Alison Leary’s Post

This is a really interesting article on the workforce impact of the introduction of the Additional Roles Reimbursement Scheme - ARRS - into the NHS primary care workforce. To be absolutely clear, individual people in ARRS roles are amazing. But this article highlights that the introduction of the roles was dogged by poor planning, poor training, and people being asked to work in new ways without adequate supervision. It also led to clear unfairness - in particular nurses being asked to train and supervise people who were being paid more than they were, and to fill in gaps that ARRS workers were unable to address. It also highlights that well established professions, such as pharmacy, who have their own clear competencies and supervision routes, can absolutely help patients and reduce other professionals' workloads. As ever, when money was thrown at a problem without proper consultation or consideration for training, supervision and management, the problem didn't go away. I feel terribly sad for the GPNs who have had similar experiences, and for their talented, well intentioned ARRS colleagues who weren't given what they needed to achieve the goals they were employed for. Proper planning and proper change management aren't nice-to-haves, they are essential.

For anyone working/interested in primary care and its workforce, this new paper from Alison Leary &co with The Queen's Nursing Institute Crystal Oldman is a really interesting and important read. The paper considers a workforce impact assessment on general practice nurses (GPNs) due to the Additional Roles Reimbursement Scheme (ARRS) (which they were not part of). Issues highlighted and addressed - GPNs experienced: Increased supervising and teaching without additional resources Duplication of work due to complexity of work (which is not recognised) Incomplete care and care left undone Inequitable pay and conditions Less access to developmental opportunities and paid time for learning (this particularly grips me given my PhD in nurses' post-registraiton development) Devaluation of the GPN role More 'rescue' work due to fractured care and taskification. This is a must read, which should be reflected on and taken on board for anyone looking at service (re)design, working practices and workforce planning at a local, regional and national level. #nhs #workforce #research #policy

'Those people aren’t smart enough to be trusted...' Last year, at a gathering of fellow nurses, someone directed that statement at me. We were convened to learn how to educate and empower Ohio nurses in shaping state policy and legislation. Amid discussions on tackling the staffing crisis, I delved into the role and potential of Medication Aides (MA-Cs) in Ohio's acute care facilities. A bit of context: In 2006, non-nurses were authorized to administer certain medications in nursing homes, assisted living facilities, and residential care facilities. What began as a pilot program soon expanded statewide by 2009. Yet, since then, progress in reevaluating and expanding the scope of medication aides has stagnated. All that said, the current staffing shortage is much more nuanced than numbers. Its complexities cannot be solved with such a narrow solution. Still, I proposed exploring tangible, quick-turnaround solutions to gauge their impact on acute care. After presenting this idea, I was pulled aside and told “It’s a great idea but won’t work. Those people aren’t smart enough to be trusted with our patients.” Do we assess patients' value based on age or their care setting? This incident showed me we still have a long ways to go in nursing. It shed light on a prevailing mindset for some nurses—a mindset entrenched in outdated paradigms, viewing the world through cracked lenses and taped bridges, desperately clinging to keep them together. It’s time for a new prescription. #nursesonlinkedin #nurseleadership #paradigmshift #nursestaffing #localgovernment #empoweringpeople #solutionfocused American Nurses Association American Organization for Nursing Leadership ANA-OHIO National Council of State Boards of Nursing (NCSBN) Ohio Board of Nursing National League for Nursing American Academy of Nursing National Center for Assisted Living National Association of Long Term Care Administrator Boards

The Commission for Nurse Reimbursement (CNR) is proud to be dedicated to advancing the modernization of nursing economic and reimbursement structures. We firmly believe that nursing is not a partisan issue. #Nurses are the backbone of our healthcare system, providing care for people across the political spectrum from all cultural backgrounds. Their commitment to patient well-being transcends any political affiliation. As we have gained momentum and exposure on the issue of #nursing reimbursement, we've spoken to many legislators and their staff about the issue and potential models. A few notable conversations we've had include (images below): Dr. Bethany Hall-Long, Dale Folwell, MedPAC, Blake Moore, Clara Adams-Enders, Bernie Sanders, HELP Committee, Mitt Romney, and Gale Adcock. Our work at CNR focuses on: 1. Robust Reimbursement Structures: Creating a reimbursement model that unbundles nurses from the room rate and creates an economic reimbursement model in parity with all other healthcare professionals. 2. Economic Stability: Building a sustainable economic model for nursing that supports recruitment, retention, and professional growth. 3. Modernization: Adapting reimbursement structures to reflect the evolving role of nurses in delivering comprehensive healthcare. We invite nurses, healthcare leaders, policymakers, and the public to join us by volunteering in this non-partisan effort to strengthen the nursing profession and improve patient care. Together, we can build a more equitable and sustainable future for nursing. #healthcareonlinkedin #nursingonlinkedin Rebecca Love RN, MSN, FIEL Sharon Pearce

