Historians have always created timelines to depict the sequence of events surrounding a particular subject or an individual's life. Timelines can be interesting, especially if vintage photographs are strategically placed along the continuum; the reader might first be attracted by the photos but then becomes drawn in to the words that accompany the pictures. Many people simply like numbers and countdowns (or count-ups) that display one event in relation to others. The visual effect of a timeline might clarify text that is often too dense to digest, making the information easier to understand and more meaningful. Our humanness and uniqueness make some of us want to interject our own experiences along the timeline and become part of the history.
Our profession's timeline
The timeline for NPs now spans more than four decades. If you visualize the NP timeline, many dates along the way highlight the evolution of NP practice as we know it today- some events in clusters and others more distanced. Notations might represent the beginning and continued struggles, obstacles, and barriers, but also the many steps forward that celebrated small and major successes. The NP timeline would show a steady progression, depicting the continuous movement and growth of the NP role. Legislative actions would certainly consume a significant number of the timeline's notches.
This month's 22nd Annual Legislative Update gives us a glimpse into past, present, and future timelines for NP practice in the United States. Susanne Phillips once again presents a comprehensive and revealing review of where each state stands on issues vital to NP scope of practice.1
Keep moving forward
While we have come a long way over the past four decades, we must now focus our energies on removing restrictive laws and regulations so that NPs are able to practice to their full capability. Greater consistency in scope of practice laws across states should also be a goal. The Consensus Model for APRN Regulation mentioned in the report holds promise in this area. In my state of New York, NPs are still working to eliminate the mandate that NPs must enter into a signed written collaborative agreement with a physician as a requirement for practice. In reality, NPs effectively complement other healthcare professionals, including physicians, and have always demonstrated a spirit of collaboration and cooperation. A legal mandate is not necessary for NPs to provide patients with the highest quality and safest care.
A permanent reality
The NP timeline is still evolving and adding notations continues to prove interesting and challenging. Optimistically, we could try to complete the timeline for the next 5 years. Unfortunately, we would have to write in pencil and not permanent ink.
Although many legislators enjoy long terms in office, the cycling of elected officials and the uncertainty of personal lives cannot guarantee constancy and support from one year to the next. Many legislative battles have to be started over and over again, year after year. As you read this year's Legislative Update, visualize the timeline and all its complex components and tangents. These are invigorating times for NPs, but our ability to record success in ink requires all of us to actively join in the effort.
Jamesetta Newland, PhD, RN, FNP-BC, FAANP, FNAP
Editor-in-Chief [email protected]
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