Oregon Study: State Needs Primary Care NPs

Oregon Study: State Needs Primary Care NPs

Counties across Oregon are suffering from a shortage of primary care Nurse Practitioners (PCNPs), according to a 2019 survey. A recent study from the Oregon Center for Nursing found that despite the promising national statistics reported by the American Association of Nurse Practitioners (AANP), which estimates that over 75% of NPs are practicing in primary care settings, the distribution of these NPs is severely lacking in Oregon.

As PCNPs are vitally needed to compensate for the shortage of physicians, their unavailability is severely felt in parts of Oregon, which is one of the 22 “full practice” states in the US. In contrast to the AANP’s national figures, a state-specific study of Oregon indicates that only one third of practicing NPs (35%) are working in primary care, with another 22% focusing on a combination of specialty and primary care. Of the 22% with combined practices, 62% spend less than half their time on primary care.

Surprisingly, the shortage of primary care NPs tends to be more evident in urban counties, whereas rural counties appear to be better served. Although there are fewer PCNPs by number in rural counties, the proportion of PCNPs is actually higher in rural areas when measured against per capita population figures.

The Oregon Center for Nursing makes three recommendations:

  1. Communities should promote incentives such as student loan repayment programs and grants to attract PCNPs to practice in their areas. In addition, incentives could be devised to encourage primary care physician groups to hire NPs and include them in their existing practices.
  2. The education system in Oregon should examine ways to increase the number of PCNP graduates. Currently, some 70% of the PCNPs practicing in Oregon received their degrees in out-of-state schools. This indicates that the facilities within Oregon are not able to meet present needs for the education of PCNPs, and until the state expands educational opportunities for PCNPs, it will be necessary to fill the gap with graduates from other states.
  3. Community leaders and health officials should explore the reasons that affect NP decisions to focus on primary care. In addition to considering the question of why PCNPs are being drawn more to rural areas in Oregon than urban counties, these officials should ask “Why do NPs choose to work in non-primary care roles? What incentives might change their minds? Once these underlying reasons are understood, communities can use this knowledge to attract NPs to provide primary care in their communities.”

For more details, visit here, or click the following link to see the full report (PDF file).

VA Asking Retired Federal Health Care Providers to Come Back to Work

VA Asking Retired Federal Health Care Providers to Come Back to Work

The Veterans Health Administration (VHA) is directly contacting retired VA and Federal clinicians to join them in the ongoing effort to combat the coronavirus pandemic.

VA needs experienced patient-care providers during the crisis to help those already providing the best care to our Veterans at VA medical centers, outpatient clinics and community living centers.  

The department is reaching out to retired VA and Federal health care providers through social media, massive postcard mailings, email and word of mouth. VA staff are currently working the phones to ask if former colleagues are interested in coming back for a 120-day assignment, renewable up to one year.

“The nation’s health care system is dealing with an unprecedented crisis,” said Dr. Richard Stone, Executive In Charge, Veterans Health Administration. “Beyond VHA’s primary mission of providing care for our Veterans, we have a fourth mission, which is to be the safety net for our Nation’s health care system. We need everyone to join us in this fight, and recently retired health care professionals can come in and make an immediate impact.”

Stepping Up

After retiring in 2014, former VHA Chief Nursing Officer and Senior Nurse Executive Catherine Rick has answered the call and is awaiting her assignment from VA. “I could work virtually from home or I could travel. I’m healthy and I’m tech-savvy,” said Rick, who lives in the Phoenix area.

Rick said her high regard for VA staff and her experience in hurricane emergency response made her want to step up during the current health crisis. “In my 22 years of experience with VA, I can say I have the highest regard for everything VA does — and can do. There is an extremely talented staff across the VA system, and the work the emergency relief staff does made me think about what they’re going through. I knew their wheels must be spinning in overtime.”

