Abstract This paper explores the contemporary role of the nurse practitioner in the care of U.S. veterans within the Veterans Health Administration (VHA) system. The VHA is is one of the largest employers of advanced practice providers (APPs) in the United States. Currently some role confusion exists between nurse practitioners (NPs), physician assistants (PAs) and physicians within the system. In addition to role confusion, NPs are practicing at various levels across the country demonstrating a lack of standardization of care within the VHA. Additionally, not all practitioners are currently practicing to the full scope of their training and are often unfamiliar with the scope/role of their colleagues. The data suggests that all three …show more content…
About the time of WWI, Congress began the work to create a system that would provide U.S. veterans with programs for disability compensation, insurance for veterans and service personnel, and vocational rehabilitation for the disabled (The Department of Veterans Affairs, 2015a). At the time the goals were established, the programs were managed by three fractured agencies: The Veterans Bureau, the Bureaus of Pensions of the Interior Department and the National Home for the Disabled Volunteer Soldiers. The first of two agency consolidations took place in 1921 creating the Veterans Bureau (VB) (The Department of Veterans Affairs, 2015a). The new organization combined all WWI services with the Public Health Service Hospitals. In 1930, the recently formed Veterans Bureau would be elevated to federal agency status and the VA is born. The purpose of the agency at this time was to “consolidate and coordinate government activities affecting war veterans” (The Department of Veterans Affairs, 2015b). Included in the first consolidation was the transfer of the 1,400 nurses working within the Public Health Service Hospitals to the Veterans Administration. With the addition, the VA Nursing Service now employed 2,500 registered nurses (The Department of Veterans Affairs, 2015b). The VA Nursing Service followed a similar trajectory of expansion and evolution as the agency itself did. The role of the nurse within the VA system has included calls to combat, serving as military
The Physician Assistant (PA) and Nurse Practitioner (NP) career fields were the medical fields’ response to the physician shortage that began in the 1960s, but the shortage still exists today. As the population continues to grow, the gap continues to grow as well. Medical schools were having a hard time producing as many doctors that were needed to fill in the gaps in a timely manner, leaving the medical field looking for ways they could have health care providers diagnose and treat patients, but educated in half the time of a doctor. The PA program was then born out of the military. Medical doctors watched as military doctors and medics came back, but they had no formal training except for on-the-job training. The NP program was derived from previous midwifery program. Currently, as the physician shortage is still impending more and more PAs and NPs are being hired to fill in the gaps. This is causing many questions to arise: Are they qualified?, What kind of education do they have?, and Should I feel safe?. Patients want to know that they are getting excellent care, and that their medical providers are qualified to diagnose and treat patients accurately.
The United States Department of Veterans Affairs (VA) was founded in 1930, and today, “operates one of the largest health care delivery systems in the nation, with 168 medical centers and more than 1,000 outpatient facilities organized into regional networks” (GAO, 2017). The VA employs nearly 350,000 people at its facilities and serves approximately 9 million veterans each year (VA, 2017).
to the Veterans who have served our country. As the organization moves forward they envision
In the past few years there has been increasing discussion about how to provide adequate care for the increasing number of veterasn who are eligible for care through the Veterans’ healthcare administration (VHA). There are concerns is that the VHA is not providing the level of access, efficiency, and quality of care that veterans expect. Lee & Begley, (2016) suggest access to care for the veteran population may be resulting in poor health outcomes. In response to these concerns, the Veterans ' Access to Care through Choice, Accountability, and Transparency Act (VACAA) of 2014, also known as the Veterans Choice Act, was created to improve Veterans’ healthcare. The VACAA proposed to do this by expanding the number of options veterans have for receiving healthcare, by providing access for healthcare at non-VA care centers as well as providing for an increase in staffing at VA facilities (U. S. Department of Veterans Affairs, 2016).
One of the most serious problems facing all veterans today is the lack of proper healthcare. Soldiers, sailors and airmen are leaving active duty without having proper healthcare to cover their physical or mental injuries. The department responsible for veteran’s healthcare is the Department of Veterans Affairs. (VA) According to The department of Veterans Affairs website, “The United States Department of Veterans Affairs (VA) is a government-run military veteran benefit system with Cabinet-level status. It is responsible for administering programs of veterans’ benefits for veterans, their families, and survivors. The benefits provided include disability compensation, pension, education, home loans, life insurance, vocational rehabilitation, survivors’ benefits, medical benefits and burial benefits. It is administered by the United States Secretary of Veterans Affairs.” The VA, who was formerly called the Veterans Administration, was established 21 July 1930, to consolidate and coordinate government activities affecting war veterans. The VA encompassed the functions of the former U.S. Veterans ' Bureau, the Bureau of Pensions of the Interior Department and the National Home for Disabled Volunteer Soldiers. On 25 October 1988, President Ronald Reagan signed legislation creating a new federal Cabinet-level Department of Veterans Affairs to replace the Veterans Administration effective 15 March 1989 (V.A.)
