Finally, the Department of Veteran Affairs has granted veterans direct access to advanced practice registered nurses.  It used to be that nurse practitioners were under the direction of a physician.  However, now in the entire VA system, nurse practitioners can practice independently.  This will give veterans increased access to care and decrease the long wait times that they have been experiencing.

There are over 200,000 nurse practitioners in the country; 5,000 who work in the VA system.  21 States allow nurse practitioners to practice independently.

With the VA allowing nurse practitioners full practice authority, it may help lead the way for other States to allow nurse practitioners to have full practice authority.

CRNAs were not included in this rule but I hope that could be changed in the near future.  The standardization of advanced practice registered nurses full practice authority will help ensure a consistent delivery of health care across the Veteran’s health system.  Therefore, regardless if the State limits the practice of advanced practice nurses, there will be standardization across the VA system, allowing full practice authority and enable veterans increased access to care.

The VA chose not to grant CRNAs full practice authority because access to anesthesiologists is not an issue in that system.

Whenever a rule is promulgated, the public is allowed to comment.  The VA received 223,296 comments on the proposed rule with 104,256 of them against granting full practice authority VA CRNAs.  There were 45,915 comments in support of full practice authority for nurse practitioners without specific mention of CRNAs.  Only 9,613 comments were in support of full practice authority for CRNAs.

However, the VA is not permitted to base its final rule on the number of comments in support of the rule over those in opposition.  In order for a rule to be promulgated, the agency must base their decision on the comments received, scientific data, expert opinions and facts accumulated during the pre-rule and proposed rule stages.

The VA considered 3 APRN rules.  Certified nurse practitioners, clinical nurse specialists or certified nurse midwives.

I am attaching the link of the summary of the final rules.

https://s3.amazonaws.com/public-inspection.federalregister.gov/2016-29950.pdf

How do you feel about nurse practitioners having full practice authority?  What can we do to get the other 29 States to follow the VA’s lead for full practice authority?

I would love to hear your comments below.