VA is especially looking for nurses and other health care providers, including physicians, pharmacists, laboratory technicians and respiratory therapists, with interest and expertise in:

  • Direct patient care/support (at a VA medical center and/or outpatient clinic)
  • Tele/virtual care
  • Travel Nurse Corps

On March 19, 2020. the U.S. Office of Personnel Management (OPM), approved a VA request to waive a section of Federal law to make it easier for the department to rehire retired VA health care providers. As re-employed annuitants, employees will receive their Civil Service Retirement System (CSRS) or Federal Employee Retirement System (FERS) annuities, as well as a paycheck as a Federal employee, without any offset to their retirement income. OPM instituted the waiver through March 31, 2021.

Expanding VA’s workforce helps the department better fulfill its mission of caring for our Nation’s heroes and supporting the Federal government in our public health mission during a pandemic.

Call to Action

VA needs you! If you would like to join your fellow health care providers in caring for our Veterans and support the national effort to combat the coronavirus, please do the following:

  • Register online if you are a retired nurse or health care provider interested in joining VA as a re-employed annuitant. Or email your availability and resume to vacareers@va.gov.  
  • Visit vacareers.va.gov if you are a registered nurse, nurse practitioner, physician’s assistant or certified registered nurse anesthetist interested in joining the Travel Nurse Corps, providing telehealth, or being assigned to a VA Medical Center.
  • Call retired nurses and other health care providers and share information about VA’s recruitment needs and efforts, including the:

You can also learn more about VA’s response to the coronavirus by visiting VA’s public health site.

Students, Retirees, and School Nurses Pitch In to Fight COVID-19

Students, Retirees, and School Nurses Pitch In to Fight COVID-19

Nursing students, nursing schools, school nurses grounded after school closures, and retired nurses are all joining the fight against the rising pandemic.

Here are just a few examples to be found across the United States:

Jackson, Mississippi

Seniors at Belhaven’s School of Nursing are performing community outreach and educating the public on how to protect themselves and others from the virus. Students are teaching infection-control techniques, discussed sanitation practices with the college’s operations team, and have posted instructions in campus dorms on maintaining safe hygiene. Senior Rebecca Rylander tells Jackson’s WJTV, “There is a desperate need for healthcare workers amidst this pandemic, and I want to help fill that need.”

Long Island, New York

At nursing and medical programs in Long Island, students barred from immediate contact with patients are playing an active role behind the scenes and on the front lines. While medical students at the Renaissance School of Medicine in Stonybrook are conducting online research and serving patients via telehealth sessions, the Barbara H. Hagan School of Nursing and Health Sciences tells Newsday that they have “alumni, graduate students and faculty working in emergency rooms and testing sites, and undergraduates are working or volunteering as nursing assistants.”

Darien, Connecticut

School nurses have volunteered at Darien High School’s COVID-19 testing station. Lisa Grant, a school district nurse at Hindley School, said “We had been asking our director what we can do to help so when Darien signed up for a site, we volunteered.” Yvonne Dempsey, of Ox Ridge School was also ready to help out. Dempsey told the Darien Times, “As nurses, we put ourselves out there any way we can. I figured that’s something I can do in my free time with the schools closed.” She adds, “Testing is the key — testing and isolation as much as possible is the only way to stop the spread.”

Framingham, Massachusetts, Caldwell, New Jersey, and elsewhere

In response to calls from the American Association of Colleges of Nursing, nursing faculty at colleges, universities, and community colleges are rushing to donate supplies of everything from masks to isolation gowns, to hand sanitizer. “This is a time when we all need to come together as a community and work cooperatively to fight this pandemic for the health and safety of everyone,” MassBay Community College President David Podell told the Framingham Source. Jennifer Rhodes, DNP, a faculty member at Caldwell University’s School of Nursing and Public Health, remarked, “As a former emergency room nurse, I cannot imagine what they are experiencing on the front lines right now.”

Chapman, Nebraska

Retired nurses are also answering individual states’ call for help. Nebraska TV spoke to 61-year-old Mary Steiner, a former emergency response nurse, has volunteered for the Central Nebraska Reserve Core. As she waits to put to use her training in natural disaster and emergency preparedness, Mary remarks, “If it’s something that becomes as serious as what’s going on in New York City right now… They’re wanting all hands on deck and so regardless of what my workplace setting has been in the past I know they’re going to be able to use me.”

