the practitionergmail.com karen holder, mhs, fnp-bc, president i want to give a big shout out to our...
TRANSCRIPT
THE
PRACTITIONER
www.arizonanp.com July 11, 2015 [Edition 5, Volume 2]
The Arizona Nurse Practitioner Council is a
local chapter of the Arizona Nurses
Association, and an affiliate of the American
Association of Nurse Practitioners.
Established in 1992, we advocate for our
membership through legislative and
educational activities. We provide members the
opportunity to network with one another and
promote their services to the public.
Arizona Nurse Practitioner Council Executive Committee
President: Karen Holder Vice President: Bessie Burk
Treasurer: Roni Fox Secretary: Janeen Dahn
Legislative Chair: Denise Link Membership Chair: Amber Porter Public Relations Chair: Katie Wall
The Practitioner Editor: Janeen Dahn
Arizona Nurses Association 1850 E. Southern Ave, Suite 1. Tempe, AZ 85282
480-831-0404 [email protected]
President’s Corner Karen Holder, AZNPC President
Karen Holder, MHS, FNP-BC,
President
I want to give a big shout out to our editor-in-chief,
Dr. Janeen Dahn for her expert work on pulling
together these quarterly publications of The
Practitioner. Many of you are authors and writers
and know the time and effort that goes into these
endeavors as we work to find ways to keep
members informed.
Hopefully most of you are preparing for a weekend
get away to Flagstaff for our Annual Southwest
Nurse Practitioner Symposium July 25 & 26, 2015
at High Country Conference Center. Dr. Bessie
Burk, our conference Chair and VP has worked
tirelessly to respond to your suggestions for a great
conference and you will find a variety of NP
speakers and specialty presentations sure to assist in
the excellence of your healthcare delivery. You can
still register through our AZNPC website.
Many of our colleagues have been stepping up to
the plate to address important current issues that
create barriers to full practice as licensed NPs, and
barriers to patient access. The Independent Nurse
Practitioner Consortium (INPC) has been working
on issues of empanelment and potential restriction
of trade imposed by some ACO and insurance
carriers. Other groups of NPs, PAs and APRNs of
all specialties are collaborating to advance our
ability to admit, follow and discharge patients from
2
in-patient facilities in Arizona. AANP has
successfully worked with the center for Medicare
and Medicaid services (CMS) to clarify language in
CMS rules to allow NPs to admit patients for less
than 20 day admissions, subject to state Scope of
Practice (SOP) and state laws.
Our statewide APRN coalition includes members
from all 4 specialties of Advanced Practice Nurses,
including Clinical Nurse Specialists (CNS),
Certified Nurse Midwives (CNM), Certified Nurse
Anesthetists (CRNA) and Certified Nurse
Practitioners (CNP). The APRN coalition is open to
any and all APRNs and there are no fees for joining.
Meetings and an active APRN coalition list serve
focus on moving Arizona APRNs forward to update
our SOP to fully align with the national Consensus
Model for all 4 specialties. One of our AZNPC
members, Paula Silva, DNP gave a presentation
June 26th in Southern AZ on the Consensus Model
and the proposed Sunrise Bill we are crafting to
present to the legislature next session. At our July
Symposium Dr. Denise Link will give an
informative update on how the Consensus Model
and this Sunrise Bill will impact NPs. Katie Wall,
FNP & Chairperson for Public Relations updates
our website frequently with information about these
and many other timely issues pertinent to your
practice. For more information on these important
topics, visit our website@ www.arizonanp.com.
Our membership Chairperson, Amber Porter, DNPc
has been working closely with AZNA in efforts to
streamline membership applications for AZNPC
chapter 9 members and all Nurses throughout
Arizona. And our treasurer Roni Fox, FNP keeps
our books and finances up to date offering
transparency to members and providing fiscal
accountability for us all.
Each year some of our executive offices for AZNPC
open. This year Treasurer, Membership &
President are open. Consider running for an office
and submit your application before August 1, 2015.
