Illinois Full Practice Authority for Nurse Practitioners is relatively new.
In fact, it’s about as fresh as popcorn too hot to eat from the microwave. Written into law in the end of 2017, instituted in 2018, with rules that have been written and the process in play since mid 2019, this is the new trend you will see around Illinois and for that matter, more states as the trend continues. Here’s a brief rundown of the process I underwent to obtain full practice authority and why, despite working in a hospital-based system with a surgeon, that I think it was the right decision for me.
It all started with a concept: nurse practitioners provide exceptional, cost-effective care. Some may dispute this or argue against the benefit for their own licensure-sake, but as we look outside our scope to recognize the service provided by nurse practitioners across the country, many in underserved areas undesirable to physicians, there is a consistent trend: the benefit of having a nurse with advanced training to diagnose and prescribe is more beneficial than 1+1=2. In fact, the ability to translate to patient-friendly words and concepts is a key benefit of nurses. As I write this, I recognize there are MANY physicians who do a fantastic job providing translational care, but as a trend, that is NOT their job description or is it ever promoted by healthcare administration. It is diagnose, diagnose, diagnose. It is why the average time spent with a patient before cutting them off is, depending on the source, 10-20 seconds for physicians, and for nurse practitioners, minutes if ever.
We also know with a long trend of full practice states to evaluate, the quality of care is not sub-par, and by some benchmarks, better than the care provided by physician counterparts. Hear me loud and clear when I say that nurse practitioners are NOT trying to be physicians. We recognize the unique process of medical school and residency training and quite honestly, it’s a great process! Were it not the for continuous relationships with physicians and surgeons, my skillset would not be what it is today.
And with a full practice authority license, there is simply NO difference in the process map, just a different set of benchmarks. Myself or anyone else desiring to seek full practice authority in Illinois will still have a 2 year, 4000 hour, 250 continuing education hour requirement before even considering applying, which allows a good residency-style immersion to the world of prescriptive and diagnostic care.
So similar, yet so different.
Where we have seen many states take up arms with this is primarily at the Medical Society level, as it certainly may seem as though NPs are “stepping on the toes” of primary care providers. The issue is made of the hours of practice being so much more for physicians during training and residency (estimated at near 10,000 hours) than with NPs, in the ballpark of 1000 practice hours during a DNP program, plus all the years of nursing experience which is entirely individual to the NP). At the end of the day, we learn in medicine that common things happen commonly. And with the resources to bare of online and standardized clinical medicine updates, it simply does not take 10,000 hours of practice to treat strep throat correctly, or diagnose and treat a UTI. Or acute hypocowbellemia for those suffering from lack of gold plated diapers.
Consultation between other nurse practitioners, physician assistants and physicians is simply part of the expectation for any complex medical need that supersedes the practice comfort of the nurse practitioner. And that is the same as it is for physicians too! Consultation is a daily part of the role of experts as well as newbies in medicine, so why would it be anything less for NP’s?
So why become a full practice authority provider?
Why do you vote? Because it’s a right that was fought for and if you qualify and choose not to, it is a slap in the face of all the progress that has been made to help expand the professional capacity of NPs in Illinois or any state with advanced practice nurse full practice authority, for that matter. I did it because it shows a precedent of interest and the skillset to do this while respecting the process of medicine as a separate and equally valuable resource to patients, but does not mean that my skillset is less. In many cases, I may represent the hands that provide skills to the physicians which they do not possess or have privilege. I get the full story from patients and provide the history and physical or consult note that gets copied and pasted by physicians when they lack the time to get a full story. I make the family aware of the plans for the patient and spend time teaching them in ways I rarely see surgeons do. It does not make me more than, but it does not make me less than either, and I’m proud to be a part of the movement of competent, appropriate nurse practitioners who are willing to stand up and say we will show you what we are capable to do, and our outcomes will not suffer despite the wishes of many who want to say “see, I told you so”.
In the end, you will find a more cost-effective workforce of practitioners who are happy to be the hands and feet of nursing-driven holistic healthcare helping to meet an expanding need for healthcare providers likely to reach an unprecedented shortage with the prolongation of life expectancy, retiring baby boomers, and expanded populations entering Medicare age.
Don’t become a full practice authority nurse practitioner for you alone. Do it for us all as a profession. Do it for the other professions seeking to show the same thing, ahem, physician assistants, ahem…who are absolutely capable of the same thing, but are hindered by their chains to the medical model. We are all trained by fantastic physicians and capable of so much, Why would we vouch the skills of a future generation of healthcare providers as prepared and then say they are not capable? In the end, it becomes very apparent the real goal of blocking appropriate full practice authority is control, and last I checked, I didn’t do this job for ego. I do it for my patients.
Let’s move forward together.
Until next time, keep pressing.
John Russell, DNP, APRN, FNP-BC
CEO and Founder, Skills On Point, LLC