Cuomo Loosens Reins on NPs, PAs, and More

Cuomo Loosens Reins on NPs, PAs, and More

As New York state climbs the steep face of its COVID-19 curve, Gov. Andrew Cuomo (D) issued an executive order vastly widening the scope of practice for some healthcare providers and absolving physicians of certain risks and responsibilities.

Among the order’s provisions:

  • Eliminating physician supervision of physician assistants (PAs), nurse practitioners (NPs), certified registered nurse anesthetists, and others
  • Enabling foreign medical graduates with at least a year of graduate medical education to care for patients
  • Allowing emergency medical services personnel to operate under the orders of NPs, PAs, and paramedics
  • Allowing medical students to practice without a clinical affiliation agreement, and lifting 80-hour weekly work limits for residents
  • Granting providers immunity from civil liability for injury or death
  • Suspending usual record-keeping requirements
  • Allowing several types of healthcare professionals — including NPs, PAs, nurses, respiratory therapists, and radiology techs — with licenses in other states to practice in New York. However, physicians were not specifically included in the order, as the Department of Health and Human Services has not yet issued the necessary regulation
  • Suspending or revoking hospitals’ operating certificates if they don’t halt elective surgeries

The order, which remains in place through at least April 22, was met mostly with applause, though with some hesitation around work-hour limits.

C. Michael Gibson, MD, of Harvard, called it “stunning in both the breadth and depth of recommendations” on Twitter.

Shariq Shamim, MD, described it as a “great move,” with the exception that trainee work hour limits shouldn’t be scrapped: “They are already working equivalent to 2 [full-time employees] without Chinese-style PPE. More hours = more risk of exposure,” he tweeted.

Art Gianelli, president of Mount Sinai Morningside hospital in New York City, told MedPage Today that his team is “grateful to the governor for throwing the regulations out the window right now. He’s encouraging us and enabling us to do what we have to do to get through this. It’s the right thing to do.”

John Puskas, MD, chair of cardiovascular surgery at Mount Sinai Morningside, agreed that the steps are the right ones given that New York City “hasn’t flattened the curve adequately to avoid a big wave crashing. We’re really going to feel it in the next 2 or 3 weeks.”

“If simultaneously with that, we lost a meaningful number of healthcare providers to home quarantine, then we’d have a shortage not just of ventilators, but of people to run them and care for patients,” Puskas said.

by Kristina Fiore, Director of Enterprise & Investigative Reporting, MedPage Today

Nurse of the Week: Pam Martin Goes Global

Nurse of the Week: Pam Martin Goes Global

This Nurse of the Week is preparing to practice nursing on a global scale. Graduate student Pam Martin has spent 20 years as a nurse in pediatric hospitals across the US, but she’s now on a mission that will take her far beyond her own national borders.

Pam’s stint as a medical volunteer in rural Haiti in 2017 expanded her horizons and inspired her to ply her skills around the world. First, though, she has to work through a crowded agenda. While she works in an adult Emergency Department, Pam is also studying for her Doctor of Nursing Practice degree at Washington State University in Vancouver. At the same time, she’s working toward a Graduate Certificate in Public Health (at the WSU College of Nursing) and a Global Leadership Certificate from the WSU online program.

Pam is focusing on anthropology for her Global Leadership Certificate, and she believes that this, along with the Graduate Certificate in Public Health are essential to her plans: “I want to not only treat the person sitting in front of me, but the population as a whole. In a refugee camp, for example, if you have an outbreak of disease you need to get that under control very quickly; if you have limited resources, how do you do that?”

What will Pam do after receiving her DNP and certificates? According to the WSU Insider, “After graduation she’ll work as a nurse practitioner to gain experience in that role. Then her plan is to do humanitarian work, whether that’s in refugee camps or with groups facing disease outbreaks or displacement from a natural disaster.” As Pam says, “With an education as a doctoral prepared DNP, with certificates in Public Health and Global Leadership, I hope to apply my experience and knowledge to humanitarian work in health care. Learning from those around the world allows us a better understanding of our differences and our shared humanity.”