The application process is simple and forms are
available on our website.
Respectfully,
Karen Holder, MHS, FNP-BC, FAANP
!!! Did You Know?!!!
Did you know there are 125,749 licensed with the
State Board of Nursing? 80,955 of those are
Registered Nurses (RN) and 5,283 Nurse
Practitioners (NP), 242 Certified Nurse Midwives
(CNM), 810 Certified Registered Nurse
Anesthetists (CRNA) and 182 Clinical Nurse
Specialists (CNS).
The Board of Nursing receives many inquiries
regarding advisory opinions related to nursing
practice and /or education. An advisory opinion
adopted by the Board is an interpretation by the
Board of what the law requires. While an advisory
opinion is not law, it is more than a
recommendation. In other words, an advisory
opinion is an official opinion of the Arizona Board
of Nursing regarding the practice of nursing as it
relates to a specific standard of care.
In March of 2015, the Board approved an Advisory
Opinion on the Role of the Advanced Practice
Registered Nurse: Treating and Prescribing of
Medications to Self and/or Family. You can find
this document posted on the Board of Nursing
website or by entering the following website in your
browser. https://www.azbn.gov/Documents/advisory_opinion/AO%20Treating%20Self
%20Family%20and%20Others.pdf
Current Events
Check out our website! The Arizona Nurse
Practitioner Council website contains information
on current events, CE opportunities, and other
resources. https://arizonanp.enpnetwork.com Click
on the link and check it out!
3
4
Scope of Practice Questions?
Janeen Dahn PhD, FNP-C, AZNPC Secretary
DISCLAIMER: The opinions offered in this column
are solely that of the author and are in no way
meant to represent those opinions of the Board of
Nursing. All scope of practice questions should be
sent to the Board of Nursing for official comment.
Question: Can I, as a nurse practitioner sign death
certificates?
Answer: Yes, after completing the appropriate
training located on the Arizona Board of Nursing
(AZBN) website located under the “Licensure and
Certification” tab
https://www.azbn.gov/deathcertificates Once you
complete the training you can sign the death
certificates.
After training is completed, in a few days, you will
see the following information show up on your
license verification page.
Question: I am a Family Nurse Practitioner. Can I
do Joint injections?
Answer: Nurse Practice Act Rule 4-19-508
“Standards Related to Registered Nurse
Practitioner Scope of Practice” (C ) states that a
nurse practitioner will practice within the scope of
practice for which the nurse practitioner “is
educationally prepared and for which
competency has been established and
maintained.” Educational preparation means
academic coursework or continuing education
activities that include both theory and
supervised clinical practice. This means that the
NP scope is limited to what the NP program
prepared the nurse to do, though skills can be added
to the scope of practice, the scope cannot be
expanded.
Knowing the population focus for your certification
is important because it helps to define your scope of
practice. Rule 4-19-508 (F) states, in addition to
the scope of practice permitted a registered nurse
practitioner, under A.R.S. §§ 32-1601(19) and 32-
1606(B)(12), may perform the following acts
within the limits of the population focus of
certification: (8) which states that, AP nurses may
perform additional acts that the RNP is qualified
to perform and that are generally recognized as
being within the role and population focus of
certification. “Population focus” is a very
important detail when considering your scope-
please refer to the National Organization of Nurse
Practitioner Faculties (NONPF ) guidelines “by
population focus”.
The Board of Nursing has published on their
website an advisory opinion algorithm, to guide
nurses in deciding what is in their scope of
practice (see the Advisory Opinion entitled
“ADVISORY OPINION SCOPE OF
PRACTICE DECISION TREE” found on the
Arizona Board of Nursing Web site at
https://www.azbn.gov/Documents/advisory_opi
nion/AO Decision Tree 1-13.pdf)
It is important for the AP nurse to realize that
“on the job training” is not sufficient to add a
skill, if that skill was not part of the NP’s program
curriculum. Also, a common misconception is that
5
the procedure in question is allowable, if the NP has
physician “supervision” or “oversight”. In AZ,
advance practice nurses are autonomous, and
therefore, the scope of practice cannot be expanded
through the supervision of a physician or by
following a physician’s order.
