Recent changes from the Department of Education have downgraded the classification of many healthcare providers. Nurse, nurse practitioner, physical therapist, and physician’s assistant will no longer be classified as “professions.”
It should come as no surprise that the roles deemed to be no longer “professions” are more often held by women. Under this stupid and short-sighted bill, only “professional degree” students are eligible for the higher loan limit of $200,000, while graduate students are capped at $100,000. They will not be able to afford the higher education, decimating the number of people who can pursue these careers. This comes at a time of crisis in primary care.
It has made me reflect back on why I became a nurse practitioner in the first place. I was 5 years into a successful career in biotech. It was interesting, but it didn’t feed my whole self.
When I first told people I was going to graduate school to become a nurse practitioner, many in my circle assumed it was because I couldn’t get into medical school. Many of my classmates had heard the same thing. Nursing was my first choice. My only choice. I had learned about the nurse
practitioner role when I was a volunteer at a local clinic.
They were highly trained AND cared for the whole person. I chose nursing because I wanted to focus on the person with diabetes, the person with high blood pressure, not the disease itself. Prescribing a medication won’t help if the person won’t take it, believes it won’t work, don’t understand it, or their family is against it. Ordering a test won’t help if they can’t afford it.
Nursing looks at the person, the family, the societal contexts. We know that a prescription for birth control is often about a change in relationship status. We know that a test for STDs may be requested because of a sexual assault someone is too afraid to report.
People feel seen and safe with us. We can have the hard conversations when people ask:
- What if I have cancer?
- What if I can’t have kids?
- Am I having a heart attack?
- Will anyone ever want me, after a diagnosis with a chronic STD
Nurses have also been at the core of many of important advances in healthcare, as well as other fields, such as forensics. Public health policies and preventive care programs were created by a nurse (Lillian Wald). Basic standards for cleanliness in care for wounded soldiers came courtesy of Florence Nightengale. Criminal profiling was based on research of a nurse (Dr. Ann Burgess)
Nurses care for our socioeconomically disadvantaged, and those living in medical deserts. They collect rape kits. They explain wound care. They are the primary hospice providers. But we nurses know all of this. We don’t ask for recognition, accolades, or adoration. We don’t need external validation. That is not why we do what we do.
This change from the Department of Education isn’t just insulting to our profession. It’s deadly. Who is going to take care of you? If we just consider the impact to primary care. Nurse practitioners and physician assistants were responsible for a quarter of all health care visits. Among all patients with at least one visit in 2019, 41.9% had one or more nurse practitioner or physician assistant visits (BMJ 2023;382:e073933 Published 14 September 2023).
This comes at a time when many physicians are looking for a way out of primary care. The 2022 Commonwealth Fund International Health Policy Survey of Primary Care Physicians found that nearly half of physicians reported burnout, and over one-third of these burned-out physicians said they plan to stop seeing patients in the next one to three years. If we don’t encourage and enable a steady stream of new providers, we are all in trouble.
The ANA has started a petition that nurses can sign to “call on the Department of Education to revise the proposed definition of ‘professional degrees’ to explicitly include nursing.”
Nurses can sign the petition directly on the ANA’s website and be subscribed to Action Alerts for updates about the petition, bill, and other efforts in which they can get involved.
