Latest / Becker’s Healthcare Podcast / Redefining Nurse Practitioner Readiness and Workforce Alignment

Transcript

Redefining Nurse Practitioner Readiness and Workforce Alignment · Becker’s Healthcare Podcast

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  This is Laura Dirdo with the Becker's Healthcare
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  podcast. I'm thrilled today to be joined by
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  doctor Marceline Ainsley,
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  assistant professor of nursing at UNH School of
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  Nursing, and doctor Tracy Chan, assistant professor and
• 0:11
  interim nurse practitioner program director at Oakland University
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  School of Nursing in Rochester, Michigan.
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  Doctor Ainsley, doctor Chan, thank you so much
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  for joining us today.
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  Thank you. So excited to, be here and
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  have the opportunity to connect.
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  Fantastic.
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  Now I know you're really focused on, NP
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  population educational preparation and figure out how we're
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  going to be working with the nursing workforce
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  of the future. So for hospital leaders, what's
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  the practical
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  problem that you're trying to solve here? How
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  are you really defining the NP population in
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  preparation
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  as they show up on the clinical agencies?
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  So hospitals experience real variability in what a
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  new graduate NP is prepared to do even
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  within the same population
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  certification.
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  NPs
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  have eight different certification
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  populations
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  that they can work in.
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  It's not an issue of whether NPs are
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  capable,
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  It's that the educational
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  preparation
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  has been described
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  broadly,
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  but not consistently bounded
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  to. So institutions
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  interpret
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  preparation
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  differently.
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  It can lead to hiring
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  based on assumptions,
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  onboarding that's longer or less targeted than it
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  needs to be, and uneven
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  transition to practice
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  outcomes.
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  This work provides a clearer shared model of
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  educational preparation
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  so clinical agencies can align hiring,
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  orientation, and early role assignment with what graduates
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  were educated to do,
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  improving efficiency
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  and patient safety.
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  And that's really helpful to understand. And, you
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  know, it's so critical right now especially to
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  have those, nurses in in the workforce that's
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  prepared to improve efficiency as well as patient
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  safety, thinking about how,
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  the patient population is changing and shifting.
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  Now in a paper that you've recently written,
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  you argue that the NP Education is fundamentally
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  different from the medical
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  model because it's population based and holistic.
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  I'm curious,
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  doctor Ainsley, if you could talk a little
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  bit more about what do hospital administrators most
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  often misunderstand
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  about this model and what misalignment does it
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  create when NPs are placed into roles based
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  on the medical model assumptions?
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  Yeah. Thanks. That's a great question. We see
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  this a lot in health systems.
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  Most health systems
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  operate in a medical model
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  lens and have a lot of administrative
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  higher level c suite administrators
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  who are physicians,
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  and it's assumed that the NPs
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  coming in are
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  have the same parameters
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  of scope of practice.
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  But NP education,
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  like doctor Chan was saying, is really grounded
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  in this holistic biopsychosocial
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  model,
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  and it's organized by patient populations and patient
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  needs.
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  The population
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  span the wellness illness
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  continuum,
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  but the emphasis
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  and implementation
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  of this vary. So what this means is
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  that when hospitals apply a medical model assumption
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  to NP roles,
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  Sometimes they might expect readiness for specific patient
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  groups,
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  a
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  severity level or visit type that aren't central
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  to the NP population's educational preparation.
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  What our work helps to do is translate
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  this population based model, which is unfamiliar
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  to a lot of hospital system administrators
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  and human resources department,
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  and it translates it into practical parameters
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  that hospitals could use to reduce the mismatch
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  between the educational preparation of the new hire
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  and the clinical environment in which they're being
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  hired
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  into.
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  And this could build,
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  just more predictable transitions into practice
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  and create a smoother onboarding
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  process.
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  I love that. I think it makes a
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  lot of sense, to really use the information
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  we have and
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  have that model then,
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  shifted for the onboarding process to, really get
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  people up to speed as quickly as possible.
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  I I really appreciate that. Now, doctor Chan,
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  what did the National Organization of Nurse Practitioner
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  Faculties National Work Group actually produce that's new?