To learn more about Pam Martin, visit the WSU Insider.

How Gig Nurses Can Stay Safe During COVID-19

How Gig Nurses Can Stay Safe During COVID-19

Demand for healthcare professionals is at an all-time high due to COVID-19, and this includes gig nurses. Unlike other industries that are shuttering or moving to remote interaction, the nursing profession is facing unprecedented demand. Nurses cannot self-quarantine; they are on the front lines providing care to patients in need day in and day out. Now that the world is in the throes of a pandemic, the question, unfortunately, isn’t if nursing professionals will get sick, but when. And when full-time staff numbers begin to dwindle due to sickness, quarantine, and lack of willingness to work, who will step into healthcare facilities and continue to provide much-needed care? 

Gig Nurses Will be More in Demand than Ever

Before COVID-19, the healthcare industry was already facing a staffing crisis– the nursing shortage. The U.S. simply does not have the number of nurses necessary to meet the rising demand for direct care. 

Fortunately, gig brands have emerged to help optimize the nursing workforce. Driven by smart matching technology and data science, gig work allows nurses to achieve a greater work-life balance. For healthcare facilities, it allows them to augment their own full-time staff, helping to reduce staff burnout and turnover. In times like these, where full-time nursing staff will inevitably burn out (or worse, become exposed to the virus), gig nurses will be integral to filling the gaps in care that facilities desperately have. 

It’s worth noting that the gig economy in nursing, for all its merits, also comes with the alarming reality of extra touchpoints of care. Gig nurses that build their own schedule through staffing apps are likely moving from facility to facility, working varied shift times, and interfacing with more patients — which can increase the risk of exposure across multiple settings. If gig economy companies working in healthcare proceed without necessary caution, they have the potential to exacerbate the COVID-19 pandemic. 

Fortunately, with some thoughtful planning and the application of technology, there are plenty of necessary steps gig economy companies can take to help facilities and their workforce avoid spreading COVID-19 in the healthcare staffing setting. 

Educate Yourself and Stay Informed

Oftentimes, per-diem gig nurses don’t have time to walk through all of a facility’s protocols before their shift, so providing nurses with training that can be completed on their device prior to arriving at the facility is key to ensuring that the entire workforce is well-equipped to treat and prevent the spread of COVID-19. Also, as personal protective equipment (PPE) supplies start to run low, nurses should also be kept informed on best practices to mitigate their exposure, even without adequate PPE on hand. It’s essential that any education is continually updated with the latest guidelines from the Centers for Disease Control and Prevention (CDC,) and that nurses are retested when those updates go live. 

Up-Front Symptom Screening

Facilities are concerned about who is coming into their facility, and nurses are concerned about who they are working with. To protect facilities, staff, and patients from unnecessary exposure to COVID-19, gig economy companies can implement an online symptoms questionnaire that workers can complete before shifts to confirm they are not experiencing symptoms consistent with COVID-19. If a nurse confirms they are experiencing COVID-19 symptoms, they can be removed from the shift without penalty. With the much-needed help of technology, gig brands can implement this screening mechanism in an efficient and effective way so that nursing professionals who are healthy can get back to work, and those that are sick can be removed from the network. 

Keep Track of Exposure Updates

Due to the rapid spread of COVID-19, it is safe to assume that facilities and/or staff will face exposure to the virus, which is why gig companies need to be proactive about their protocol. If a worker or facility reports exposure, technology can contact and alert the entire network of exposed facilities so that workers can take necessary precautions and quarantine themselves, if needed. 

At this stage of the COVID-19 epidemic, whether a nurse works full-time at a facility, or works per-diem at multiple facilities, providing direct care in a healthcare setting presents a high-risk for exposure to the virus. The bottom line is that facilities, their staff, and their patients will need gig nurses to pick up the torch as this pandemic rages on, and gig nurses will need their employers to provide them with innovative solutions to ensure that they can keep themselves, and their patients, safe from COVID-19. 

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