Independence Day, A Father’s Wish and a Bedpan

What does independence day, a father’s wish, and bedpans have to do with full practice authority?

Independence Day…

It’s a bittersweet time of the year for me. My father was really big on holidays and especially liked to have fireworks at home for us kids (with strict safety procedures in place I might add!).

His last 4th of July was spent in the hospital, leaving me (daughter #1) with fireworks duties for my younger siblings. Of course, he gave me explicit instructions over the phone, with a mandate that Mom keep an eye on it all.


The next morning, I was able to report that all went well and of course, let him know who behaved well and who did not.  It was 1971 and he died the next evening.

My Father’s Wish

My father was big on “liberty and justice for all”. We had lived through the turmoil of the 1960’s. He wanted all his children to do well in life – and that included lots of education and a stellar career. He did not want us struggling as he and my mother had.

His instructions to me included being a doctor, a lawyer, or the president of the United bariatric-bedpan-steelStates (progressive!). Until the last few years of his life, being a nurse was “okay”. Unfortunately, he experienced first hand what nurses in hospitals did in those days. No daughter of his was going to have to follow the orders of a doctor or carry a bedpan.

He wanted freedom for this children. Freedom to be who we were and do what we would one day be educated to do. For him, education equaled freedom.

Full Practice Authority – for all

As I reflect back on his words and apply them to my current situation, those words continue to ring true. Each of us should all have the freedom to practice to the full extent of our education and training.

All healthcare providers should be free of the restraints put on them by other providers, payers, and silly, inefficient legislation that hamper our freedom to do what we are educated to do.

All patients should have access to the healthcare provider of their choice. And no one should have to make a choice between feeding their family or getting basic healthcare services.

Good providers should not be driven out of healthcare because someone else controls how fast the hamster wheel has to turn or how long we have to sit on the phone to obtain a prior authorization. Nor should they have to worry about getting paid (or having the money taken back) for the work they do.


And of course, nurse practitioners and other APNs should not have to worry that their practice can be shut down because a physician has decided to stop being a collaborating physician as required by most of our states. The Institute of Medicine Report on the Future of Nursing, the Federal Trade Commission, and over 50 years of research shows this legislation to be archaic, redundant and unnecessary.

We all know that healthcare is a business. I have no problem with that. In fact, it’s my choice to be a healthcare provider in my own business. However, I do have a problem when smaller, independent offices are being squeezed from all sides, making it difficult, if not impossible for them to do what they do best – care for healthcare consumers.

Our country is supported by small business and it should support small business and that includes smaller healthcare practices. I shutter to think what will happen if that goes away.

My Wish

My dream is to allow all independent providers (APNs, PAs and Physicians) to practice in a way that works for them and their patients. Practice in a way that allows us to be at our best..where our patients are cared for in an appropriate manner, and we (like everyone else) are paid fairly for the work we do. No hamster wheels in this dream.

In other words, freedom to practice for all. Freedom for consumers to access care, and freedom for us all to have a balanced life full of joy, love, and purpose.

As for my father…I bet he’d still be talking about freedom. He’d also be glad his daughter is no longer carrying a bedpan.

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  1. Great post, Barbara. I agree with you… Freedom is important. In all aspects, including at the workplace. It’s actually one of my most important values I put above many others. Thanks for sharing both your personal experiences and the professional encouragement in this post. Great work!

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