American Nurses Association.
The March issue of American Nursing Today published the article “How Magnet® designation affects nurse retention: An evidence-based research project.” The article was the result of a critical literature review conducted by Nebraska Methodist College Master of Science in Nursing students Mellisa Renter, Anna Allen and Anne Thallas. Dr. Linda Foley, director of Nebraska Methodist College’s Nursing Graduate Program, mentored the group throughout the project.
During the spring and fall semesters of 2013, the group conducted critical analysis of literature researching the levels of nurse satisfaction and retention among hospitals that achieved Magnet Recognition®. The Magnet Recognition Program® recognizes healthcare organizations for high levels of patient care and nursing excellence.
According to American Nursing Today, the group’s analysis “confirmed that Magnet designation correlates to positive work environments and nurse satisfaction, both of which may influence nurse retention.”
The evidence-based research project was a capstone project for Renter, Allen and Thallas. Nebraska Methodist College graduate students are challenged to conduct capstone projects that address needs, gaps or issues in nursing and healthcare that ultimately help improve patient outcomes.
The Affordable Care Act (ACA) has continued to be a hot-button issue as its changes are rolled out. Political debate over the ACA has created confusion about what the future holds for varying healthcare career fields. Whether you are already working in healthcare or are considering a career in the healthcare industry, that uncertainty can be concerning, especially as you try to make decisions that are best for your own future.
Experts, however, tend to agree that research indicates careers in the healthcare industry will continue to be on solid footing. In fact, many experts believe the ACA, in addition to other factors, will increase demand for careers in healthcare over the next decade.
According to the Centers for Medicare & Medicaid Services (CMS), healthcare spending is projected to increase over the next decade at significant rates. That projected increase will result from new demand from millions of newly insured Americans under the ACA, increased demand from aging baby boomer populations and improved economic conditions throughout the country. Economists say that more spending means more healthcare jobs as hospitals and other healthcare facilities will need additional staff to meet these growing needs.
Here are a few healthcare career fields that can expect increased demand as a result of the ACA:
- The ACA’s emphasis on primary care will increase demand for nurses in primary care settings. In particular, nurse practitioners with Doctor of Nursing Practice degrees will be needed to fill primary care roles in rural areas that suffer from physician shortages.
- Demand for sonographers will likely increase because diagnostic and preventive screenings are now covered by the ACA.
- Physical therapy assistants will be needed to support patients in their rehabilitation, which is considered an essential benefit by the ACA to be covered by insurance.
- More medical assistants will be needed to support physicians and nurses in primary care settings.
By Dennis Joslin, PhD
President and CEO of Nebraska Methodist College
Who’s tired of talking about the Affordable Care Act (less affectionately known as Obamacare)? Not me. That’s because for healthcare educators, the discussion should be just beginning. Now that the debates have finished on Capitol Hill and the bugs are getting worked out of Healthcare.gov, the conversation should now focus on moving forward.
And that’s where healthcare educators come into play.
The Affordable Care Act (ACA) is changing healthcare on a fundamental level, affecting how insurance companies provide coverage, how care providers like hospitals and clinics operate, and how everyday consumers navigate the system. But what can’t be ignored is the role healthcare educators have in meeting the needs of tomorrow’s industry. As healthcare educators, we need to proactively work to identify and address industry demands resulting from the new law, and we need to be ready to prepare students for the new realities in healthcare.
One of the most important aspects of the new law is access to healthcare — access by those with pre-existing conditions and those who previously could not afford coverage. Now, millions of Americans have health insurance who didn’t before, giving them access for the first time to healthcare services. As many healthcare experts will tell you, that presents a major challenge because the healthcare industry is already dealing with shortages of doctors, nurses and health professionals in other disciplines. At the same time, the baby boomer population is aging, which is forecasted to increase demand for healthcare services in the next decade.
This is where we as health professions colleges and universities have a responsibility to respond to the demands of the healthcare industry. Colleges and universities can’t sit back and be content with their current healthcare offerings. Even though the ACA has opened the door to accessible healthcare, we haven’t solved the issue if enough healthcare providers aren’t available. Instead, we need to continue researching the needs of the industry and working to add and expand programs to meet those demands.
At our institution, Nebraska Methodist College, one example of this is our recently-added Doctor of Nursing Practice (DNP) program. We added the program because we saw a void in primary care providers in Nebraska and the region, especially in rural areas. Primary care providers are crucial in detecting illnesses and diseases in patients at early stages when care is both more effective and less costly. We found rural areas of the state are having a difficult time recruiting physicians; however, those roles can be filled by DNP-prepared family nurses practitioners. We felt that this type of education and skill set was really needed most in our state and aligned best with the ACA’s focus on preventative care.
Preparing more healthcare professionals is only half of the challenge. Health professions institutions need to work to place individuals in jobs and locations where they are needed most and can be successful. This means utilizing the networks of your health system, faculty and alumni to connect students to those careers. For instance, at Nebraska Methodist College, we have a rural health advisory committee that we work with in planning our curriculum. Many of those advisory members are willing to have students precept in their communities as part of their clinical experience. Those opportunities prepare students for what they will actually experience in that rural environment and can often lead to jobs.
In addition, healthcare educators need to accept the challenge from the ACA to improve care. Graduates should be prepared to provide care using the best evidence-based practices for each respective discipline. They also should be prepared with skills to engage patients in the care they are receiving and educate communities about prevalent health issues.
Lastly, graduates should recognize their role in helping their patients understand the ACA. For the average patient, the law can be very confusing, and health professionals should encourage patients to be informed healthcare consumers. While each one of us may not have all the answers, we can direct patients to the right resources where they can find the information they need.