Nurses have always played a key role in health disaster management around the world and for centuries, but their roles often go understated. Nurse practitioners are not excluded from that list of understated medical heroes either since they seldom get the credit that they deserve for fighting adverse situations and deadly diseases in rural America for countless years now. However, never have any US medical personnel alive faced a disaster as big and as overwhelming as the ongoing one we have with Covid-19.
A Scarcity Which Precedes Covid-19
Unfortunately, there was already a severe scarcity in the availability of trained nursing professionals and doctors in the United States, but things as they stand now have made the situation so much worse. 600+ US healthcare workers have perished so far while fighting the deadly novel coronavirus, with stats indicating that those numbers are yet to increase, and significantly at that. In a nation that was already suffering from a deficit in the availability of healthcare workers, a loss of 600 doctors, nurses, and other direct care workers is a huge tragedy.
Once we compound the pre-existing deficit in healthcare workers, the decreasing number of available healthcare workers, and the massive increase in patient admissions, what we get is the present situation of the US healthcare system. If more states do not act and decide to join the list of US states that provide full practice authority (FPA) to qualifying advanced practice nurses, the situation will simply keep getting worse.
How Nurse Practitioners Provide an Alternative that Doctors Cannot
The deficit in the total number of available nurses cannot be fulfilled by doctors since they are already shorthanded in fulfilling their own specific roles, but advanced practice nurses with a DNP can fill their shoes up to an extent. For example, Pediatric Acute Care Nurse Practitioner programs from a well-recognized university will equip the DNP-PNP to handle:
- The diagnosis and assessment of acute/chronic pediatric illnesses and conditions
- The treatment of multiple acute and chronic pediatric illnesses and conditions with prescription medication
- Ordering and assessing diagnostic reports from medical examinations (blood test, stool test, X-ray, etc.)
- Patient management, treatment and discharge duties in their own PNP clinics
- Suggesting aftercare routines and follow-up treatment procedures for the child, as and when required
Unfortunately, the years of training, on-the-job experience, and advanced education would practically be wasted if a PNP decided to work in one of the states which do not allow its NPs full practice authority. They would still be well paid and could be able to help in managing the crisis by taking up leadership positions, but they will not have the autonomy to help in as many ways as they are trained and educated. The same applies if we are discussing family nurse practitioners (FNP), orthopedic nurse practitioners (ONP) psychiatric or mental health nurse practitioners (PMHNP) among others.
By simply letting the nurse practitioners handle duties that they are indeed equipped to handle, doctors can find a little reprieve and patients can finally seek treatment when physicians are unable to provide that to them. It would be a big decision if more states decide to take that route, but now is the most urgent time ever in recent history to take that decision.
5 States Have Temporarily Suspended the CPA and Seen Immediate Response
The Collaborative Practice Agreement (CPA) prevents nurse practitioners from acting without a physician’s consultation, consent and authority. States with full practice authority already got rid of the agreement a long time ago, but five states have temporarily joined in to help nurse practitioners deal with the emergency with better efficiency. These states are:
- New York
- New Jersey
- Kentucky
- Wisconsin
- Louisiana
New York was by far the worst hit state, and NYC was a deep red zone when the epidemic began earlier in 2020. In light of the situation, Governor Cuomo decided to temporarily enact the Uniform Emergency Volunteer Health Practitioners Act. After the governor declared a temporary abolishment of the Collaborative Practice Agreement, over 2400 NPs stepped up to the task and agreed to help as independent frontline healthcare workers.
Even though the situation in New York is still dire, it should be noted that Covid-19 cases in California have outgrown even New York in recent weeks, placing New York in the second position for the first time ever since the epidemic began in the United States. Although the two cannot be linked with any degree of certainty, the fact that more patients can now receive active medical care from nurse practitioners is definitely helping in mitigating the situation in these five states.
Perhaps if similar actions were taken sooner, NPs would have had a less problematic and more manageable situation to deal with. It also remains to be seen whether any or all of the five states decide to retract their Uniform Emergency Volunteer Health Practitioners Act soon after the crisis is dealt with or make the FPA for Nurse Practitioners permanent.
The Role that Nurse Practitioners Play in Rural Areas
In rural healthcare settings, not much has changed except the fact that doctors are even more scarce than they were before in these parts. However, that is to be expected, since even the big city hospitals are running out of staff to manage and care for so many patients at once. In such remote locations, the nurse practitioners present are the local population’s biggest hope, be it for treating Covid-19 or an ordinary skin rash!
If it wasn’t for the NPs working in these parts of the US tirelessly, it would be difficult to ascertain how the locals would have handled the present situation without the necessary medical facilities and personnel. Family nurse practitioners and pediatric nurse practitioners are keeping a semblance of a medical facility alive in some extremely remote parts, but without the proper aid to help them, that can get more and more difficult with time.