Healthcare reform and state economics will likely increase demand in Arkansas for Advanced Practice Nurses over the next few years, said Jean K. Zehler, MSE, president of the Arkansas Nurses Association.

 

In the nursing field, the new healthcare reform legislation will have the biggest impact on Advanced Practice Nurses, or APNs, Zehler said. Because APNs, through a collaborative practice agreement with a physician, can prescribe medications, they will be in greater demand as primary care providers for the state's uninsured.

 

The Arkansas State Board of Nursing recognizes four categories of APNs: Advanced Nurse Practitioner; Certified Nurse-Midwife; Clinical Nurse Specialist; and Certified Registered Nurse Anesthetist. Arkansas law does not require the collaborating physician to be at the same site as the APN.

 

Zehler has been president of the Arkansas Nurses Association, also known as ARNA, since October 2007. She is currently the magnet coordinator for the Central Arkansas Veterans Healthcare System in Little Rock. She worked for many years as a nurse educator directing hospital and nursing education departments.

 

ARNA recognized Zehler as Nurse of the Year in 1987. She has twice received the Distinguished Service Award, and in 2006 received the President's Award. Since 1993, Zehler has been the nurse responsible for the ARNA Approver Unit, which is accredited by the American Nurses Credential Center's Commission on Accreditation.

 

Zehler said APNs can also help the state's Medicaid division contain costs by taking on a greater role as primary care providers.

 

Gene Gessow, who was appointed Arkansas' Medicaid director in December, asked organizations and agencies throughout the state to submit proposals on how Medicaid can compensate for an expected budget shortfall.

 

“ARNA submitted a proposal showing how we can save millions by increasing use of APNs,” Zehler said. The deadline for submissions was in February, and the recommendations are now posted on the Arkansas Medicaid Web site.

 

Specifically, ARNA recommended:

 

 

Arkansas' Medicaid program serves about 750,000 people each year, according to the division's Web site.

 

As the need for advanced training for nurses continues to grow, Zehler said a new role in nursing, the Clinical Nurse Leader, is emerging. The CNL is a credential developed over the last few years and trademarked by the American Association of Colleges of Nursing. The Clinical Nurse Leader Association's Web site states that this is the first new role in nursing in more than 35 years.

A CNL is an advanced generalist clinician with education at the master's or post-master’s level in a formal CNL education program. CNLs practice at the point of care, with a focus on evidence-based practice, safety, quality, risk reduction and cost containment, according to the CNLA.

 

The University of Central Arkansas in Conway is nearing its own CNL program. 

 

“Currently, we are in the approval process for a Clinical Nurse Leader track within our graduate nursing degree program, and hope to implement it next academic year,” said Barbara Williams, PhD, UCA chairman of the Department of Nursing. “It has been developed by the graduate nursing faculty and per UCA's policies, is now being considered by other bodies on campus. This summer (assuming university approval) it will be considered by the Arkansas Board of Higher Education, because it is a new graduate track for us. I fully anticipate that it will receive approval at each stage.”
In 2009, 102 schools in 38 states had CNL programs. Another 15 schools were in the planning or development stage, according to a presentation given at a conference sponsored by the AACN and the Department of Veterans Affairs.

 

Currently, master's degree-level education is available at many universities for clinical nurse specialists, nurse practitioners and nurse educators.