Tiffany Rossi

During the first four years of my career as a nurse at the bedside, I had witnessed firsthand the dire need for more advanced practice nurses to step into the role of primary health care providers to meet the increasing needs of our ever-growing population. While caring for patients in the acute care setting, I had frequently taken care of patients that would not have been hospitalized if they had adequate access to their primary care provider. Often times when our patients come into the hospital, they reveal to us that they would attempt to make appointments with their primary care provider and they could not get appointments for months and when they finally do get into the office for their appointment, they would feel rushed or not want to impose on their provider or "waste" their provider's time with their concerns, which could have ultimately prevented their hospitalization later down the road.
The overwhelming patient population demand is not being met in today's society by the current supply of primary health care providers, which is putting an overwhelming and unnecessary strain on Emergency Departments and acute care hospitals around the country. Thus, creating a vicious cycle of patient's abusing the health care system by overusing Emergency Departments for non-emergent situations that could have been treated by a primary care provider, causing extended wait times in Emergency Departments, which could potentially increase negative outcomes for patients, an increasing number of "social admits" that do not have acute health issues that need acute care but are using acute care resources inappropriately, which leads to increased number of patients needing to be admitted being held in the Emergency Department, and so on and so forth. Every aspect of this vicious cycle only exacerbates the nursing staffing crisis in the acute care setting, which also increases the potential for negative patient outcomes and sentinel events.
Advanced practice nurses, particularly Family Nurse Practitioners, have the ability to step into the role of primary care provider for the lifespan of the patient population and provide continuous and comprehensive care that is holistic, focused on health promotion, and patient education, which can potentially prevent unnecessary hospitalizations and improve the quality of life for the patients.
Another commonly observed situation as a nurse at the bedside in the acute care setting is that patients frequently come into the hospital without the knowledge or education to be in control of their own health. Frequently, we have patients that can only tell us the names of their illnesses and medications they take for it and that is the extent of their knowledge. Sometimes, they are even unable to tell us what organ is involved with their illness or they barely know the name of their medications and are oblivious to what condition they are actually taking those medications for. These patients are blindly being subjected to polypharmacy instead of being educated about their health and being put in charge of it.
Health care is ever-evolving and the mindset that "the health care provider ordered these medications so I am just going to take them blindly and put my health in that person's hands without questioning or gaining knowledge of my own health" needs to be phased out and that can only be achieved by current and future health care providers focusing on patient education and health promotion. I believe that current younger generations and future generations will be taking a more autonomous role in their health, where they will be seeking more education and taking accountability for their own health, which will fall back onto the health care providers to meet the evolving needs of society.
Therefore, my goal as a Family Nurse Practitioner is to provide quality, continuous care to my patients across the lifespan that ultimately focuses on increasing patient autonomy in regards to their own health through patient education and health promotion. I truly believe that if all of the current and future health care providers could follow suit, we could revolutionize health care in our country. I know that I am not the only person in health care that shares this point of view and many other health care providers out there have the same goal and are actively pursuing it. Health care has evolved tremendously over the last hundred years or so and it will continue to evolve long after I am gone, but I want the focus of my career to be that I actively contributed to the bigger picture of a better health care system for all.