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Nursing Coalition Praises Commission on Care Recommendations to Improve Veterans’ Healthcare

Nursing Coalition Praises Commission on Care Recommendations to Improve Veterans’ Healthcare
APRNs, RNs looking forward to being part of solution to improve access to timely care

WASHINGTON, D.C. — Advanced practice registered nurses (APRNs) and other registered nurses (RNs) in the Veterans Health Administration (VHA) stand ready to be part of the solution to improve veterans' access to timely, quality healthcare by working to their full practice authority as recommended by the Commission on Care in a report to the White House on July 5, said Juan Quintana, DNP, MHS, CRNA, president of the American Association of Nurse Anesthetists (AANA).

The commission, established as part of the Veterans Access, Choice, and Accountability Act of 2014, was charged with examining veterans' access to VHA healthcare and determining how best to deliver healthcare to veterans during the next 20 years. The 308-page report was the culmination of an exhaustive 10-month assessment by the commission.

Speaking on behalf of a Nursing Coalition which endorses direct access to APRNs including Certified Nurse Practitioners (CNP), Certified Registered Nurse Anesthetists (CRNA), Certified Nurse Midwives (CNM), and Clinical Nurse Specialists (CNS), Quintana said that allowing all VA APRNs to practice to the full scope of their education and abilities without physician supervision would improve veterans' access to essential healthcare by reducing long wait times for appointments and services.

The commission's recommendation supports a Veterans Administration (VA) proposed rule to grant direct access to VA APRNs that was published in the Federal Register on May 25; comments on the rule are being accepted by the VA until July 25. With less than two weeks to go, more than 62,000 comments have been received from veterans, healthcare professionals, and the general public, mostly in favor of the rule.

"The evidence cannot be denied," said Quintana. "The commission's final report adds more data to the growing stack of evidence highlighting the need to allow all APRNs to have full practice authority as a major step toward increasing veterans' access to quality healthcare." 

During its examination of veterans’ access to healthcare and how to best deliver healthcare services over the next two decades, the commission reviewed the results of the independent assessment of the VHA that was ordered by Congress in 2015; met with a broad range of stakeholders, including veterans and leaders of Veterans Service Organizations; made site visits to VHA facilities; and exchanged ideas with VA leaders and employees, members of Congress, and healthcare experts. Ten APRN and nursing groups provided an outline for the commission on the role and recommendations of APRNs to improve VHA healthcare delivery.

"The American Organization of Nursing Executives (AONE) applauds the Commission on Care for its support of full practice authority for advanced practice registered nurses in the VHA," said Maureen Swick, RN, MSN, PhD, NEA-BC, AONE chief executive officer/American Hospital Association senior vice president, Nursing. "APRNs are a vital link to ensuring quality care is readily accessible for America's veterans."

"The clinical evidence and informed recommendations that patient care is improved by direct access to APRNs continue to grow," said Cindy Cooke, DNP, FNP-C, FAANP, president of the American Association of Nurse Practitioners (AANP). "Veterans, the AANP, other APRN groups, the VA, and now an independent congressional commission on the VHA all agree that the VA's highly-qualified APRNs, including 4,800 nurse practitioners who provide a wide range of healthcare services, are the right solution to ensuring veterans have access to timely, quality healthcare."

American Nurses Association (ANA) Chief Executive Officer Marla Weston, PhD, RN, FAAN, who previously served in the VHA as program director in the Office of Nursing Services and then as deputy chief officer in the VA Workforce Management and Consulting Office, praised the commission's recommendations on clinical operations.

"The commission's recommendation that clinical operations should be enhanced through more effective use of health professionals – particularly optimizing use of advanced practice registered nurses – along with improved data collection and management, is right on target," said Weston. "The commission's recommendation is consistent with the recommendations of the National Academy of Sciences to remove scope-of-practice barriers and allow the VA to fully utilize the skills of its APRNs to the full extent of their education, training, and certification."

The American Association of Colleges of Nursing (AACN) commended the commission for recognizing that the way in which APRN students are educated must align with how they practice to achieve the best patient outcomes. "The Commission on Care should be applauded for its steadfast work to advance recommendations based on the evidence," said Juliann Sebastian, PhD, RN, FAAN, chair of the AACN Board of Directors. "For our nation's Veterans to receive the care they need, when they need it, we must look to the decades of data that show APRNs excel in providing high quality care when practice barriers are removed."

The VA's proposed policy to allow direct access to APRNs in order to improve veterans' access to timely healthcare is supported by veterans groups such as AMVETS, Paralyzed Veterans of America, Military Officers Association of America, and Air Force Sergeants Association; AARP (whose membership includes 3.7 million veteran households); numerous healthcare professional organizations; and more than 80 Democratic and Republican members of Congress.

Comments on the proposed rule can be submitted at

Coalition Members
For more information about the coalition members, visit: 
American Association of Colleges of Nursing (
American Association of Nurse Anesthetists (
American Association of Nurse Practitioners (
American Nurses Association (
American Organization of Nurse Executives (


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