Today, the American Academy of Ambulatory Care Nursing (AAACN) and the Commission for Nurse Reimbursement announce our groundbreaking strategic partnership aimed at transforming how nursing care is valued and reimbursed. This collaboration marks a pivotal moment for the nursing profession, as it will focus on: ✅ Policy and Rule Changes: Advocating for changes that recognize the true value of nursing care. ✅ Innovative Models: Testing new approaches to ensure a robust and comprehensive reimbursement for nursing services. ✅ Feasibility Tests: Implementing real-world tests to demonstrate the impact of nurses across various ambulatory care specialties. Why This Matters: 1️⃣ Empowering Nurses: This partnership aims to give nurses the recognition and compensation they deserve. 2️⃣ Transforming Healthcare: Showcasing the value of nursing care will lead to better patient outcomes and a stronger healthcare system overall. Stay Tuned! This is just the beginning of an exciting journey. Be sure to follow AAACN and CNR for updates on this partnership and how it will shape the future of nursing. #NursingValue #HealthcareInnovation #nursing #nursesonlinkedin #healthcareonlinkedin #nursingreimbursement #timeforchange Stephanie Witwer, PhD, RN, NEA-BC, FAAN Rachel E. Start RN, MSN, NEA-BC, FAAN

nursing is not a “partisan issue” is a cop out in a time where reproductive rights are being ripped apart, maternal mortality rates continue to accelerate, private equity “rescuing” healthcare systems only to eliminate services & bankrupt them months later, insurance companies completely destabilizing healthcare access with inpunity, healthcare systems leaving care settings vulnerable to cyber attacks & all of this disproportionately impacting minoritized communities. nursing might not be “partisan,” but it should be rooted in JUSTICE. not tiptoeing around what our patients actually need & deserve. let’s be honest about what our “priorities” are y’all.

Celebrating First Case Success: Insights from PACU Nurses Join us in this insightful discussion celebrating professional milestones in healthcare. Discover how PACU nurses navigate assessment practices amidst a lack of concrete policies. This video highlights the journey from completing a first case to addressing crucial nursing protocols. Tune in for expert insights! #HealthcareSuccess #PACUNurses #NursingPractices #MedicalMilestones #ClinicalAssessment #PatientCare #NursingDiscussions #HealthcareCommunity #SurgeryCenter #NursingProfession

I recently came across an article from the International Journal of Nursing Studies highlighting the critical role of nursing staff in patient outcomes during the Covid-19 pandemic. The research is not new and underscores the longstanding connection between adequate staffing levels and improved patient survival rates, emphasizing the ongoing challenges in providing optimal care to the sickest and most vulnerable individuals. The focus on retention, recruitment, and reimbursement in the nursing profession remains essential. However, attracting younger generations to this profession poses a significant challenge. Despite the hurdles, the need for passionate individuals to join and enrich our profession is more pressing than ever. #Nursing #PatientCare #Healthcare #Covid19 #NursingStaff #HealthcareProfession

Navigating California's AB 890: New Pathways to Nurse Practitioner Independence In 2020, California made a significant move towards empowering nurse practitioners (NPs) with the passage of AB 890, which introduced a pathway for NPs to practice without physician supervision. Effective January 1, 2023, the Board of Registered Nursing has detailed the provisions of this new law, bringing California closer to the "full practice authority" (FPA) seen in many other states. AB 890 introduces a two-tiered system: 103 NP License: Allows NPs to practice without standardized procedures after completing a transition-to-practice period of at least three years or 4,600 hours. However, this independence is limited to practice locations where physicians are also present, posing challenges for NPs in smaller or remote settings. 104 NP License: Grants full independence without the need for physician presence. To qualify, NPs must first hold a 103 license and practice for an additional three years. Although the law permits potential reductions in this requirement for Doctor of Nursing Practice (DNP) holders, no exceptions are currently being made. Thus, NPs must wait until at least 2026 to attain a 104 license. While AB 890 marks progress, the stringent requirements may compel many experienced NPs to relocate to group practice settings to meet the qualifications. This shift could be more manageable for new NPs, but established professionals might face significant challenges. The Board of Registered Nursing is working on additional resources and clarifications, and future legislative changes could further impact these pathways. Stay tuned for updates as California continues to evolve towards greater NP autonomy. #NursePractitioner #Healthcare #Nursing #FullPracticeAuthority #CaliforniaHealthcare #AB890 #MedicalNews #ushealthcare #IndiviualPractice #Nurse

🚀 Exciting New Findings on the Role and Value of GP Nurses! 🚀 We've just released the third and final report in our ground-breaking series, "Leading the Way," commissioned by NHS England. Our latest research overturns the outdated notion that general practice nurses merely follow where GPs lead. Instead, it highlights the crucial leadership roles that nurses are playing in primary care across England. 🏥 Key Findings: 💡 Leadership in Care: Nurses are leading programmes in primary care and managing practices, especially in areas covering respiratory conditions and diabetes. 💡 Essential Roles: Beyond patient care, nurses are vital in training and line managing other practice staff. 💡 Untapped Potential: With the right support, nurses could further alleviate the pressures on the NHS by taking on more clinical and non-clinical responsibilities. However, to fully harness the potential of practice nurses, we need to address barriers such as unsustainable workloads and challenges in recruitment and retention. Our report offers a series of recommendations to tackle these issues head-on. Discover how nurse-led care can shape the future of primary care in England and support the NHS in meeting the demands of an ageing population and increasing healthcare burden. Also see the article covering this report in the Nursing Times at https://bit.ly/3yb7n1E #Healthcare #NursingInnovation #PrimaryCare #NHSEngland #HealthcareResearch #Nursing #GP #SocialImpact https://lnkd.in/enJiEmT4