- Associated Press - Saturday, April 28, 2018

HAMPTON, Va. (AP) - Earlier this month, Gov. Ralph Northam signed legislation that will allow many nurse practitioners in Virginia to practice without oversight from a doctor.

The Hampton VA Medical Center already has a head start.

Thanks to federal policy changes already in place, more than two dozen nurse practitioners at Hampton are seeking more independence as front-line caregivers. They say it will increase efficiency and reduce patient wait times at Hampton, one of the busier veteran hospitals in the country.

Terry Guyton-Smith is the first nurse practitioner at Hampton to achieve what’s called full practice authority. She spent 21 years in the Air Force, working as a medical technician and then a surgical technician. Now as a nurse practitioner, she can diagnose illnesses, prescribe medications and manage conditions like high blood pressure and diabetes. She also stresses educating patients and family members on how to avoid health problems. She holds a doctorate of nursing practice and focuses on short- and long-term care, as well as hospice care.

But in some cases, a doctor had to approve decisions, such as whether to admit a patient to the hospital. The nurse practitioner still did the exam and made the call, but a doctor had to review the documentation and talk to the patient.

“Now we’re able to do that without having someone sign off on those particular types of things,” she said.

Shelita Nicholson-Gillis, a fellow nurse practitioner who focuses on mental health, who has worked at Hampton since 2007, is about halfway through the authorization process. which takes about 90 days. She holds a Ph.D. in nursing philosophy from Hampton University.

It doesn’t involve additional classes or training - nurse practitioners have at least a master’s degree-level education - but requires them to be monitored and reviewed on procedures and documentation. Nicholson-Gillis called it “very, very exciting” because it allows nurse practitioners can now function to the full range of their abilities.

For example, a doctor has been required to lead small teams of caregivers that oversee a patient’s treatment. They’re called Patient Aligned Care Teams, or PACT. Now a nurse practitioner can lead a PACT, Nicholson-Gillis said.

It allows primary care physicians more time to care for patients, as opposed to signing off on admission forms or leading meetings.

“We know that there’s a big physician shortage,” said Guyton-Smith. “And so what it allows for some of the work to be streamlined.”

The Hampton VA is the first veterans hospital in the VA’s Mid-Atlantic Health Care Network where nurse practitioners have received full practice authority. The move has already taken hold in VA hospitals in Texas and California.

It hasn’t come without hard questions. When the Department of Veterans made the initial move in December 2016, it brought a rebuke from the American Academy of Family Physicians.

AAFP President John Meigs said he understood concerns about long wait times, but “it’s quite clear that in their haste to find a quick and easy solution to a very public problem, the VA has taken a sharp turn in the wrong direction.”

Nicholson-Gillis, who specializes in mental health, said patients can always request to be seen by a physician. And nurse practitioners know when to hand off a case to a doctor.

“We’re going to function appropriately to our level of expertise,” she said. “We’re not going to function outside of our expertise.”

There are 19 nurse practitioners, including Guyton-Smith and Nicholson-Gillis, who are seeking or have already achieved full practice authority. But another 50 are potentially in the pipeline, ready to work more independently as front-line caregivers.

The potential goes beyond reducing hospital wait times, they said.

It will improve rural healthcare outreach, as well. The Hampton VA’s service area covers portions of North Carolina and Virginia’s Eastern Shore.

Meanwhile, nurse practitioners outside of the VA system will soon have the same opportunity. The bill signed by Northam, who is a medical doctor, applies to nurse practitioners with at least five years of full-time clinical experience. It passed the General Assembly with only two negative votes.

___

Information from: Daily Press, http://www.dailypress.com/


Copyright © 2018 The Washington Times, LLC.

The Washington Times Comment Policy

The Washington Times welcomes your comments on Spot.im, our third-party provider. Please read our Comment Policy before commenting.

 

Click to Read More and View Comments

Click to Hide