APNs from Rush Advocating for SB 642
Monday, May 8, 2017
Family nurse practitioner faculty and students regroup to discuss their progress during lobby-day at the Illinois State Capitol. Left to right: Lucy Amaro, Raechel Ferry-Rooney, Kathy Swartwout, Melissa Kalensky and Katherine Bauer.
(Photo credit: Rush University)
Two nurses, one senator, a chance encounter and five minutes to influence: This formula generated a new co-sponsor for Senate Bill 0642, keeping hope alive for Illinois APRNs who are passionate about primary care and the health of underserved communities.
This imminent vote to expand access to care prompted a Rush nursing faculty member and her doctoral students to show up in Springfield, press for face time with a senator and utilize their leadership training.
Legislative bills like this one have failed twice before, and this one is still too close to call, as we went to press.
THE PRIMARY CARE PROBLEM
In Illinois — and across the country — there’s a growing shortage of primary care providers. Some estimates put the national shortage as high as 96,000 in the next 10 years. Today, Illinois alone needs 454 more primary care providers.
But advanced practice registered nurses (APRNs) can solve the problem — if lawmakers let them.
“We need the providers right now,” explains Melissa Kalensky, assistant professor at Rush University College of Nursing and a family nurse practitioner at Oak Street Health, a network of primary care clinics targeting underserved, Medicare-based populations across Chicago. “It’s unfortunate and shortsighted that practicing APRNs who are trained and qualified to do this work are prevented from doing so,” she adds.
At the end of 2016, the Department of Veterans Affairs (VA), the nation’s largest employer of nurses, made a sweeping decision to allow APRNs to practice to the full extent of their scope and licensure without mandated physician collaboration, regardless of state restrictions. It represents a slow but steady shift toward empowering highly trained and experienced nurses to help solve this nationwide problem.
In Illinois, however, there remains a reduced practice regulatory structure — which is where Senate Bill 0642 comes in. It would amend the Nurse Practice Act to allow APRNs to practice without having a collaborative agreement in place with a physician. SB0642 would simply allow more APRNs to reach communities without primary care options.
“It requires a team effort to reach everyone in need of primary care, and that’s what this bill would accomplish,” said Kalensky.
CHANGE IS INEVITABLE
Forty years of research points to the positive patient outcomes with APRNs — providing safe and high quality patient care that matches their physician counterparts. In 2010, the Institute of Medicine (IOM) called for the removal of barriers to advanced practice nursing to address the changing pressures on the health care system.
Twenty-three states have already lifted restrictions.
To Kalensky, the argument is straightforward. “The data is there to support it. The IOM wants it to happen. And it is a solution for patients whose lives would be improved with access to primary care.” The delay from some Illinois lawmakers is prolonging the inevitable, while the health of communities continues to deteriorate, she says.
OPPORTUNITY FAVORS THE PREPARED MIND
In March, Kalensky and several Rush students and staff traveled to Springfield to make that very point to Illinois lawmakers. The Illinois Society for Advanced Practice Nursing briefed them beforehand, providing talking points to help them make the most of their limited time.
Alongside Kalensky, Katherine Bauer, a doctoral student in the Rush family nurse practitioner program, had the opportunity to speak for several minutes with Illinois State Sen. Patricia Van Pelt.
Kalensky explained, “I’ve always spoken to staff, so this was my first experience speaking to a senator directly. We made multiple stops at her office and persisted until we caught her between meetings.”
“We were able to tell the stories of our patients in Chicago who have access-to-health-care issues,” says Bauer. The personal touch mattered — and, she says, it helped that both she and her patients were constituents on the city’s West Side.
In those few minutes, Bauer and Kalensky persuaded Van Pelt not just to vote for the bill, but also to co-sponsor it.
“We did a high-five, and had to control our excitement about what just happened,” Kalensky said.
Later in the day, Kalensky ran into a Rush alumna, Marie Lindsey, PhD, FNP-BC, who is an influential nurse advocate and current professor at the University of St. Francis. Lindsey said the encounter was “meant to be” as Sen. Van Pelt, in particular, has a schedule almost impossible to penetrate without an appointment.
The success lay not just in finding an additional sponsor, but also in the inherent lesson about an APRN’s role — and responsibility— to help shape health policy.
GROOMING ACTIVISTS THROUGH DOCTORAL EDUCATION
Nurses are the largest group of health care professionals worldwide. Kalensky explains that nurses are a patient centered profession, making them the ultimate patient advocates.
“This is exactly what a DNP prepared nurse is designed to do,” she says. “I tell students, if you care about what happens in the exam room, you need to care about what happens in the Legislature.”
And, says Kalensky, “You can’t teach that in a classroom.”
— Laura Lambert for Rush University College of Nursing