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  Can you describe some of the population specific
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  narratives and
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  visual depictions
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  and how they can set clear educational boundaries
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  using age, severity, and visit content?
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  Sure. Yes. That's exactly
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  where our article was on. And NAMFC
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  is the acronym for our organization, the National
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  Organization of Nurse Practitioner
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  Faculties,
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  and we convened an inclusive consensus
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  based
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  national work group that had representation
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  from all NP populations
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  and collaborated
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  with
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  population specific
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  nursing
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  organizations.
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  So there is specifically
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  the pediatric nurse practitioners,
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  there's women's health,
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  neonatal,
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  So we worked with those groups as well,
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  and it expanded to being 81
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  experts
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  who work together
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  to produce
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  an outline,
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  of
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  population
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  specific narrative descriptions
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  as well as visual
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  depictions
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  that define the educational
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  preparation
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  using
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  the
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  patient centered categories of
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  age, severity of presentation,
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  and visit content.
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  So
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  this really gave
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  more
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  clearer educational
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  parameters
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  to help reduce
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  regional and institutional
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  variability
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  and create a more predictive model for transition
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  into practice.
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  So looking at what
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  ages have been defined in the consensus
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  model, there was confusion
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  out there on
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  what age range
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  fell for the adult gerontology.
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  It said that it begins
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  with young adult.
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  Well, when we talk to
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  programs
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  within
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  within this group of experts,
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  we found that the definition was defined as
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  12 years old in some institutions
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  and as 21 years of age in others.
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  So this variable
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  interpretation
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  resulted
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  in adult GEO MPs
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  receiving
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  either full adolescent curriculum,
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  some receiving just medical components and not the
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  behavior or social components,
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  and some receiving no adolescent
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  curriculum.
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  So this document
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  helps to define that better so that hospital
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  systems
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  and employers
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  understand
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  what their,
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  NP that they're hiring has been educated to
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  be able to provide care for.
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  That makes a lot of sense and, you
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  know, it is so helpful to, see some
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  of those variations and, you know, really being
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  able to get to the bottom of how
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  patients are treated and, where, you know, they
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  have,
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  the best results.
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  Now I know overlapping between NP populations can
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  be somewhat confusing, especially for workforce planning.
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  Doctor Ainsley, what are some of the most
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  important overlap versus distinction takeaways for hospitals, especially
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  the idea that some populations may stabilize and
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  refer or consult rather than provide that full
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  spectrum of care for certain ages and severity
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  levels.
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  Yeah.
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  That's great. So I I I I think
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  I wanna answer this in two, like, two
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  levels.
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  Because the first,
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  issue around overlap
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  is a misinterpretation
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  about RN prior work experience
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  and NP education.
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  So
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  also different from the medical model is that
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  our students have preexisting
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  experience in the health care system.
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  So we may receive
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  ICURNs
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  or acute care practicing registered nurses into,
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  a family practice nurse practitioner
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  program where the educational curriculum is grounded in
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  a primary care environment, not acute care.
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  And then when that
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  student graduates
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  and if they wanna go work somewhere
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  in an inpatient
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  setting,
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  the capacity
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  of their
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  scope of practice is limited to their NP
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  educational
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  parameters.
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  It is not dependent on
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  their prior registered nurse experience.
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  Now that registered nurse experience
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  creates,
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  more depth of knowledge.
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  It,
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  grounds
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  and facilitates transition
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  into,
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  back into the health system in a new
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  role.
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  The prior RN experience
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  creates
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  value
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  in hiring nurse practitioners because they have that
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  depth of experience already,
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  and they're not coming out as brand new
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  healthcare practitioners.
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  That being said,
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  within the NP populations,
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  there is also this second layer of overlap
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  and distinction.
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  So the first one being not to confuse
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  their registered nurse experience with their nurse practitioner
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  educational preparation.
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  Those are distinct.
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  And the second layer is within nurse practitioner
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  populations
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  themselves.
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  So when we did this work,
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  we found that NP populations
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  really share
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  more foundational
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  educational preparation
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  than even most educators
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  assumed to be real.
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  But when we drill down into
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  what
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  students needed to know and how we,
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  engage in the health care system,
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  The behaviors and the knowledge and the skills
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  are very similar across NP roles, and it's
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  really the context and setting
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  that changes based on the NP population.
