About Dr. Katherine Abraham Evans: Dr. Evans is a family and geriatric nurse practitioner certified in hospice and palliative care. She received her BSN at the University of Memphis, MSN from Emory University and DNP from Vanderbilt University. Her primary area of practice is long-term care and she has also served as the DNP Program Director at Georgia State University. She is currently Associate Director of Clinical Business Support for United Healthcare Retiree Solutions.
Dr. Evans is the current national president of the Gerontological Advanced Practice Nurses Association (GAPNA). She has held a variety of roles in GAPNA including Georgia Chapter President and conference planning chair, as well as national nominating committee chair. She also serves on the board of directors for the Georgia POLST Collaborative and is a Fellow of the American Association of Nurse Practitioners.
[OnlineFNPPrograms.com] What legislation at the state and national levels controls APRNs’ scope of practice?
[Dr. Evans] Federal policies from the Centers for Medicare and Medicaid Services impact APRN practice and national organizations are consistently looking to modify legislation to improve patient access to care. Many practice restrictions are at the state level and critical to scope of practice. The Veterans Administration recently set a new precedent by allowing APRNs employed by the VA full practice authority. This was a significant step forward in removing practice barriers and increasing access to care.
[OnlineFNPPrograms.com] How do a state’s APRN scope of practice regulations impact APRNs’ daily work with patients, and do the regulations apply differently to APRNs of different specializations? For example, how do the same APRN scope of practice regulations impact AGACNPs versus AGPCNPs, in terms of their ability to treat patients, prescribe medications, etc.?
[Dr. Evans] State legislation and policy that affect scope of practice varies widely. Currently 22 states and Washington, DC grant APRNs full practice authority. APRNs should carefully review their state policies in order to remain in compliance. When advocating for legislative change it is critical to showcase examples of how these restrictions prevented patients from receiving needed care. For example, in my practice the inability to order CT and MRI scans leads to unnecessary delays in patient care. Cataloguing these examples and presenting them as a cohort provides a powerful message for legislative change. Encourage your patients to call their legislators as well to voice their support of APRN practice.
[OnlineFNPPrograms.com] What are the main barriers preventing APRNs from obtaining full practice authority in certain states, and how can nursing students and APRNs collaborate to overcome these barriers?
[Dr. Evans] There are many barriers to obtaining full practice authority, which are often dependent upon each individual state. The overarching goal is to ensure patients access to quality care. APRNs should focus their legislative efforts on defining how full practice authority will improve healthcare in their state by increasing the number of available providers. When advocating for legislation, it is critical to keep the patient at the forefront of the conversation. To become involved in advocacy, APRNs should look to their state and local APRN organizations, AANP Health Policy conferences, and the GAPNA Health Policy committee.
I started policy advocacy before becoming a nurse by working on local and national campaigns. That experience gave me intimate knowledge of the importance of developing relationships with your local and national representatives and having your voice heard. I have since maintained relationships with my representatives and regularly contact them regarding legislative efforts. I have also invited these legislators to speak at GAPNA events to further strengthen our relationships and allow time for our nurses to hear the current legislative landscape directly. Nurses are the largest group of healthcare providers and carry a strong voice when we develop relationships and speak as a united front.
[OnlineFNPPrograms.com] How does joining nursing associations such as GAPNA as well as local nursing associations empower graduate nursing students and advance practice registered nurses to impact APRNs’ scope of practice, both in their state and nationwide?
[Dr. Evans] GAPNA has policy priorities located on our website identifying those areas of advocacy for APRNs caring for older adults. These priorities include supporting our members through networking opportunities, conferences, continuing education, resources on care best practices for elderly patients, and advocacy for the gerontological APRN’s ability to practice to the full extent of his or her training and qualifications. GAPNA has constant vigilance for issues that affect those nurse practitioners caring for older adults. The Health Policy committee is active in keeping policy statements up to date, supporting legislative efforts and informing members of critical policy changes. GAPNA encourages members to maintain relationships with their legislators and discuss any legislation that affects APRN practice. APRNs can also serve as local experts to legislators in need of healthcare and nursing information. GAPNA also sponsors members through a scholarship process to attend the AANP Health Policy conference and engage deeply into the policy making process.
[OnlineFNPPrograms.com] What are the benefits of GAPNA membership, both for the overall state of the APRN profession as well as on an individual level? How does GAPNA benefit nursing students?
[Dr. Evans] GAPNA membership and benefits are not just subscriptions to a journal and other discounts. The primary benefit of joining a professional organization is personal and professional growth. These organizations are critical to advocating to ensure nurse practitioners are best able to meet the needs of our patients.
GAPNA welcomes all new members and provides leadership, networking and mentorship opportunities at the local and national level. One of our primary strategic priorities is to delight our members with dynamic, relevant conferences, committees, special interest groups, and evidence based resources.
Thank you, Dr. Evans, for your insight into APRN scope of practice regulations and their impact on patient care!