Organizing NPs and NP Organizations


For Nurse Practitioner World News
Nov-Dec 2009
By Carla Mills, ARNP

Synergy is the dynamic and energetic atmosphere created when individuals and groups work together to produce results they could not obtain independently. It comes from two Greek words – syn meaning “together” and erg meaning “to work”, i.e. “work together”. My “NPs on the Edge” columns this past year outline a vision for the future that NPs can achieve if we can only learn to work together synergistically.

In my first column in NPWN this year, I evoked two historic nursing visionaries and social reformers. Florence Nightingale brought nurses into positions of respect and advanced the evolution of medicine by sanitizing operative procedures and hospitals. Lillian Wald founded the Henry Street Settlement and the Visiting Nurse Service in New York City in 1893, creating public health institutions still at work today. Both of these women established nurses as social reform leaders. Their actions and achievements prove that disrupting the status quo is essential if the goal of social change is to be achieved. If NPs today are to live up to these visionary leaders’ legacy, we must match their bravery and tenacity with our own. We must come together with their same determination to solve the major public health problem of our time – chronic lifestyle diseases.

In my second column I wrote that in order to fulfill our social responsibility and put right a broken health care system, full practice and prescriptive authority for NPs is essential. This is a non-negotiable mandate that must be demanded by every individual NP and every NP organization. It should be the unifying political cause that directs our legislative agenda. We can not equivocate and we need not doubt ourselves. The essence of NP care suits the health needs of our time just as perfectly as Nightingale’s and Wald’s care suited the health needs of their time. We must defend and take ownership of our methods of practice. We must describe our unique expertise to everyone who does not understand us. At every opportunity we must challenge demeaning labels such as “non-physician”, “mid-levels” and “physician extenders”. We must constantly explain the distinctions between the titles “nurse” and “nurse practitioner” until NPs are well understood.

In my third column I laid out the core measurements for optimum health that will prevent and treat chronic diseases. Reaching these goals requires a combination of healthy lifestyle behaviors and, sometimes, medications. NPs are the only health care professionals who are trained in both medicine and nursing. NPs are trained to treat both the health problem itself and the patient’s response to the problem. Helping patients get to goal on all of these measurements is the only way chronic diseases will ever be effectively controlled and prevented.

Then in my last column I discussed the need for NPs to reach out to the media. Overcoming our social invisibility is the key to having a voice and having influence. Neither legislators, government leaders nor the general public will pay any attention to us until we are seen and heard from in the media.

Challenges for NPs and Our Organizations

So far NPs have not been effective organizers. NP organizations suffer from fragmentation, divisiveness between different groups, and low membership numbers relative to the total number of NPs. It is hard to say they truly represent NPs given the fact that the majority of NPs do not support them by joining and paying dues. Their small sizes and small membership numbers prevent them from garnering the resources and clout they need to accomplish any meaningful political reform or effective media outreach on behalf of NPs. [See the list below of the current membership numbers of the national NP organizations.]

Lack of coordination and resource sharing between national, state and local NP organizations dilute what money and energy members do contribute. Individual and organizational NP initiatives repeatedly hit dead ends because their efforts aren’t supported or carried forward by a unified community of organized NPs working synergistically with the nursing profession as a whole. NP organizations and educational institutions continue focus only on NP issues and ignore issues of public health leaving us lacking in social relevance.

It’s time we take a giant, bold collective leap over the edge and into the future. NPs need to get organized. The NP profession is made up of 147,000 disconnected individuals and a whole host of disorganized organizations, foundations, networks and councils – all have some growing and changing to do and it needs to be done fast.

NP Organizations Need to Organize

NP organizations need to coalesce, merge and share resources. If they want to attract more members (and more dollars) they must prove themselves competent and relevant to a larger percentage of 147,000 practicing NPs.

Reaching out and inviting all NPs (clinicians, educators, researchers, and administrators) to the table and incorporating all the divergent views will find innovative solutions to old problems. Abandoning the status quo will allow NPs to evolve into something more socially relevant.