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  And it's
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  key to name this overlap accurately and define
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  the boundaries of preparation so that hospitals aren't
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  relying on guesswork
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  in their hiring
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  or in the alignment
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  of the new hire with the clinical area
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  in which they're
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  being assigned.
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  So it's a critical nuance in some scenarios
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  and students may be educated to stabilize and
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  refer or provide consult
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  for certain aspects of care,
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  but not have the full spectrum delivery of
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  care. So if you think about like in
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  the primary care setting,
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  you know, students or patients inappropriately
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  present to settings and
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  you may have,
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  a chest pain showing up to a primary
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  care office. Right? And primary care is going
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  to want to assess, stabilize, and refer to
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  the next level of care.
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  So the scope of dealing with that, within
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  the primary care setting is not full spectrum
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  of care,
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  but how to move the patient through the
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  system effectively
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  to receive, the most appropriate level of care.
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  And this
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  full spectrum of care aligns with the bio
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  psycho psychosocial model for the age and severity
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  range identified
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  for each NP population.
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  So why is this important for hospitals?
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  It supports smarter staffing models,
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  creates clearer role expectations,
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  and safer assignment decisions,
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  especially in the high acuity and complex settings
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  that represent our current health care system.
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  That's helpful to understand. And, I think especially
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  looking at the complexity of health care today,
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  knowing all of these,
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  different areas of variation and then being able
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  to zero in on what is, the patient
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  where the patient is and how you can,
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  address some of those gaps makes a big
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  difference. Now before we wrap up here, doctor
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  Chan, I was curious if an
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  member
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  hospital wanted to act on this tomorrow. What
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  would you advise?
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  Thank you. So the first part really is
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  looking at, you know, the document that shows
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  what the educational
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  preparation of MP populations
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  by age and severity
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  are reading, looking at both that visual depiction
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  as well as the narrative descriptions,
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  and using those
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  to
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  write your job descriptions and make them more
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  explicit
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  that reflect the age range, the typical severity
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  your service expects.
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  Then
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  secondly, would be looking at your onboarding
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  process and transition to practice pathways.
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  Make sure they're targeted
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  based on the predictable educational
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  preparation and the actual clinical
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  environment.
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  And then engaging your clinical leaders and academic
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  partners.
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  So student clinical
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  placements,
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  precepting
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  expectations,
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  and early career role assignments
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  align.
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  The payoff is gonna be reduced variability
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  and readiness,
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  more
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  efficient onboarding investment,
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  a stronger team integration,
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  and ultimately
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  improved
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  patient safety.
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  Yeah. So I just wanted to add that,
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  as soon as this work published
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  and the table that doctor Chan's referencing
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  is in the preamble to the competency implementation
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  guide for nurse practitioner faculty that NAMF put
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  out in 2024.
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  There's also a peer reviewed article,
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  that I provided the reference for. I hope
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  the citation can make it,
• 14:54
  where the podcast is listed.
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  And as soon as it's published, we receive
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  contact from the veteran health affairs
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  appreciating,
• 15:03
  the work that has been done and coaching
• 15:07
  them through,
• 15:08
  appropriate interpretation of the work so that they
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  were able to do a workforce assessment
• 15:14
  for NP alignment and really work on improving
• 15:17
  their some of their hiring processes.
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  So we know from working with VHA
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  that this is something that's meaningful and desired
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  by health systems.
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  So we appreciate the opportunity to bring it
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  to your group today.
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  Absolutely. And we so appreciate your time and
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  and energy in, spending with us and sharing
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  with us a bit deeper into the work
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  that you're doing. We can certainly make sure
• 15:41
  the citation and link is appearing within the,
• 15:44
  podcast notes and make sure that any listeners
• 15:47
  are able to easily access it, which will
• 15:48
  be fantastic.
• 15:50
  Doctor Chan, doctor Ainsley, thank you so much
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  for joining us again, and I I truly
• 15:54
  appreciate your expertise and look forward to continuing
• 15:56
  the conversation in the future.
• 15:58
  Thank you.
• 15:59
  Thank you.