VA Proposes Full Practice Authority for VHA APRNs

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VA Proposes Full Practice Authority for VHA APRNs

Throwing down the gauntlet

By Working Nurse
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Advanced practice registered nurses (APRNs) in more than half of all U.S. states are still struggling for autonomy, but that fight just gained a formidable new ally: the Department of Veterans Affairs (VA). Proposed new rules would extend broad-based autonomy to all APRNs within the Veterans Healthcare Administration (VHA).

Full Practice Authority

On May 25, the VA published proposed new regulations that, if enacted, would preempt state law and authorize the VA to grant full practice authority to all VHA advanced practice registered nurses — including nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists and certified nurse-midwives — within the scope of their VHA employment.

The one exception would be “the authority to prescribe and administer controlled substances,” which would still be subject to state regulations. Otherwise, the VA proposes “to allow [VHA] APRNs to practice to the full extent of their education, training and certification.”

The rules’ stated goals are to “increase VA’s capacity to provide timely, efficient and effective primary care services, as well as other services ... particularly in medically underserved areas ... [and] decrease the amount of time veterans spend waiting for patient appointments.”

A Domino Effect?

Unsurprisingly, the proposed rules have the enthusiastic support of leading nursing organizations, including the ANA, the American Association of Colleges of Nursing and the American Association of Nurse Anesthetists, as well as AARP and several major veterans’ groups.

While the VHA currently employs only about 6,000 APRNs nationwide, the new rules could be a powerful weapon for other advanced practice nurses in their battle for autonomy. Such a strong move by the VA may put new pressure on states to lift their remaining physician supervision requirements for APRNs.

Call for Public Comments

If you would like to make your voice heard on the proposed regulations, the VA is accepting public comments through Monday, July 25. Review the proposed rules, including a detailed summary, at the Federal Register. Click here to submit comments.  

Photo above
: Nurses have long played an important role in VA healthcare. Here, Kimberly Kirkpatrick, RN, M.S., CNL (with dark hair and teal scrubs), a clinical nurse leader at Portland VA Medical Center, works with Paul Ahola, LPN (left), and Andrea Elia Gill, RN (right), a Marine Corps veteran.

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