Can Nurse Practitioners Help Save the VA?

We’ve all heard of the VA scandal brought to light earlier this year. At least 35 veterans died awaiting life saving care at the Phoenix, Arizona Veterans Health Administration facilities. It turns out the facility in Phoenix wasn’t alone in its mismanagement woes.

Medical inspectors found that the VA health system, charged with caring for our nation’s heroes, is failing on several fronts. One of the core issues plaguing the VA? A shortage of medical providers.

This Veterans Day week, national leaders are starting to take action to fix the issues that led to the scandal costing several vets their lives. On the books for the coming months is “the largest restructuring in the department’s history” says new Secretary of Veteran Affairs Robert McDonald. Nurse practitioners and their representative organizations are taking note of planned changes, vying for a better place for NPs in the new and improved VA system.

VA secretary Robert McDonald plans to hire tens of thousands of new healthcare providers as part of his plan to restructure the VA, nurse practitioners included. NPs are a natural solution to the VA’s problems. Physicians working for the system receive notoriously low salaries making recruiting difficult. Nurse practitioners, however are paid competitive six-figure salaries in the system. While some could argue redistributing dollars to make MD salaries more attractive would be an effective strategy, the number of medical providers the system can afford will be more favorable with NPs.

Not only would it be wise for the Veterans Health Administration to make hiring nurse practitioners a core part of its restructuring plan, eliminating the red tape and bureaucracy that limits nurse practitioner’s ability to provide patient care is also in order.

The Veterans Health Administration presents a unique opportunity for nurse practitioners. Being that the organization operates under federal jurisdiction, NPs practicing within the VA system aren’t subject to often restricting state laws. As a result, the VA has the option to independently grant nurse practitioners practicing within its walls the ability to function within their full scope of practice, without physician oversight.

In most cases physician oversight rules confer little value when it comes to patient care. Rather, they require organizations like the VA to use physician hours for chart reviews and signing paperwork rather than hands-on patient care. Naturally, there will be collaboration between NPs and MDs working together in the hospital environment. There’s no need to regulate this process in an already strapped system.

The American Association of Nurse Practitioners has taken the lead in urging the VA to increase usage of NPs and consider more favorable policies. Dr. Ken Miller, president of the AANP says “it doesn’t make sense to prevent NPs from doing everything they’re trained to do, especially in a system there they are struggling to have enough doctors”.

Time will tell if the Veterans Health Administrations’s massive restructuring efforts will prove effective. With nurse practitioners the VA increases their chances of executing a restructuring plan effectively in turn improving care for the most deserving patients in our country.

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