KRISTI HILLMAN: Help nurse practitioners help rural MinnesotaGiving nurse practitioners independent practice authority will not only allow rural health care consumers to seek medical care in their own communities, it will keep those communities healthy and thriving.
By: Kristi Hillman, Grand Forks Herald
WARREN, Minn. — Giving nurse practitioners independent practice authority will not only allow rural health care consumers to seek medical care in their own communities, it will keep those communities healthy and thriving.
Nurse practitioners perform a vital role in rural health care. Barriers to health care access, as well as health care inequities and disparities, have forced rural residents to seek basic primary care services away from home or to not seek medical care at all.
With primary care and family practice physician shortages looming, nurse practitioners are well equipped to meet the health care needs of those in rural communities and of patients across all age spans, cultures, and geographic locations.
A look at 2012 U.S. Census and 2011 Minnesota Department of Health data shows that poor health care access and shortages of primary care physicians have a significant effect on the health of rural Minnesotans.
Nearly half of Minnesota’s population lives outside of the seven-county metro area. And compared to metro counterparts, a higher number of rural Minnesotans reported having only fair or poor health. The death rate for those living with diabetes, heart disease and stroke is higher in rural areas of the state.
Rural Minnesotans also are shown to have a higher suicide rate than people living in more populated areas.
Also alarming is the data on infant mortality rate, a major indicator of the health and wellness of a population. Northwest Minnesota, a region categorized as “isolated” by the Minnesota Department of Health, has the highest infant mortality rate in the state at 6.1 deaths per 1,000 births — higher than the 2011 U.S. infant mortality rate of 6.05 deaths per 1,000 births.
Why should choosing to live in rural Minnesota be a death sentence?
In February, a bill that would allow increased practice authority and autonomy for Minnesota nurse practitioners was introduced to the Minnesota House and subsequently referred to the House Health and Human Services Policy Committee. Unfortunately, the chairwoman of that committee — Rep. Tina Liebling, DFL-Rochester — has refused to allow the bill to be presented to the committee for hearing.
The bill, HF 0435, also has encountered robust opposition from groups such as the Minnesota Academy of Family Physicians and the Minnesota Medical Association. Liebling’s spouse, an internal medicine physician, sits on the association’s board of trustees; and the association’s political action committee contributed to Liebling’s House campaign.
This begs the question: Should the future of health care in rural Minnesota be decided by an individual with conflicts of interest? Shouldn’t it instead be decided by the committee that was designed to evaluate and debate the issue for the greater good?
Expanded provider choice and improved access are not the only reasons that practice restrictions should be removed. A 2011 study in the journal Nursing Economics shows that when compared with physicians, nurse practitioners draw equal scores in measures of patient satisfaction, health perception, functional status, glucose control, blood pressure control, rate of hospitalization and length of stay and better outcomes in patient lipid control.
That fact, along with advanced training and attention to evidence-based holistic care that is at the core of the nursing profession, makes nurse practitioners well positioned to take care of the communities they work and live in.
Hillman is a public-health nurse.