Specifically, all NP organizations should coordinate their efforts to pursue the following three unified agendas:

  • Obtain funding and grass roots support from a majority of NPs in order to lobby effectively to obtain full practice and prescriptive authority for NPs across all 50 states.
  • Advocate boldly for a national health initiative led by NPs to get every American to goal on every single health risk.
  • Launch a robust and coordinated media outreach campaign that explains and promotes NPs’ vision, authority, and expertise and outlines a clear health care plan for the public.

Individual NPs Need to Become Activists

NPs have an unprecedented opportunity at this moment in history. It is up to each one of us to take full advantage of it. Whatever your passion, whatever cause you support, whatever you believe – act on it and invest money in it. As I see it, every NP should be making 3 types of donations: time, money and self. Every NP should

  • Reach out to local, state and national politicians and legislators at every opportunity. Explaining NPs’ urgent need for full practice and prescriptive authority and how we will use that authority to provide exactly the type of health care that’s most needed and in shortest supply. This is easy to do these days via email. It’s a donation of time.
  • Join and pay dues to local, state and national NP organizations. Don’t skip organizations because you’ve given to a group on another geographic level. Make additional donations if you feel the organizations’ performance is adequately representing your interests. Do it today! It’s a donation of money.
  • Reach out to the media. Write a letter to the editor. Call in a story to your local newspaper. Get interviewed on a local radio show. Meet the press whenever and wherever the opportunity arises. It’s a donation of self.

Synergy = Energy Squared

United and cohesive NP organizations, when aligned with 147,000 NP activists, all working toward the same solutions – that would be a powerful force for health reform!

Finding solutions to the difficult social and behavioral problems that lead to disease is both a humanitarian issue and a political one. Eliminating the causes of chronic disease will require changing the very nature of our social values and disrupting many of our social structures. NPs can help guide those changes if we will work together energetically and synergistically.

National NP Organization Membership #s

TOTAL # of NPs in the U.S. = 147,295 as of 02/2009 (Pearson Report, 2009)
AANP (American Academy of Nurse Practitioners) = 26,600 members as of 09/2009
ACNP (American College of Nurse Practitioners) = 4,500 members as of 10/2009
NPWH (National Association of Nurse Practitioners in Women’s Health) = 2,500 members as of 11/2008
NAPNAP (National Association of Pediatric Nurse Practitioners) = 7,000 members as of 04/2008
GAPNA (Gerontological Advanced Practice Nurses Association) = 1,805 members as of 06/2008
NONPF (The National Organization of Nurse Practitioner Faculties) = 1,100 members as of 10/2009

This information is offered for educational purposes only and is not intended to diagnose, prescribe or treat. For that please seek direct care from a health professional.

Permalink  ·  

#1 | On January 22, 2010, Christy Price Rabetoy said:

I just read your most recent article and have a few comments. First, keep it simple “NP” (period)! No one understands APRN, or your title of ARNP—what is that??  Let CNSs be CNS ( no one uderstands what they do), let CRNAs remain doing their work and keep their identity. Let nurse midwives, be nurse midwives.  We are not all NPs, and we are not APRNs.

Second, you did not mention that NPs do not join nursing organizations because many do not consider themselves nurses. Nursing, and nurses, have such baggage because of their inability to establish a BSN entry level, that even many practicing RNs do not want to be identified with those who only have a junior college degree or diploma.  Certainly there is no benefit from meeting wit them or belonging to an organization where they members.

Fianlly, with all the any BS or BA, or AA degree to NP programs, these graduates are not nurses, do not identify with nurses, and definitely prefer to indentify with their physician colleages. Physicans keep it simple - MD or DO, not a bunch of alphabet soup to hide behind.

#2 | On January 22, 2010, Carla said:

Thanks for your comments.

I agree with you about the NP title. I debated about which to use on my book - ARNP or NP - I finally chose ARNP because it is my legal title in the state of Florida. The next book printing I plan to change it to simply NP.

Any nurse - LPN, RN, BSN, NP, midwife, clin spec, nurse anesthetist - who is not proud to be a nurse and serve the mission of nursing needs to go back and study Florence Nightinggale’s work and read (or re-read) her writings. Only when nurses act with mutual respect and mutual support will we be successful in serving patients according to our mission and becoming influential to society as a profession.

Carla Mills, NP

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