National Healthcare Issue
The Affordable Care Act (ACA) of 2010 significantly impacted the expansion of
Medicaid and increased coverage of adults 18 to 30 years old (Marshall & Broome, 2017). As
the Affordable Care Act (ACA) was passed, the need for more primary care providers increased.
Before the law was passed, I experienced difficulties in finding a doctor. Before the law was
passed, I had to call various medical offices to see which ones were accepting new patients.
The lack of access to primary care providers (PCPs) is a national healthcare issue that I
would like to address. It is also the need for more advanced practitioners such as physician
assistants and nurse practitioners. Various care models have been used to investigate if the use of
nurse practitioners can keep up with the demand for primary care. Norful et al. (2018) concluded
that the successful use of co-management between physician and nurse practitioner could help
prevent burnout, improve the quality of care and lead to increased patient access to care.
Furthermore, Marshall and Broome (2017) identify that (e addition of nurse practitioners to an
inpatient care team at a single site demonstrated enhanced revenue through gross collections and
cost efficiency, reduced overall length of stay, and standardization of practices to improve
quality care(p. 66).
The focus on this healthcare issue raises another question. How many advanced practice
clinicians are required to provide adequate care for our population (Ricketts & Fraher, 2013)?
Impact of Issue on My Work Setting
The county that I work in currently has an over-saturation of NPs. Jobs for APRNs are
highly competitive and require numerous professional connections. The hospital system I work
in underwent multiple furloughs and even fired considerable acute care NPs and PAs due to the
COVID-19 crisis. All the NPs with the hospitalist group were fired, which has significantly
impacted the workload for the hospitalist group. Our critical care group has six NPs and six
physicians that cover four intensive care units. Most of our specialties rely heavily on the use of
NPs, such as cardiology, gastroenterology, oncology, neurology, and neurosurgery. The
advantage of using acute care NPs and PAs allows the hospital to have higher patient volumes
while significantly lowering the cost of physician provided care (Auerbach et al. 2018). Some of
our high-volume surgeons even have two NPs, allowing him to take on more surgical cases, thus
increasing our ability to provide care to our community. I am happy to say that there were no
cuts in clinic NPs or primary care NPs/PAs.
Analysis of My Work OrganizationàResponse to the Issue
The recent cuts and furloughs from my facility have been devastating, to say the least,
especially as a future FNPI do not think that the removal of acute care providers from our
hospital allowed us to serve the community properly. We currently have a high population of
patients, and we do not have enough staff to meet the needs of our community. With a lack of
staff comes to burn out, increased patient length of stay, and poor patient care.
References
Auerbach, D. I., Staiger, D. O., & Buerhaus, P. I. (2018). Growing Ranks of Advanced Practice
Clinicians mplications for the Physician Workforce. New England Journal of Medicine,
378(25), 2358-2360. https://doi-or.ezp.waldenulibrary.org/10.1056/NEJMp1801869
Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert
clinician to influential leader (2nd ed.). Springer.
Norful, A. A., de Jacq, K., Carlino, R., & Poghosyan, L. (2018). Nurse Practitioner- Physician
Comanagement: A Theoretical Model to Alleviate Primary Care Strain. Annals of Family
Medicine, 3, 250. https://doi-org.ezp.waldenulibrary.org/10.1370/afm.2230
Ricketts, T., & Fraher, E. (2013). Reconfiguring Health Workforce Policy So That Education,
Training, And Actual Delivery Of Care Are Closely Connected. HEALTH AFFAIRS, 32(11),
1874-1880. https://doi-org.ezp.waldenulibrary.org/10.1277/hlthaff.2013.0531

Purchase answer to see full
attachment