Op-Ed: Beyond Barriers: Why Nursing Scope Of Practice Reform Is Needed In Wisconsin

"We should work to keep and empower APNs in our state to practice to their fullest extent, and support access to quality care for all Wisconsinites from the provider of their choosing."

Op-Ed: Beyond Barriers: Why Nursing Scope Of Practice Reform Is Needed In Wisconsin

When it comes to health care, Wisconsinites deserve a personalized approach that delivers more choice, control, affordability, and quality from the medical professionals we trust. The Advanced Practice Registered Nurse Bill (SB 145/AB 154) marks a giant step in the right direction. This legislation will eliminate the requirement for Advance Practice Nurses (APNs) to have mandated contracts with physicians, allowing them to provide care to the fullest extent of their education and training, and perform what they have been taught and nationally certified to do. No more. No less. The time is now for this type of healthcare reform in Wisconsin.

As a Pediatric Nurse Practitioner, I have worked alongside many APNs who would benefit from this legislation, along with the patients they serve. Currently, 27 other states, along with Washington DC, have passed APRN legislation that safely allows APNs to provide care at the fullest level of their training. Wisconsin’s neighboring states of Minnesota and Iowa currently offer full scope of practice, and Illinois remains less restrictive than Wisconsin, as well. Why does this matter?

First, we must consider the work climate. APNs are capable and trained to independently provide care to the fullest extent without onerous collaboration agreements that hinder and dictate their abilities. Newly graduated APNs seeking career opportunities will likely seek out a state more favorable to their long-term professional growth. Likewise, an APN with years of experience should not have to navigate onerous restrictions—contemplating the need to relocate to a state that is more favorable or worry how they will continue to serve their patients when collaborating physicians move or retire—as it disrupts their ability to provide care. Ultimately, patients suffer when that continuity of care is lost.

Next, we must consider access to care. APNs’ ability to deliver quality care and improve healthcare outcomes is especially relevant for our rural communities. Nearly one-third of Wisconsin residents live in rural communities that are currently underserved by healthcare providers. When APNs establish independent practices in these areas, they can help reverse health disparities and intervene before an illness or disease progresses. After Arizona passed its APRN scope of practice legislation, it saw a 73% increase in APRNs serving in rural and underserved communities in the following five years. We cannot continue to leave our rural communities in a healthcare desert when highly trained and available practitioners are ready and waiting to serve them.

Lastly, we must consider the quality of care. Studies consistently show that APNs provide high-quality care, spend more time with patients, provide more preventative education to drive key health outcomes, and rank high amongst patient satisfaction. The fear from some groups that patient safety may suffer under this reform is false. APNs will continue to collaborate and consult with their colleagues in other fields and subspecialties when it is appropriate. APRN scope of practice reform does not replace this system of mutual collaboration and benefit—it simply removes barriers so that APNs can practice with the full potential and authority they have to provide the best quality of care to patients.

The personal relationships I have built with my patients and families over the years have been the highlight of my nursing career. I know for certain the impact I have had on their lives, and helping them feel more confident and empowered caring for their child is an experience I hold dearly. However, I have seen firsthand the very real struggles that Wisconsinites are facing when accessing health care: the barriers of traveling to receive quality care—or worse yet—delaying care until it is too costly because of these burdens.

During my time as a nurse and nurse practitioner, I have experienced these burdens from both ends, seeing patients lose out on care but also APNs losing out on opportunities because of onerous restrictions. I have helped educate nursing students, nurses, nurse practitioners, medical students, residents, and fellows. If I am qualified to help train and educate these individuals -- our future generation of healthcare workers -- then APNs are equipped to practice independently and provide quality care for Wisconsinites.

Wisconsin is falling behind in advancing meaningful healthcare reforms that benefit our citizens. With an aging population and a shortage of healthcare workers, there is no better time than now to remove restrictions on APNs. We must fill the void in areas of patient care where it is so desperately needed. We should work to keep and empower APNs in our state to practice to their fullest extent, and support access to quality care for all Wisconsinites from the provider of their choosing.

Alyssa Pollow is a pediatric nurse practitioner with 10+ years experience working in Wisconsin healthcare. Alyssa is an advocate for healthcare and education policy reforms.

Last Update: May 23, 2023 12:45 pm CDT

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