President's Message

Happy NP Week!

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Dawn Garzon Maaks, PhD, CPNP-PC, PMHS, FAANP

Happy NP week everyone! I graduated with my PNP in 1994, and I admit I have never regretted the decision to go back to school. I'm so grateful that the University of Florida gave me an exceptional education and that I have a professional home like NAPNAP that pushes me to always be at the top of my game. Almost every day I go to clinic, I have a moment where I think to myself that it amazes me how much I love being a PNP, even after all these years. As a profession, we have come far these last decades. I am much more likely to have a parent or youth tell me they are glad to see a NP than to ask me why they can't see a physician. Almost half of our states allow practice at the fullest extent of our licensing and education. We have strong partnerships with physician and healthcare organizations, and I have had dozens of conversations about how they view us as esteemed partners; many even talk about how the task at hand should determine the leader of an interprofessional team, and that means that teams shouldn't always be physician led. I've heard healthcare administrators and non-nursing leaders talk about how DNP-educated NPs' knowledge of quality and process improvement increases health outcomes and creates new opportunities for NPs to lead broad initiatives. I had the incredible honor of being invited to present at the board meeting of the American Academy of Pediatrics (AAP) - in fact, I was the only non-physician in the room. I was there in recognition of the warm and collegial relationship between our organizations, and it was an incredibly positive experience. Unfortunately and despite this, all is not positive, although I argue we are closer to our aims and it's time to step up our game.

It seems ludicrous to me that in 2018 NPs still have to fight to get on panels. As I've talked about in previous messages, media rarely asks nurses for interviews on healthcare topics. I really dislike that so many of us bill "incident to" physicians because of reimbursement inequities. It leaves us invisible to the system at large and adds to the idea that our care is less than that of a physician. Every day, I hear of another attempt at limiting our practice whether in institutions, in credentialing or via legislation. On my way out of the conference room after my presentation to the AAP board, I overheard two NPs speaking in the hall about how they didn't feel comfortable speaking up about a practice issue in their local children's hospital because they were "just nurses." Last weekend during the NAPNAP Executive Board meeting, one of our board members said she had previously overheard some NPs referring to themselves as mid-level providers. We must stop this!  It goes without saying that nothing about NPs providing evidence-based, high-quality care is mediocre. In fact, I personally can recall dozens of times a child with a difficult presentation was diagnosed by a NP specifically because we bring the nursing perspective with us, and this holistic view is what solved a complex situation. The term mid-level provider was coined years ago, and not by nursing. Think about what this term tells the patients and families we see. Language matters - we know this and tell parents this all the time. Advocate in your practice and in your institutions to change the term to advanced practice provider (APP).

Be careful of the terms you use when speaking with others. And please stop thinking of yourself as "just a nurse". You are a graduate-educated, board-certified clinician with a wealth of education and experience from a spectrum of healthcare sciences. You are the front line that helps keep our children from bearing an undue burden of illness and injury. You teach children about wellness and set them off on a solid foundation to prevent a lifetime of chronic health challenges. You teach laypeople and healthcare team members about child development, health and illness. You advocate for children with special healthcare needs to get access to life changing care and services, you teach adolescents about healthy relationships, and you reassure overwhelmed caregivers. That is "just" amazing and it is exceptional, not mid-level.

Since Thanksgiving is around the corner, I want to tell you I am so grateful for the honor of being your president, I am thankful for being a PNP, and I'm thankful for every encounter with a child or youth in need. As a way of saying thank you for these opportunities, I just made a small donation to the NAPNAP Foundation. It's easy and takes less than 5 minutes. I went online to and filled out the form. The money for the Foundation supports travel scholarships to attend our national meeting, research grants, student scholarships, and the Foundation regularly sponsors online education and conference sessions at our annual meeting. I can assure you that many of you have directly benefitted from this critical organization whether you realize it or not. Would you join me in making a small donation as a way of saying thank you while celebrating NP week?

Lastly, please know my heart breaks for the millions being affected by the fires and severe winter weather. My heart warms at seeing communities come together to care for one another. I honestly believe that is what America is all about. I wish each of you the happiest of Thanksgivings. May the upcoming week give you time with people you love and time to reflect on the joys and blessings in your life. May you and your loved ones be safe, happy, healthy and warm, and thank you, from the bottom of my heart, for your support of NAPNAP and for your tireless advocacy for children and families. You are rock stars!

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