Legislative Report Legislative Chairperson: Denise Link, PhD, WHNP-BC
SAVE THE DATE – in
anticipation of the
introduction of a bill in 2016
to amend Arizona Revised Statutes Title 32
(otherwise known as the Nurse Practice Act), the
date and location for Arizona Nurses Association
Lobby Day have been reserved. Lobby Day 2016
will be held on Tuesday, January 19, 2016 the
Supreme Court and Copper Dome Conference
Rooms at the Arizona State Capitol in Phoenix. In
order to insure maximum participation and show of
support from the entire nursing community, this will
be the ONLY Lobby Day sponsored by AzNA.
There will not be a separate APRN Lobby Day. We
are asking all nurses from all roles to reserve this
day and to plan on attending to urge our
representatives to vote in favor of our bill to grant
full practice authority for all APRN nurses in
Arizona. There is a special call out for APRNs
from the voting districts outside of those that
include Maricopa, Pima and Coconino counties.
We usually get a good turnout from the Phoenix,
Flagstaff and Tucson areas and we really need
constituents from all the districts to be on hand to
visit their legislators. We realize that it may mean
traveling a distance, and we are asking nurses to
make a special effort since this is an historic piece
of legislation. Please mark your calendars NOW
and reserve the day. Please watch your email and
the Arizona Nurse e-newsletter for announcements
as plans continue to evolve.
APRN Coalition for the Consensus Model– We
are moving along our timeline for submitting the
Sunrise Report in support of our legislation to
update Title 32 (aka the Nurse Practice Act) to
bring our legislative authority for full practice
authority in line with the National Council of State
Boards of Nursing Consensus Model. Major
funding for this effort that covers the cost of having
an expert advocate at the Capitol and support from
the Arizona Nurses Association staff is derived
from dues paying members. We are ready to begin
the process of assembling letters of support from
physicians, health facility administrators, leaders of
consumer advocacy groups and patients. A sample
letter of support has been drafted for your use to
approach those that you know personally to put
their support for APRN full practice authority in
writing.
Support from the Arizona Nurses Association
and American Association of Nurse
Practitioners- from time to time we are asked why
nurses should be members of their professional
association. The simple answer is that your state
and national nurse practitioner organizations
represent you where policies are being crafted and
debated that affect your patients and your practice
on a daily basis. Not many of us have the time to
call on our elected officials about issues of interest
to nursing so we depend on having well educated
and experienced professionals available to do that
for us. These advocates earn a salary and benefits,
which are paid by dues. The professional advocates
are backed up by a team of paid staff members who
are also highly qualified and knowledgeable about
the legislative and regulatory processes. Some of
them attend meetings on our behalf and others do
the research and produce fact sheets and other
supporting documents to get our message out to
members and the public. Both our state and national
professional organizations maintain an office where
6
the staff work on initiatives to benefit nurses, create
and maintain websites with information of
importance to your profession and an email
messaging system that makes it easy for members to
communicate with their legislators. Policy does not
only happen in the legislature. There are hundreds
of committees and regulatory agencies that impact
on health policy and regulations that have the force
of law. Your state and national organization leaders
and staff represent you in those areas as well.
Belonging to a geographically focused group for the
purpose of attending dinners does not contribute to
the support of these activities that we all benefit
from. All of this representation, staff support,
equipment, facilities and supplies cost money. We
need the financial support of all nurses to share the
price of the benefits that all of us obtain from our
professional organizations. I strongly urge you to be
a contributor to the effort and join your state and
national nursing organization.
