Attached Files:
AAFP repond to VA APRN practice role.pdf (79.738 KB) —-attached below
This is the AAFP general position on nurse practitioner: https://www.aafp.org/about/policies/all/nurse-practitioners.html. Please read the attached file and the AAFP general position on NP practice. Write a one page response to the AAFP’s general position statement and AAFP view on VA ARNP practice proposal. Write the way as if you are writing back to the author at AAFP about your view on this issue. Submit your letter here.
July 22, 2016
David J. Shulkin, MD
Under Secretary for Health
Department of Veterans Affairs
810 Vermont Ave. NW, Room 1068
Washington, DC 20420
Re: RIN 2900–AP44-Advanced Practice Registered Nurses; Proposed Rule (May 25, 2016)
The undersigned physician organizations representing national specialty and state medical societies are
writing to provide comments on the Veterans Health Administration’s (VHA) Advanced Practice
Registered Nurses (APRNs) Proposed Rule which, if finalized, would permit all VHA-employed APRNs to
practice without the clinical supervision of physicians and without regard to state law.
Nurses are an integral part of physician-led health care teams that deliver high quality care to patients.
They are often the first and last person to interact with a patient during an episode of care, and, in the case
of APRNs, they are well equipped to play advanced roles in the health care team. However, APRNs are no
substitute for physicians in diagnosing complex medical conditions, developing treatment plans that take
into account patients’ wishes and limited health care resources, and ensuring that the treatment plan is
followed by all members of the health care team. Nowhere is this more important than in the VHA, which
delivers highly complex medical care to disabled veterans, including those with traumatic brain injuries and
other serious medical and mental health issues. Our nation’s veterans deserve high quality health care that
is overseen by physicians. For the reasons below, the undersigned organizations strongly oppose the
Proposed Rule and urge the VHA to consider policy alternatives that prioritize team-based care
rather than independent nursing practice.
Education and Training Matter
The key difference between medical and nursing education and training is the fact that medical students
spend four years focusing on the entire human body and all of its systems—organ, endocrine, biomedical,
and more—before undertaking three to seven years of residency training to further develop and refine their
ability to safely evaluate, diagnose, treat, and manage a patient’s full range of medical conditions and
needs. And, by gradually allowing residents to practice those skills with greater independence, residency
training prepares physicians for the independent practice of medicine. Combined, medical school and
residency training total more than 10,000 hours of clinical education and training.
In contrast, a nurse generally must complete either a two- or three-year masters or doctoral degree program
to become an APRN. While all baccalaureate nursing programs require a minimum 800 hours of patient
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