Representing more than 8,000 pediatric-focused nurse practitioners (NPs), the National Association of Pediatric Nurse Practitioners (NAPNAP) denounces WGN NewsNation and Rich McHugh’s poorly sourced and inaccurate portrayal of NPs. Any child’s death is heartbreaking and causes families to have unfathomable grief, and we send our most sincere condolences to any family who has experienced such tragic loss. These stories, while deeply saddening, do not represent the comprehensive, high-quality care provided by NPs in more than one billion patient encounters each year.
We are disappointed our physician colleagues would choose to expend effort to misrepresent the safe, evidence-based and trusted care NPs deliver to children. The dissemination of such inaccuracies fractures the public’s confidence in nursing, ranked by Gallup as the most trusted profession in the country for almost 20 years, by encouraging unfounded patient fear and suspicion of all NPs based on two tragedies. At a time when the public is already reluctant to seek care in a pandemic and preventive care delivery has declined, these accusations present a threat to the health of the public.
There are currently more than 290,000 NPs in the health care workforce who provide nearly one-fifth of all primary care services in the US and represent the fastest-growing segment of the primary care workforce. Over two-thirds of NPs work in primary care, and collectively NPs positively impact access, quality, and cost-effectiveness of primary and acute health care across the nation.
Contrary to the misinformation reported by WGN NewsNation, data shows that NPs consistently deliver safe, high-quality, evidence-based care and are indispensable to producing excellent outcomes for patients. Based on mastery of nationally validated competencies and competency-based standards during their advanced education in nationally accredited nursing programs, clinical training and national board certification, pediatric-focused nurse practitioners are licensed to provide a variety of patient services, including the evaluation and management of pediatric patients, ordering and interpreting diagnostic tests, developing differential diagnoses, prescribing medications and devising treatment plans in primary, acute and specialty care settings.
The National Council of State Boards of Nursing developed the APRN Consensus Model to support national standards for educational curriculum models, university accreditation, state licensure and national certification for NPs. The high-quality care NPs bring to health care is recognized by the Department of Veterans Affairs (VA) , which enacted full practice authority for Advanced Practice Registered Nurses (APRNs) including nurse practitioners in 2016, joining the now 22 states, the District of Columbia and two territories that allow nurse practitioners to practice to the full extent of their education and licensure in the United States. Furthermore, the American Hospital Association recently called for CMS to expand the physician supervision requirement waiver introduced during the pandemic to include all nurse practitioners providing care within the scope of their license and privileges to help mitigate widespread staffing shortages across the country.
The pediatric nurse practitioner role originated in 1965 at the University of Colorado following the collegial collaboration of a pediatrician and pediatric nurse to give nurses advanced training to optimize child health. Since then, a plethora of credible data, spanning several decades, substantiates comparable clinical patient outcomes to physicians, often at a lesser cost (Liu et al, 2020; Coddington, 2011; Horrocks, 2002). The quality of care NPs provide is supported by recommendations from several policy-influencing organizations such as the National Academy of Medicine, National Governors Association, and the Hamilton Project at the Brookings Institution to expand the use of NPs, particularly in primary care (Schiff, 2018). Science supports us with evidence, and our patients support us with their trust, with millions of families choosing NP-provided care.
Rather than celebrating care delivered by front line nurse practitioners during this COVID-19 pandemic, WGN NewsNation has elected to direct its resources to air a news story intended to incite fear in the hearts of parents, who are already struggling. Throughout this pandemic, nurse practitioners have stepped up for all patients, often providing care in spaces void of or underrepresented by other health care providers. It is time for interprofessional collegial respect and recognition of the contribution of care of all health care providers in the delivery of high quality, accessible care to our patients and families. NAPNAP will continue to support our members as experts in pediatrics and advocates for children, so they can continue to provide equitable, accessible, affordable, high-quality, family-centered care to children across the nation.
Dec. 17, 2020
https://www.beckershospitalreview.com/hospital-physician-relationships/letter-to-the-editor-nurse-practitioners-are-not-mid-level-providers.html Letter to the editor: Nurse practitioners are not ‘mid-level’ providers, Colleen Chierici, BSN, RN; Aney Abraham, DNP, NE-BC, RN; Lynne Braun, PhD, CNP, FAHA, FAANP, FPCNA, FAAN; Raechel Ferry-Rooney, DNP, APRN, ANP-BC; Ingrid Forsberg, DNP, APRN, FNP-BC; Terry Gallagher, DNP, APRN, FNP-BC; Angela Moss, PhD, APRN, ANP-BC).
Coddington, J., Sands, L., Edwards, N,….Chen, S. (2011). Quality of health care provided at a pediatric nurse-managed clinic. Journal of the American Academy of Nurse Practitioners. 23(12); 674-680.
Horrocks, S., Anderson, E., Salisbury, C. (2002). Systematic review of whether nurse practitioners working in primary care can provide equivalent care to doctors. BMJ, 324; 819-823.
Liu, C-F, Hebert, P.L., Douglas, J.H., Neely, E.L., Sulc, C.A., …. Wong, E.S. (2020). Health Serv Res. 55(2)l 178-189.
Maria Schiff, “The Role of Nurse Practitioners in Meeting Increasing Demand for Primary Care,” National Governors Association, December 2012, https://www.nga.org/cms/home/nga-center-for-best-practices/center-publications/page-health-publications/col2- content/main-content-list/the-role-of-nurse-practitioners.html; and E. Kathleen Adams and Sara Markowitz, “Improving Efficiency in the Health-Care System: Removing Anticompetitive Barriers for Advanced Practice Registered Nurses and Physician Assistants,” Brookings Institution, Hamilton Project, June 2018, http://www.hamiltonproject.org/assets/files/AM_PB_0620.pdf.