Future of Nurse Practitioner Workforce During Ongoing Burnout, Extreme Fatigue, Stress

Contemporary Clinic interviewed April Kapu, RN, a professor at Vanderbilt University; acute care nurse practitioner based in Nashville, TN; and president of the American Association of Nurse Practitioners (AANP), on the future of the nurse practitioner workforce amid growth in the field and simultaneous extreme fatigue and stress among health care workers.

Alana Hippensteele: Hi, I’m Alana Hippensteele with Contemporary Clinic. Joining me is April Kapu, RN, a Vanderbilt professor; acute care nurse practitioner based in Nashville, TN; and president of the American Association of Nurse Practitioners, or AANP, which represents over 350,000 nurse practitioner, who is here to discuss the future of the nurse practitioner workforce amid simultaneous growth in the field and extreme fatigue and stress among health care workers following the COVID-19 pandemic.

So what is the future of the nurse practitioner workforce amid ongoing challenges relating to burnout and extreme fatigue and stress?

April Kapu: I think that's an excellent question. We know that we are growing at a rate of 9% to 10% per year, and that our growth rate in the upcoming years will continue because nurse practitioners are in high demand.

We've shown that we provide very high quality, very valuable, and vital health care services to everyone everywhere, [and] we've increased access to care. Especially in those states that I had mentioned that have full practice authority, we've seen in those states the workforce increase, we've seen more access, more NPs moving to rural areas. Nebraska alone—when they moved to full practice authority, 25 of their counties that had historically been known as provider shortage areas, 25 of those counties saw an increase in nurse practitioners moving to rural areas. So this is substantial.

In order to keep our workforce supported and growing and meeting those needs, we need states to update their laws so nurse practitioners can practice to the full extent of their education and training. We mentioned mental health and the health and wellbeing of nurse practitioners, we can fall to the ‘Future of Nursing’ report 2020 to 2030—recommendation number 3 [is] we need to support the health and wellbeing of our nursing workforce, so that they can achieve all that is important to providing health care for healthy lives for everyone everywhere. Health equity is huge, understanding social determinants of health, access to care—these are very important matters in the future in the direction of nursing and all of health care, and to do that we need to support the health and wellbeing of our caregivers and surround them with infrastructures and support that destigmatize mental health services that support mental health and all those things that we had talked about earlier.

Alana Hippensteele: Kind of looking beyond that to the nurse practitioner workforce more broadly speaking, what is your outlook on the future based on your work supporting nurse practitioners at AANP?

April Kapu: So the American Association of Nurse Practitioners—we are the largest nurse practitioner organization in the world. It's a member-driven organization, so it's members speaking up and voicing what their needs are for their practice. So we have lots of practice tools to support voicing their needs in terms of education. We have workshops, online courses, continuing education, conferences, journals—so many different ways for nurse practitioners to immediately access education—podcasts—lots, and lots of ways to immediately have access to education and advocacy—we have an amazing state and federal advocacy team.

For research—not often do we mention how engaged AANP is in research to better patient care outcomes, but also to continually demonstrate our impact to health care and continually demonstrate the quality outcomes of NP practice.

Then leadership—we have so many opportunities for NPs to take different paths to lead. They want to be more of an executive leader, if they want to lead in health policy, if they want to lead more in the educational realm. We have lots and lots of resources to help develop those relationship skills. So a lot of resources for support and much of this is just really driven by the voice of our members.