Moderator LT_Oneal_PAC Posted October 1, 2015 Moderator Share Posted October 1, 2015 A major independent assessment of the Veterans Health Administration (VHA) issued in September recommends that the VHA recognize nurses to their Full Practice Authority in order to improve care for the nation’s Veterans. The assessment, ordered by Congress as part of the Veterans Access, Choice and Accountability Act and conducted by the RAND Corporation, is being reviewed by the House Veterans Affairs Committee at a hearing on Oct. 7 – and is a significant new impetus for the VHA to publish an APRN Full Practice Authority rule now. Within the VHA healthcare system assessment’s section on increasing productivity within existing resources, the first recommendation is to “formally grant Full Practice Authority for all advanced practice nurses (APNs) (that is, nurse practitioners, clinical nurse specialists, nurse anesthetists, and nurse midwives) across VA, superseding individual state laws governing scope of practice where applicable.” The report states, “Allowing full nursing practice authority is often raised as a key approach to addressing physician workforce shortages and access problems in non-VA contexts….” Referencing both the Institute of Medicine report The Future of Nursing: Leading Change, Advancing Health and current AANA backed legislation (HR 1247, the “Improving Veterans Access to Care Act”) the report says that allowing APRNs to practice as Full Practice Providers may favorably improve Veterans access to care and produce cost savings for the VA. Underscoring one significant reason for AANA and CRNAs to continue engaging their own legislators on this issue, the report also says that the proposal “could face strong political resistance from physician advocates within and outside the VA,” adding that “physician reluctance to accept the role of nonphysician practitioners remains a persistent cultural barrier that will require sustained and intensive attention by VA leadership and beyond to overcome.” It adds, “Physician organizations often state that substituting APNs for physicians may put patients at risk for poorer outcomes despite a lack of evidence to support this claim.” To read the healthcare portion of the VHA independent assessment, see: http://www.va.gov/opa/choiceact/docu...pabilities.pdf (the APRN Full Practice Authority proposal begins on p. 266 of the document). To support Veterans access to quality care by backing Full Practice Authority for CRNAs and other APRNs, see www.Veterans-Access-To-Care.com and urge your Veteran colleagues and friends to do the same. Link to comment Share on other sites More sharing options...
Moderator ventana Posted October 1, 2015 Moderator Share Posted October 1, 2015 once again NPs have great advocacy and another study to support uncoupling from docs we have aapa.... Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted October 1, 2015 Author Moderator Share Posted October 1, 2015 Yup. Why can't we petition the VA to do this same study for PAs? Or at least add us in to these studies already ongoing? Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted October 1, 2015 Moderator Share Posted October 1, 2015 step 1: IOM study....a PAFT goal... Link to comment Share on other sites More sharing options...
Guest Paula Posted October 2, 2015 Share Posted October 2, 2015 Yup. Why can't we petition the VA to do this same study for PAs? Or at least add us in to these studies already ongoing? Do you think anyone at the VA is asking to include PAs. It took the VA five years to declare that PAs are collaborative providers. Denni Woodmansee was involved in the process. Does anyone know if he still works at the VHA? Could PAFT contact VHA and ask for PAs to be included? Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted October 2, 2015 Author Moderator Share Posted October 2, 2015 Do you think anyone at the VA is asking to include PAs. It took the VA five years to declare that PAs are collaborative providers. Denni Woodmansee was involved in the process. Does anyone know if he still works at the VHA? Could PAFT contact VHA and ask for PAs to be included? I doubt seriously anyone has asked for a study like this for fear of backlash similar to how the ANA came out against CRNAs at the VA having independence. We are big enough now as a profession to handle the flak without serious blow back, unlike in our infancy. Link to comment Share on other sites More sharing options...
Gordon, PA-C Posted October 3, 2015 Share Posted October 3, 2015 NPs already have 100% independence in VA centers and have so for at least the last 5 years. This "study" was done by a group who didnt actually follow the NPs around on a day to day basis inside the VA system. BTW, some of the deaths at the VA system in Alabama were tied to an NP writing for narcotic scripts 100% independently with no physician "collaboration" Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted October 3, 2015 Author Moderator Share Posted October 3, 2015 How ARNPs practice varies from one VA to the next, usually adapting to local practices, despite written instruction. I've seen many that had much less that full autonomy. A PA was recently indicted on $150million dollar insurance fraud and found to be performing Orthopaedic surgery solo, at the order of he "collaborating" physician, with many patients suffering complications. Not sure I see the point in your n=1 statement. Link to comment Share on other sites More sharing options...
SocialMedicine Posted October 3, 2015 Share Posted October 3, 2015 When you have nursing schools that are academic/research centers, and PhD nursing programs you can produce data and consult accordingly. When you have a PA school on every street corner with over worked small quantity faculty to train small numbers of students you do not get this information. Take a look at who the researchers are at RAND. Quite a few top quality PhD RN types who worked previously in nursing schools and were trained in research and policy by nursing schools. Our top PA schools need to expand and we need to stop creating a new one on every street corner which brings down the potential of others. Link to comment Share on other sites More sharing options...
SocialMedicine Posted October 3, 2015 Share Posted October 3, 2015 A major IOM study is great but if you only have a total of 25 PA people throughout the US that could potentially steer the study that is very unfortunate and may create some barriers. Although I understand you do not need to be a PA to effectively study PA issues. Link to comment Share on other sites More sharing options...
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