Public Relations
Public Relations
Chairperson: Katie Wall,
MSN, FNP-C
You may contact the Public
Relations Chairperson by
emailing: [email protected]
The education on consensus model is in full swing.
Several organizations partnered for an event in
Phoenix in October 2914. The AZNPC partnered
with the SAZAPN/NPS in Southern Arizona in June
2015 to raise awareness to the APN's in that region.
Please attend the symposium in Flagstaff this July if
you missed the events in Phoenix or Southern
AZ. If you are unable to attend the symposium or
missed the prior events, more information can be
found
at https://arizonanp.en
pnetwork.com/page/184
71-consensus-model.
Nurse Practitioner History The Nurse Practitioner role evolved in response to a
nationwide shortage of healthcare services in the
mid-1960’s. The first Nurse Practitioner program
was developed as a Master’s degree curriculum,
based on the nursing model, at the University of
Colorado’s School of Nursing. This pioneer
program was co-founded jointly by Loretta Ford,
RN, a nursing faculty member and Henry Silver,
MD, a pediatrician. The first program specialty was
in pediatrics. Other healthcare specialties were
added shortly after as programs developed across
the country to provide primary healthcare services
to large underserved populations.
In 1971, the Secretary of Health, Education, and
Welfare issued recommendations that supported
these nurses' roles as PCPs. Federal monies were
then allocated to increase Nurse Practitioner
programs nationally. By the mid-1970’s, there
existed more than 500 certificate programs that
prepared nurses to provide primary care. During the
late 1970’s and 1980’s, programs shifted from
certificate to Masters degree preparation as
certifying bodies required a Masters Degrees. In
2000, Nurse Practitioners were legally able to
practice in every state. Currently, there is another
shift that will require Nurse Practitioners to obtain a
Doctor of Nursing Practice. All Nurse Practitioner
who will be graduating after 2015 will be required
to obtain a Doctor in Nursing Practice as Masters
degree programs are being phased out.
Currently, there are more than 5300 nurse
practitioners in Arizona.
Southwestern Regional NP
Symposium Conference is just around the corner. I would like
to thank all those that helped put together this great
conference this year and there is still time for you to
7
get registered for the 27th Annual Southwestern
Regional Nurse Practitioner Symposium. There are
so many amazing educational opportunities. But we
are opening this year with one of Arizona’s one
great nationally known speakers, Dr. Alan Agins.
He will be updating us on the mechanisms and
potential clinical outcomes of drug interactions.
This is a must hear as
anyone who has ever
heard him speak can tell
you. I will just mention a
few more of the exciting
presentations being
covered – we have a
couple on technology;
diabetes, anemia, ADHD,
coding and billing and the
list goes on. And new this year are presentations by
DNP students, what a great opportunity to hear new
research and translational research. Then of course
are the three workshops on Sunday, it will be hard
to select from these three great selections. In
addition to the wonderful education is the
opportunity to network with new colleagues and
those you have known for years. And all in the
COOL mountains of Flagstaff. So head on over to
www.aznurse.org/NP to get registered so you don’t
miss out on this opportunity on July 25-26, 2015
conference.
Membership Report
Membership Chairperson: Amber Porter, FNP-C
You may contact the Membership Chairperson by
emailing: [email protected]
Happy Warm and Toasty Arizona day!
Thank you all for your continued support of Chapter
9 and Arizona Nurse Practitioners! We have some
updates regarding membership. AZNA met with
key leadership to discuss updates in membership.
As many of you know, there has been some
confusion on how to join Chapter 9 and how many
secondary memberships you can hold. These
changes are encouraging for those of us that have
multiple special interests! Please note the changes
below:
We are currently utilizing a new system to assist
with membership: Personify
Two click membership
New process – Home chapter based on
address
o Prior you were given choice as to what
chapter you joined
o Now everyone is automatically assigned a
geographic chapter based on zip code
o In addition, each member ALSO CAN
choose special interest groups (SIGs) at
no added cost
o There will no longer be a limit to how
many special interest chapters you can
belong to.
o There will no longer be additional charge
for you to participate in more than one
chapter.
o Total dues paid to AZNA will be
proportionately to chapters. Prior this was
a set amount and in part was the rationale
behind the additional cost of $15. This is
no longer the case.