The role of nurse practitioner is valuable when discussing collaborative care. There are so many levels of care, so many health entities, and so many insurer criteria involved that it is instrumental to have a role that can work towards help bring all aspects together. In addition to diagnosing, treating, and managing care, the role of the nurse practitioner is to manage simple and episodic acute health issues along with chronic disease (Sangster-Gormley, Martin-Misener, & Burge, 2013). It is important to note that although this is a function of this role, nurse practitioners also practice from a holistic point of view which allows them to help manage patient conditions or wellness in a more complete fashion. This includes helping patients have access to care beyond primary and secondary care settings. This encourages nurse practitioners to work alongside other health care and allied health professions, and families to create an individualized plan for every patient (van
The Veterans Health Administration is home to the United States’ largest integrated health care system consisting of 150 medical centers, nearly 1,400 community-based outpatient clinics, community living centers, Vet Centers and Domiciliary. Together these health care facilities and the more than 53,000 independent licensed health care practitioners who work within them provide comprehensive care to more than 8.3 million Veterans each year. VHA Medical Centers provide a wide range of services including traditional hospital-based services such as surgery, critical care, mental health, orthopedics, pharmacy, radiology and physical therapy. In addition, most of the medical centers offer additional medical and surgical specialty services including audiology & speech pathology, dermatology, dental, geriatrics, neurology, oncology, podiatry, prosthetics, urology, and vision
In order to practice as a Nurse Practitioner (NP) in Indiana you must hold a state registered nursing license complete a master 's program with certain course requirements. According to NursingLicensure.com (n.d.) there are two educational options leading to Advanced Practice Nurse (APN) recognition in Indiana: obtain a master 's degree or higher in nursing, or obtain a bachelor 's degree in nursing plus national certification. There is not a specific application to become a NP unless you are also pursuing prescriptive authority. Most laws in Indiana focus on regulating practice of nurse practitioners center around prescribing.
Budzi, Lurie, Singh, and Hooker (2010) state, “Nurse Practitioners’ (NP) interpersonal skills in patient teaching, counseling, and patient centered care contribute to positive health outcomes and patient satisfaction.” According to their research they encourage healthcare systems in the U.S. to hire more NPs to allow for better access affordable, and quality care (Denisco & Barker, 2016). With the demand for primary care providers, The NP role aids in delivering a solution to some of the healthcare issues that exist today. Organizations like the Institute of Medicine (IOM) and Centers for Medicare and Medicaid (CMS) all agree to allow nurses to practice to their full abilities to make healthcare more accessible and affordable, especially for the aging baby boomers and less accessible rural neighborhoods, and densely populated urban areas. Research has proven that NPs that provide primary care have similar health outcomes to primary care physicians (DeNisco et. al., 2016). NPs particularly take pride in their holistic approach, forming therapeutic relationships between other providers of the healthcare team, patients, and their families, aiding the informed decision making process, use of the evidence based practice approach in health management (Brown, 2005). Some of the other actions or qualities that
While the demand of healthcare need increasers the United States facing a physician shortage. In recent years the number of nurse practitioners (NPs) and physician assistants (PAs) has significantly increased and they are taking the part in providing healthcare cervices to the majority of patients. I believe nurse practitioners and physician assistants can practice independently from doctors and be free of oversight. Expanding the scope of NPs and PAs is essential to overcome the healthcare crisis we are facing; it will increase patient satisfaction and stabilizing the healthcare economy.
One of the most serious problems facing all veterans today is the lack of proper healthcare. Soldiers, sailors and airmen are leaving active duty without having proper healthcare to cover their physical or mental injuries. The department responsible for veteran’s healthcare is the Department of Veterans Affairs. (VA) According to The department of Veterans Affairs website, “The United States Department of Veterans Affairs (VA) is a government-run military veteran benefit system with Cabinet-level status. It is responsible for administering programs of veterans’ benefits for veterans, their families, and survivors. The benefits provided include disability compensation, pension, education, home loans, life insurance, vocational
Fry, M. (2011). Literature review of the impact of nurse practitioners in critical care services. Nursing In Critical Care, 16(2), 58-66. http://dx.doi.org/10.1111/j.1478-5153.2010.00437.x
Since the inception of the Nurse Practitioner (NP) role in the 1960s, NPs have thrived in the delivery of primary healthcare and nurse case management. Despite patient satisfaction with NPs ' style of care, nurses have been critical of NPs, while physicians have been threatened by NP encroachment on MD practice. Balancing assessment, diagnosis, and treatment with caring defines NPs ' success as primary care providers. Understand the role and Scope of Practice of NPs is sometimes difficult for some to understand. The purpose of this paper is to define the role and history of NP, compare and contrast licensure versus certifications, understand NP Scope Of Practice and Standards of Care, discuss how the State Practice Acts regulate FNP practice, discuss credentialing and privileging, and differentiate between legislative and regulatory processes.
It is clear that Family Nursing Practitioner Program is increasingly becoming valuable for nurses competing for the best job positions. Pursuing a FNP program can open many doors to students in the field of nursing as well as nursing administrators. Additionally it can result into higher salaries throughout the entire career of an individual.
The role that nurse practitioner (NP) plays within the increasing complex health care system is a constant changing role with the Consensus Model and the introduction of the Affordable Care Act in 2010. The scope of the nurse practitioner (NP) includes the care of the young, the old, the sick and the well. The educational needs of a nurse practitioner vary greatly from that of a Registered Nurse (RN), in the amount of education as well as the focus of the education. NPs provide coordinated primary care with the use of comprehensive health histories and physical examinations, diagnosing and treating acute and chronic illnesses, the management of medications and therapies, ordering and interpreting tests results, and educating and