California’s nurse practitioners play a critical role in a stretched healthcare system

For the past several years, California nurse practitioners have been advocating for legislation that would grant them independence. With the work of a tremendous coalition, we were able to get the bill passed. In September of 2020, Gov. Gavin Newsom signed Assembly Bill 890 into law.

We spent many months educating policymakers and our elected leaders about the role and education of nurse practitioners. The bill had strong bipartisan support and is in the implementation process. This new law will allow nurse practitioners to help provide quality health care and expand access for those desperate for care.

I was proud to be part of this effort.

During the legislative process, we accepted amendments to AB 890 that included several provisions that ensure patients are guaranteed consumer protections and disclosure, including a requirement that Spanish language speakers be informed using the term “enfermera especializada.” This term, which loosely translated means nurse practitioner, was agreed upon during the process of crafting the bill.

There are many safeguards in current law and statute that require everyone is guaranteed access to translation and services in a language they can understand. Our patients understand who is caring for them when they see a nurse practitioner. The law also requires that the nurse practitioner must post a notice that they are regulated by the Board of Registered Nursing. We are proud to post our qualifications for all patients.

Nurse practitioners are advanced practice registered nurses. We hold a master’s or doctorate degree, and many nurse practitioners also pursue specialty training in areas like pediatrics or women’s health. We diagnose, prescribe medications, conduct physical exams and promote health by ordering screening or preventative therapies.

After graduating from two Ivy League institutions, I returned to the same Northern California community that raised me to provide care. As a bilingual Latinx nurse practitioner, I provide exceptional health care to my own community. I specialize in pulmonology, the focus on the health of the respiratory system. While the past two years of COVID have been a challenge, the importance of my work has never been greater.

With specialty care in Northern California so impacted that waiting times to see a specialty physician is often more than three months, I know the frustrations of patients forced to wait for care. This issue is compounded by the fact that many specialists will not contract with Partnership Health Plan or accept MediCal insurance, further exacerbating the inequities facing marginalized and low-income communities.

In addition, California is suffering from a lack of primary care doctors. The federal government recommends 60 to 80 primary care doctors per 100,000 people. In reality, this number is down to just 50 per 100,000. Moreover, in a 2020 nationwide survey of doctors, advanced practice providers, and nurses, a third of respondents plan to reduce their work hours in the next 12 months. One in five doctors says it’s likely they will leave their current practice within two years.

The Northern Bay Area is especially hard hit as more doctors retire, leaving more gaps in an already stretched healthcare system. I have seen this first-hand as more people are forced to wait longer for doctor visits or travel longer distances for routine care.

I’ve been able to provide care to my own Latinx community through times of wildfire and the pandemic, moments in our recent history that have laid bare the disproportionate health and economic burdens facing my community. In addition to providing specialty healthcare, I have also helped my patients find housing; I have advocated for better working conditions; encouraged the vaccine-hesitant to receive their COVID vaccines; and helped direct patients to mental health and substance abuse services.

As some continue to oppose efforts to expand access to healthcare, California’s nurse practitioners look forward to practicing independently and providing quality care across California.