Pa. must do more to retain nurse practitioners
Graduation is almost here and, for the world of nursing, it can’t come soon enough. My students — who will become registered nurses or doctors of nursing practice — will serve patients amid a hiring shortage in all 50 states.
As a nurse practitioner myself, I see how badly needed they are.
As resident of the Pennsylvania Coalition of Nurse Practitioners, I want as many nurse practitioners as possible to stay in the state and serve patients here. As chair of the nursing program at West Chester University, I also want my students to succeed at the top of our field.
Unfortunately those things are in conflict: Some nurse practitioners will have to leave Pennsylvania in order to rise to the highest level of their education and training. That’s because other states offer nurse practitioners a more competitive practice environment than Pennsylvania.
New York is the most recent state to modernize its rules for nurse practitioners, joining a list of 26 states, including our neighbors in Delaware and Maryland.
I’m worried my daughter will be one of the nurse practitioners who has to leave. After five years of serving patients, she is completing her master’s degree as a family nurse practitioner right now. She can’t wait to start the next chapter of her nursing career.
Neither can employers — she receives a daily deluge of recruitment outreach from hospitals and health systems up and down the East Coast. There is fierce competition to hire nurse practitioners, and I want Pennsylvania to retain as many as possible. I want my daughter and my students to be able to flourish close to home.
We can and should do more to encourage nurse practitioners to serve in Pennsylvania and support the nurse practitioners who already do. We owe it to our patients.
The past few years of pandemic have been exhausting for our health care workforce. Many of my colleagues have chosen to retire. But even when COVID19 abates, we need to be ready to face other health care challenges. We have to plan for the next five, 10 and 20 years.
Nurse practitioners are educated and trained to serve patients. We are nationally certified to prescribe medicine, order and interpret diagnostic tests, admit patients to hospitals, and see patients in their homes.
Above all, we practice “whole” patient care, putting the patient in
the center. We stand ready, willing and able to help, and patients trust us to do it.
Pennsylvania has some big and unique challenges. Our aging population is growing much faster than other states. We have significant medically underserved populations in rural and urban areas.
We are projected to need thousands of additional health care workers in the coming years just to keep pace. Primary care — where nurse practitioners are especially strong — is a constant
need.
Luckily, we have some big advantages, too.
Pennsylvania is a national leader in nursing education. We have 26 schools of nursing that offer board-certified nurse practitioner programs. Pennsylvania graduated 2,410 nurse practitioners last year. Per capita, that’s more than double the number of nurse practitioner graduates in California.
We should use our strengths to their full advantage. Policymakers can take some straightforward steps to make sure the nurse practitioners we educate in Pennsylvania choose to practice here. Here is what I recommend we do:
- Loan forgiveness: We should maintain and expand state funding for loan forgiveness for all providers, especially those in underserved communities.
- Full practice authority: We need Pennsylvania to outcompete neighboring states, including Maryland and New York. We should align the commonwealth with national best practices to streamline the licensure process and make it more affordable to practice as a nurse practitioner.
This reform has broad support from stakeholders including AARP Pennsylvania, the Hospital and Healthsystem Association of Pennsylvania, the Insurance Federation of Pennsylvania, the Pennsylvania Rural Health Association, and many more.
- COVID waivers: As we recover from the latest COVID19 wave and rebuild workforce capacity, we should extend the temporary waivers that make us more flexible. With fine-tuning, some of them could be made permanent.
- Chief nursing officer: Pennsylvania should create a chief nursing officer position within the Department of Health to ensure nurse practitioners and our nursing colleagues are fully represented in the agency decision-making process.
- Expand telemedicine: As the state faces a critical health care shortage, we support efforts to make it easier for providers to serve patients across the state.
All of these ideas are tried and true. They will improve patient care, protect patient safety, expand access to care and lower costs. Best of all, they leverage Pennsylvania’s great strengths to solve our biggest challenges.
Nurse practitioners and policymakers can take on any problem if we work together.