Join in to make change.
Article Type: Editorial
Subject: Nurse practitioners (Powers and duties)
Nurse practitioners (Practice)
Nursing (Practice)
Obesity in adolescence (Statistics)
Authors: Cella, Ann
King-Jensen, Meredith
Pub Date: 03/22/2011
Publication: Name: Journal of the New York State Nurses Association Publisher: New York State Nurses Association Audience: Academic Format: Magazine/Journal Subject: Health; Health care industry Copyright: COPYRIGHT 2011 New York State Nurses Association ISSN: 0028-7644
Issue: Date: Spring-Winter, 2011 Source Volume: 42 Source Issue: 1-2
Topic: Event Code: 200 Management dynamics; 680 Labor Distribution by Employer
Geographic: Geographic Scope: New York Geographic Code: 1U2NY New York
Legal: Statute: Affordable Care Act
Accession Number: 278760661
Full Text: This issue of the journal of the New York State Nurses Association contains two articles that address the role of the nurse practitioner (NP) and pose solutions to the growing shortage, which is a particular issue in underserved areas of New York State. A third article highlights a current health concern, obesity in adolescent girls, which is also identified specifically in these areas.

Pericak outlines the need for removal of the requirement that NPs practice in collaboration with a licensed physician. NP shortages exist in New York and throughout the United States, and statutory collaboration restricts the areas in which they can practice. In 2010, the President signed into law comprehensive healthcare legislation called the Affordable Care Act, which represents the broadest changes to the American healthcare system since the 1965 development of the Medicare and Medicaid programs. With the enactment of these laws, the United States has the opportunity to transform its healthcare system and provide higher quality, safer, more affordable, and more accessible care than ever before. Realizing the vision of the Affordable Healthcare Act, however, will require a transformation of many aspects of our healthcare system, most notably pertaining to advanced practice registered nurses (APRNs).

There are far more people in need of primary care than there are primary care providers. Limited research suggests that NPs, as well as physician assistants and family physicians, are more likely to care for low-income patients or the underserved. Pericak maintains that NPs need to advocate for their autonomy by educating and convincing legislators to remove this barrier to practice. Unfortunately, fewer than 20% of NPs in New York State are members of their professional organizations, which focus on legislative action and education. In addition, each state independently determines the APRN legal scope of practice and the criteria for entry into advanced practice. This inconsistency has created a significant barrier preventing APRNs from easily moving from state to state and has had the overall effect of decreased access to care for patients.

Muxworthy and Bowllan reviewed the literature on barriers to practice for the psychiatric mental health NP role and found that this specialty faces similar barriers related to statutory collaboration. A rising need for mental health care reveals the impact of demands that exceed available providers, especially for the indigent and uninsured. Not only does statutory collaboration diminish the NP role, it is complicated by the rules of managed care and insurance companies that impose additional practice restrictions that support the collaboration agreement. There is hope, however, since New York State legislators Gottfried and Young have co-sponsored the NP Modernization Act (2011), which, in essence, amends the education law to allow NPs the right to practice without statutory collaboration.

In another article, Groth and Morrison-Beedy explore the obesity epidemic in minority adolescent girls. The negative impact of unhealthy dietary patterns over time has a significant effect in this population. More than 70% of these young women are considered impoverished, leading this group to fall into the underserved category referenced in the two other articles featured here.

The takeaway message of this issue is that N Ps are appropriate providers to attend to and educate about multiple healthy behaviors that are indicated for underserved populations. It is important and necessary to know that, in order to make changes in how and where care is provided, nurses need to be involved. This action begins with belonging to our professional organizations. If you have been putting it off, please take the plunge and join your state nursing organization today.

We hope that the research presented here is interesting and inspiring. Perhaps you are considering submitting a manuscript for publication in journal. The editorial board would be happy to support your effort through constructive feedback and guidance. For information and author guidelines, go to the publications area of


Affordable Care Act, H.R.3962 (2010).

NP Modernization Act, A.5308/S.3289 (2011).

Ann Cella, MA, MEd, RN

Meredith King-Jensen, MSN, MA, RN
Gale Copyright: Copyright 2011 Gale, Cengage Learning. All rights reserved.