Again, thank you for your support of AZNPC and
most importantly for supporting each other in what
we do every day!
8
9
AZNPC 2015 Election – Call for Nominations
Arizona Nurse Practitioner Council (AzNPC) Executive Committee 2015
DEADLINE: August 1, 2015
VACANT POSITIONS:
1. The President shall be the Chair of the Executive Board and ex-officio member of all committees. The
President shall appoint individuals to do special projects to further the work of the Arizona Nurse
Practitioner Council, appoint ad hoc committees, and serve as a representative of the organization. The
President shall serve as a designated signer with the Treasurer on all AZNPC accounts.
2. The Treasurer shall oversee the preparation of the annual budget; oversee the implementation of the annual
budget; and ensure the annual independent review audit is conducted; maintain affiliation status with
national organizations as agreed upon by the executive committee. The Treasurer shall serve as Executor of
Finances and designated signer on AZNPC accounts. The Treasurer will provide a financial report to the
Executive Board biannually and as deemed necessary by the Board.
3. The Membership Chairperson is responsible for membership recruitment and retention, maintaining a list
of active and updated members in coordination with AzNA; maintain an updated list of executive board
members with pertinent contact information; calling for scholarship applicants and coordinating the
scholarship approval process.
CANDIDATE QUALIFICATIONS: The Nominating Committee will consider candidates' experiences and
skills relative to AzNPC leadership model and advancing the goals of the organization. Candidates must
demonstrate a commitment and willingness to serve on a volunteer working Board and accept assignments
related to the work of the organization. The AzNPC leadership model includes an executive Board composed
of 7 volunteer officers, President, Vice President, Secretary, Treasurer, Legislative Chair, Membership Chair,
and Public Relations char. No officer shall serve more than two (2) consecutive terms in the same office or
more than eight (8) consecutive years on the Executive Board. An officer who has served more than half a term
shall be considered to have served a full term.
The PURPOSE of AzNPC is to advance the practice and the professional status of Nurse Practitioners
throughout the State of Arizona by means of legislation, education, networking and community involvement.
Executive Board Members are expected to attend monthly telephonic executive meetings, quarterly telephonic
Chapter Membership meetings and the annual Southwestern NP Symposium in person.
If you are interested in assuming a greater leadership role in the future of Arizona Nurse Practitioners by
running for one of the four vacant positions, please complete the attached Biographical Sketch/consent to
Serve form that includes your educational and professional background, existing relationship with AzNPC, and
goals for your tenure in the position you are running for. Send the completed form to the AzNPC Secretary at
[email protected] no later than August 1, 2015. Each nominee will be reviewed by the Arizona
Nurse Practitioner Executive Council and vetted for final slate of nominees. Candidates must be approved by
the Council in order for a nominee to be included on the ballot (Art V. Sec 1). August Elections will be
managed by the AzNA and held open for 30 days. Nominees will be notified of their status in a timely manner.
Elected officers will be asked to assume their offices November 1, 2015.
10
1850 E. Southern Avenue, Suite 1. Tempe, AZ 85282 480-831-0404 [email protected] http://www.arizonanp.com
BIOGRAPHICAL SKETCH/CONSENT TO SERVE
I wish to have my name placed on the 2014-2016 ballot for the office of: CIRCLE ONE
President Treasurer Membership Chairperson
Name:
Credentials:
Address:
Phone:
City, State:
Zip
Employer Name:
Position:
Email:
Past Experience/Activities with Professional Nursing Organizations:
In 100 words or less, briefly and concisely state relevant experience (in 1st person) and if elected, how you would
contribute to this position:
Signature: Date:
________________________________________________ ___________________