Through the course of completing this historical retrospective of the California Association for Nurse Practitioners, we spoke with the pioneering NPs who founded and developed the organization. To conclude, it’s fitting to both reflect and look ahead. So, we asked early members to share their insights on the future of the practice, with their wisdom and past experience in mind. Here are their thought-provoking responses:
I am not convinced that the over specialization of NP Practice is the best direction for the betterment of healthcare and quality care results for the public. Years ago I went from an internal medicine practice to a respiratory sub-specialty practice. I found that the quality of care improved because I was a family nurse practitioner – a generalist. I provided “added value” to the overall health and assessment of the patients and the practice. I also saw patients in the SNF who were primary patients of the Pulmonary Practice. This was years before NPs practiced in nursing homes. I feel this direction of overspecialization does not serve the quality of care for patients at large. When our base is primary care – with, if you will, OJT in the specialty areas – this is a commanding contribution. It broadens what patients receive with the interaction and episode of care.
In considering the future of NPs, I believe that we will continue to solve the global problem of providing comprehensive healthcare to patients around the world, hand in hand with physicians and other care givers. NPs will help create, innovate and recommend technologies that will improve the quality of healthcare, by reducing clinical errors and expediting the assessment of the big data that is created in healthcare. There are challenges, too: We will never have enough clinical providers to meet the needs of our growing population, so we must identify technologies that will help us provide care.
I remember being very idealistic at how we could work together as colleagues and take care of families across the lifespan and improve the quality of care. However, I had two small children when I began this quest: eight months and three years old. I just hoped I could survive while other major crises occurred in my life. As I look back, I think I succeeded. I have been in a private practice for 41 years and have watched those families grow. My long-time colleague is still working and we added a partner 20 years ago. Our practice includes all socioeconomic groups and diverse nationalities. It is truly a family practice and our staff has been very stable. Since I also taught at UC Davis in the FNP/PA program for over 22 years, I feel I have achieved the goal and mission of the UCD program, working with diverse populations in underserved communities, in urban and agricultural areas of California.
Looking into the future, NPs will expand their clinical responsibilities resulting in full practice authority. Full practice authority will allow NPs to continue to provide high quality care, lower health care costs, and increase accessibility to primary care. Many states have full practice authority. For more than 40 years, Californian NPs have repeatedly tried to pass legislation leading to full practice authority. Several medical organizations have lobbied against full practice authority fearing too much competition. I foresee that we will reach our goal for full practice authority in the next 50 years, allowing NPs to practice to their full potential without barriers.
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