What it will mean for health care when California’s nurse practitioners get more freedom under new law
What happens when there isn’t a family doctor in the house? Most likely, a nurse practitioner can help.
Whether it’s writing prescriptions, ordering tests or offering treatment options for patients with chronic conditions like diabetes, NPs perform much of the same work as family doctors.
But there’s a catch: NPs haven’t had the freedom to practice without a doctor’s supervision.
That will soon be changing, thanks to Assembly Bill 890, legislation authored by Assemblymember Jim Wood, D-Santa Rosa, designed to allow NPs to practice on their own. There are many provisions to the legislation, including NPs qualifying only after having worked for three years under a doctor’s supervision. But in its entirety, AB 890 will give NPs more autonomy than ever before. Gov. Gavin Newsom on Sept. 29 signed the bill into law, which will take effect on Jan. 1, 2023.
“For the past decade, there have been multiple attempts in the Legislature to make this change,” Wood said in a Sept. 29 press release announcing his bill had been signed into law. “During that time, it became obvious to me that we have a serious shortage of primary care physicians, so I dove into the issue – the need, the research and what other states have done – in order to come up with an appropriate process that can improve access to quality health care, especially in rural and underserved areas.”
California will join more than two dozen other states that already allow nurse practitioners more freedom when treating patients, he noted.
AB 890’s main opposition throughout the years has come from the California Medical Association, which advocates for physicians. Among the group’s gripes is its long-held position that allowing NPs to work without a physician on-site would result in a lower standard of care.
Nurse practitioners first came onto the scene in 1965, with their role and education levels evolving over the years. Today, an NP must be a registered nurse, hold a bachelor’s degree in nursing, complete an NP-focused graduate master degree or doctoral nursing program, and successfully pass a national NP board-certification exam, according to the American Association of Nurse Practitioners.
NPs focus on managing people’s health conditions and preventing disease. They often specialize in treating one segment of the patient population, be it pediatrics, adults or geriatrics. NPs with advanced certification may add a subspecialty, such as dermatology, cardiovascular health, women’s health or oncology, according to the association.
Passionate about the profession
Surani Hayre-Kwan, a nurse practitioner who since 2002 has practiced at Russian River Health Center in Guerneville, has had her eye on the profession since she was a child.
“I had always wanted to be a nurse practitioner,” Kwan said, recalling the NP who treated her while growing up in Marysville, in Yuba County. “I just fell in love with her as a provider. She was so warm and approachable. I learned how to spell ‘nurse practitioner’ even when I was 10 because I wanted to be (one).”
Kwan has been a registered nurse for 26 years, and a nurse practitioner for 18 of those years. She also works in management at Sutter Health, serving as director for professional practice and nursing excellence.
Kwan, who completed her advanced studies at Sonoma State University, has been involved with the California Association for Nurse Practitioners since her college days. She is a past president, and has served on the board of directors and on the policy committee. She was eager to see AB 890 become law.
“We have been working on practice issues for decades, looking at the option to remove standardized procedures, which is a really an administrative restriction on our practice,” Kwan said. “I always like to explain to the press and to legislators that nurse practitioners are not trying to do anything beyond what we're trained to do, ever. I am not a physician. I've never been a physician, and I have no interest in being a physician.”
Every year, Wood and other Assembly members in the state honor someone from their district who stands out for their service to the community.
This year, Wood named Kwan “Woman of the Year” for his district.
“Today, I’m recognizing your commitment, compassion and dedication to providing high-quality health care as a nurse practitioner to individuals living in the North Bay area,” Wood told Kwan during a Sept. 10 presentation in front of her clinic. If this were any year other than 2020, Kwan would have been honored at a luncheon and event at the state Capitol.