VA grants Full Practice Authority to APRNs; Nurse Anesthetists Left Out

In a controversial debate that garnered more than 200,000 online comments, the Department of Veteran Affairs last week announced that it has decided to grant full practice authority to advanced practice registered nurses. The move, the VA hopes, will bolster access to care for veterans in hospitals that may be short on physician manpower. “Amending this regulation increases our capacity to provide timely, efficient, effective and safe primary care; aids the VA in making the most efficient use of APRN staff capabilities; and provides a degree of much-needed experience to alleviate the current access challenges that are affecting VA,” David Shulkin, M.D., undersecretary for health, said in a press release.

As we’ve explored in previous Nurse Watch blogs, doctors and nurses have been deeply divided over this issue. The American Society of Anesthesiologists, for one, went as far as calling the proposal “dangerous” for patients. The VA listened and has decided to leave registered nurse anesthetists out of the proposal. However, the professional association representing that workforce has vowed to continue fighting that omission.  

Nurses Still the Most Trusted Profession

For the 15th year in a row, nurses again were ranked as the profession most trusted by Americans, a new Gallup poll found. Health care is well represented on the list, with pharmacists and medical doctors rounding out the top three. Insurance salesmen, car dealers and members of Congress, meanwhile, rounded out the bottom of the list. The data were gathered through phone interviews with more than 1,000 Americans in all 50 states.

Harnessing Telemedicine to Staff School Nurse Offices

Nemours Children’s Hospital, Orlando, Fla., launched its on-demand pediatric telemedicine program a year ago, and now it’s piloting the service at Morning Star Catholic School, a special needs school in Orlando, the Orlando Sentinel reports. The program uses a “station” to virtually connect a pediatrician to school nurses — allowing a Nemours physician to see everything the nurse does via video. The service also allows the parent to remotely become part of the nurse visit as well. “Kids with special needs have ways that only parents can tell if it’s a serious situation,” Terri Schon, who has a son at Morning Star, said to the Sentinel. “Obviously, as a mom I want to be as close as I can if he’s not feeling good.” Many schools in the area face nursing shortages, but until the program gets going, it’s too early to tell how this telemedicine program will shape that problem.

Of EHRs, Alarms and Lifting Devices

A new report explains the current state of affairs regarding three major technological challenges to nurses’ work, though the technologies are supposed to make their lives easier: electronic health record systems, clinical alarms and lifting devices. The report, from Robert Wood Johnson Foundation, carries a headline that sums it up nicely, “Boon or Bane? Making Sure Technologies Improve (Not Impede) Nursing Care.” In addition to identifying problems with those three health care solutions, the RWJF report — part of its ongoing “Charting Nursing’s Future” series — highlights some examples of hospitals or health systems finding solutions to the problems the technologies present. Included are examples from Johns Hopkins Medicine, Mayo Clinic and Cleveland Clinic.

10 Things This ED Nurse Wishes She Knew Before Getting Hired 

Tens of thousands of RN graduates enter the nursing field each year, but there are some experiences their educations just won’t prepare them for. In an article for, Emergency Nurses Association President Kathleen E. Carlson points out some of the unanticipated issues she’s faced as an emergency department nurse. For example, dealing with death and all its gravity is no easy thing; being the target of patients’ wrath is a common experience; and getting a job in the ED isn’t always an easy path. For more of Carlson’s insights, read the full list.

Quick Hits

Here are a few more nurse-related items that caught our eye over the past week, in rapid fashion:

  • Diagnosed with leukemia at age 13, a pediatric oncology nurse at Cardon Children’s Medical Center reflects on why he chose to work alongside the nurses who once treated him.
  • The American Organization of Nurse Executives Foundation is on the hunt for a new executive director.
  • A simulation program at Johns Hopkins School of Nursing is teaching future RNs how to spot addicts early on, WBAL-TV reports.
  • And finally, The Tennessean tells a heartbreaking story of a retired nurse who couldn’t save her daughter from the grips of opioid addiction.