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   Kristi Alvey, APRN

An educator at Columbia VA Health Care System in South Carolina, Kristie Alvey, APRN used her positive spirit and compassionate attitude to make a meaningful difference in a year when positivity was hard to come by.

Kristie embraced the new challenge of cross-training bedside nurses for med-surg and ICU, while healthcare providers were sick, and units were at capacity. She later helped to open a new clinic to vaccinate between 150 and 500 people per day. Kristie believes her ability to partner with and support her colleagues has proven to be invaluable in supporting the truly monumental task of vaccinating patients and “Kicking Covid to the Curb in 2021,” as is the Clinic’s motto. She is invested in inspiring her colleagues, caring for their health, and making a positive impact on the clinical environment during periods of high stress. By leading with care and compassion, her efforts during the past year have transformed her colleagues’ experience and helped them provide enhanced care to patient.

Tanya Henry, RN

Tanya, the Nurse Manager in the cardiology and medicine clinics, volunteered to oversee the coordination and staffing at a COVID-19 patient entry point on the main campus. She created staffing plans, solicited volunteers and constantly motivated staff to conduct consistent, reliable screenings. She also developed a protocol for testing facilities so that nurses and staff would be better equipped to assess, order, and perform COVID-19 tests. Through her leadership, the VA was able to build a cohesive, high-functioning team in a time of unprecedented need. Thanks to Tanya’s innovative leadership, the entire screening and testing operation for the medical center has been nurse-led and nurse driven.

Forrest Fortier – Retired RN

The artwork featured at the top of the article, titled “The Power of Nursing Through Learning,” is by Forrest Fortier, an artist and retired nurse from South Carolina. Forrest was inspired by her former colleagues to create a series of paintings that captured the strength and resilience of nurses everywhere, particularly during the challenges of the COVID-19 pandemic. You can learn more about Forrest and her artwork at https://forrestfortier.com/)

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South Carolina and Maryland are the latest states to pass laws increasing people’s access to the high-quality care provided by advanced practice registered nurses (APRNs). Earlier this month, Gov. Henry McMaster signed S.345 into law, easing consumer access to nurse practitioners in the Palmetto state. In Maryland, Gov. Larry Hogan signed HB 863, modernizing laws that govern consumer access to the state’s certified registered nurse anesthetists (CRNAs).

In South Carolina, nurse practitioners will still be required to maintain a contract with a physician, but beginning July 1, physicians can contract with more nurse practitioners at a time, increasing the cap on the number of nurse practitioners. The bill also removes a distance limitation tied to the physician’s location. In addition, nurse practitioners will be allowed to prescribe more of the medications that they are educated and trained to prescribe. While the new law does not grant nurse practitioners the ability to practice to the full extent of their education and training, it marks a step in the right direction. It is expected to improve consumers’ access to health care, especially in rural areas where few physicians practice.

“Better access to health care at a lower cost is a clear win for all South Carolinians,” wrote the bill’s sponsor, State Sen. Tom Davis, an op-ed in The Island Packet.

High rates of obesity, diabetes, cancer, and cardiovascular disease are prevalent in South Carolina. Nineteen of the state’s 46 counties have 10 of fewer family physicians, and one county has no physicians at all.

A diverse coalition of organizations supported the bill, including AARP South Carolina, the South Carolina Hospital Association, the New Morning Foundation, Michelin, the Carolinas Center, the South Carolina Medical Association, the South Carolina Academy of Family Physicians, the South Carolina Nurses Association, CVS Pharmacy, the South Carolina Department of Mental Health, Community Medical Clinic of Kershaw County, Eau Claire Cooperative Health Centers, and the Free Medical Clinic.

In Maryland, where nurse practitioners are already able to practice fully, a new law will lift barriers on CRNAs by removing a burdensome requirement that CRNAs maintain a written contract with a physician. The Maryland Association of Nurse Anesthetists (MANA), who championed the bill, noted that: “CRNAs strive to provide high-quality, modern anesthesia care to patients. Our certification laws should be modern, too.”

In a letter praising the new law, MANA’s President Shawn Seifert, MS, CRNA, thanked the bill’s many supporters, which included “allies in patient and professional interest groups.” The bill was co-sponsored by Delegate Bonnie Cullison and Senator Joan Carter Conway.

With these changes, South Carolina and Maryland join the ranks of a growing number of states lifting restrictions on APRNs in order to give people greater access to the care provided by highly skilled nurses. State laws govern the practice of each of the four types of APRNs: nurse practitioners, clinical nurse specialists, CRNAs, and certified nurse-midwives. In many states, APRNs can do everything they are educated and trained to do, but in some states outdated and unduly restrictive laws keep them from contributing all they can to meet America’s health and wellness needs. In 2017 alone, legislatures in more than 20 states passed laws lifting restrictions.

Note: The Campaign is closely watching states’ efforts to modernize these laws and will be reporting on the progress made in the months to come. If you are working to remove barriers to APRN practice and care and would like guidance or assistance with your efforts, please contact us. 

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• Distribution of population by race/ethnicity
• Percentage of population living in rural versus urban areas
• Distribution of population by federal poverty level
• Areas in which there is a shortage of primary health professionals

These statistics can guide your Action Coalition’s work in shaping a nursing workforce to better meet local needs and overcoming health disparities in your state. As you integrate other Culture of Health aspects into your work, consider how demographics play a role in health equity and fostering cross-sector collaboration.

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The State Implementation Program bolsters efforts already underway in 50 states and the District of Columbia—the Future of Nursing: Campaign for Action—to improve health and health care through nursing. A joint initiative of AARP and RWJF, the Campaign is working to implement the Institute of Medicine’s (IOM) evidence-based recommendations on the future of nursing. It provides a vehicle for nurses at all levels to lead system change to improve care for patients and families through collaboration with business, consumer, and other health professional organizations.

The State Implementation Program is providing two-year grants of up to $150,000 to a total of 30 state-based Action Coalitions that have developed or made substantial progress toward implementing the IOM recommendations. States must obtain matching funds to receive the grant. Grants were announced today in: Alabama, Alaska, Arkansas, Illinois, Minnesota, Nevada, Ohio, South Carolina, Vermont, and Virginia. The 20 states that received grants in February are: Colorado, Connecticut, Florida, Georgia, Iowa, Idaho, Kansas, Louisiana, Maryland, Michigan, Missouri, Mississippi, Nebraska, New Jersey, Pennsylvania, Rhode Island, Tennessee, Utah, Wisconsin, and Wyoming.

The Center to Champion Nursing in America (CCNA), an initiative of AARP, the AARP Foundation, and the Robert Wood Johnson Foundation, serves as the national program office for the Future of Nursing State Implementation Program. To learn more, read the full press release from the Robert Wood Johnson Foundation.

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A new paper, Access to Care and Advanced Practice Nurses, A Review of Southern U.S. Practice Laws, from the Center to Champion Nursing in America (CCNA), provides an overview of these laws. CCNA is a joint initiative of the Robert Wood Johnson Foundation, AARP and the AARP Foundation.

APRNs have advanced training in preventing, diagnosing and treating illness. Allowing them to provide a fuller range of services can help address provider shortages, the paper says. It is part of a new series on issues relating to nurses’ scope of practice.

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