When I created the American Academy of Nurse Entrepreneurs back in 2017, I did so with the intention to help nurses open their own practices so that we – as a profession – could be a part of the cure to our declining healthcare system. If APNs knew that they could 1) actually own their own practice and 2) knew the steps to starting and growing a practice, then they could provide better care for their patients, improve their own quality of life, and be fantastic employers for the up-and-coming generation of NPs. My heart was in it from the start.
In fact, prior to starting the AANE, I was an active member of the Texas Association of Nurse Practitioners. I’ve been a guest speaker at a number of their conferences. I’ve donated to their Public Action Committee (PAC). And, I’ve also testified on behalf of TNP and Texas nurse practitioners to the state legislature. I love nursing. I love nurses. And I love this profession.
One of the things I hold dearly about nursing and my fellow nurses is that, in spite of our healthcare system’s shortcomings, nurses have always been trusted. When polled, nurses were routinely ranked at the top of most trusted professions. Throughout everything, we have collectively been a trusted profession in the eyes of the public and the people we care for.
There are many reasons we’ve earned that honor. In my mind, one of the top reasons is because nurses aren’t afraid to ask questions. We question each other, and we question the other health professionals we work with–including those in higher ranking positions. Why? Because asking questions is what’s best for the patient (i.e. – “Hey doc! This patient has a penicillin allergy. Are you sure you want me to give that amoxicillin?”)
And if we ever disagreed on something, we could have a respectful conversation. And equally so, if I ever had a question, I could ask a colleague and get the support I needed. That truth is regularly demonstrated within the AANE facebook group. Nurses are asking questions and sharing perspectives.
And up until recently, that had been my experience in other nursing forums, including the Texas Nurse Practitioners FB group.
A Policy Statement for Nurses
On November 16, 2021, the NCSBN sent a Policy Statement for “Dissemination of Non-scientific and Misleading COVID-19 Information by Nurses. (linked here)
One nurse posted the letter to the Texas NP Facebook group and started the posting with, “Correct me if I’m misinterpreting this…” and what followed was a normal, respectful post sharing her concerns about this policy. Concerns that I also shared.
The policy statement begins by saying:
For the purposes of this statement, misinformation is defined as distorted facts, inaccurate or misleading information not grounded in the peer-reviewed scientific literature …
So far so good. But the the statement continued to say..
For the purposes of this statement, misinformation is defined as distorted facts, inaccurate or misleading information not grounded in the peer-reviewed scientific literature and counter to information being disseminated by the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA). (Italics added)
And as the nurse who posted succinctly pointed out, “…if we don’t agree with the FDA and CDC and express that opinion outwardly then we could be disciplined by the TXBON?”
A valid question.
There’s a lot to be discussed here. I’m totally on board with promoting policies that are evidence based, but is everything that the CDC and FDA promote actually grounded in the literature?? No, not even close. Don’t take it from me, listen to Dr. Vinay Prasad.
But those aren’t the reasons why I’m sharing this article. It’s to share what happened after she posted her question.
Can We Ask Questions?
The moderator (also an NP holding a leadership role within the Texas NP community) turned off comments to posts, effectively ceasing any opportunity for all of us to have a conversation. Prior to turning off the comments, was there a heated, disrespectful, or childish back and forth happening in the comment section? Not at all. In typical nursing fashion, we were having a respectful discussion, as professionals.
So, I grabbed a screenshot of the original post, posted it to the group inquiring why comments had been turned off. I pointed out that I couldn’t see how the post violated the group rules and that it seemed to be an important conversation for our profession to have.
The response:
The moderator then turned off comments on that post.
Followed by her removing me from the group.
I felt comfortable messaging her privately because we know each other and she is a leader within the Texas NP community. And I asked her which group rules I violated that led to me being removed. To which she never responded.
I was later told by someone else in the community that the comments were turned off in order to “protect” the individual nurses having the conversation and to protect the profession. That’s bullshit. Who and what exactly are you protecting the profession from???
I understand that there are larger, difficult, and trigger-filled conversations associated with these topics. But they are still conversations we should be able to have with one another.
And this is what truly saddens me. Of course I have my concerns about governments and regulators abusing and misusing their power, and I’m happy to talk about that. In fact, I’ve talked about this a lot over the past two years. I’m not saying I have all the answers. But maybe we could find them, if we have conversations. But, my biggest worry isn’t about overarching government bodies…
It’s one thing to censor conversations about a “hot topic” like COVID. But it’s going to another level entirely when leaders within our own community censor conversations about censorship in our profession.
Yes, we could have private conversations, but why should this be a private conversation in comparison to all the other conversations we have in the forum that pertain to important issues in our profession? Isn’t that the function of a forum?
And remember, I’m someone who has stood side by side with nurses. I’ve stood in front of audiences of nurses. I’ve stood in front of the legislature on behalf of nurses. And I’ve regularly opened my checkbook to my state and national organizations to help nurses.
So, if I can be removed without justification, then who else isn’t getting to speak either?
My hope is simple: that nurses are able to embrace questions and conversations – especially about important topics.
We’ve all had to navigate through so many challenges these past few years. And we need to be able to talk to each other and learn from each other as we continue to serve our patients through difficult times.
Veronica Pike
FNP-C President & Co-Founder
Veronica co-founded Med2You, a healthcare company based in Austin, Texas that provides primary and psychiatric care to underserved populations with a completely remote care team led by nurse practitioners.
Veronica started her business as a single provider with a mobile “doctor bag,” cellphone and a laptop.
As a family nurse practitioner and entrepreneur who has operated her own practice since 2013, Veronica knows the unique challenges and needs APNs have when navigating the business, legal and regulatory components of starting and operating a thriving healthcare practice.
Now, her mission is to put this knowledge in the hands of other advanced practice nurses so that they can realize their full potential as clinicians, entrepreneurs and leaders in their community.
With her business partner, Griffin Mulcahey, a healthcare regulatory attorney, Veronica has designed the educational programs, resources, and community support network that is the American Academy of Nurse Entrepreneurs (AANE).
Veronica is also a sought-after speaker around the country. She speaks to healthcare entrepreneurs, clinicians, hospitals, and associations – proudly educating and helping the growing community of healthcare entrepreneurs who are giving more options and better care to communities around the country.
Practicing Patient Autonomy Within Your Practice
Patient autonomy has become a buzzword in our industry and it tends to be discussed like a philosophy, but rarely in terms of actual patient interaction. So, today I'd like to share some insights about patient autonomy and how you can approach it in your practice.