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EPISODE SUMMARY:
In this episode of Frank About Health, Frank R. Harrison is joined by nurse practitioner leader and entrepreneur Lynn Rapsilber, alongside healthcare strategist and coach Phyllis Quinlan, for a timely conversation about why one of the most essential healthcare workers in America is still struggling to practice, lead, and thrive. While nurse practitioners are trusted providers on the front lines of chronic disease management and community care, the discussion reveals how regulatory barriers, lack of business training, and outdated reimbursement models continue to limit their impact and restrict patient access in the process.
Together, Frank, Lynn, and Phyllis unpack the real-world consequences of scope-of-practice restrictions, rising educational debt, and monopolized control over coding and reimbursement by institutions such as the American Medical Association. Phyllis brings a broader systems and leadership lens to the conversation, helping frame these challenges within a larger transformation of healthcare delivery and previewing an upcoming Frank About Health mini-series focused on the Nurse Practitioner Experience. The episode moves beyond critique to spotlight collaboration, collective advocacy, and practical pathways for elevating nurse practitioner voices—making it essential listening for clinicians, healthcare leaders, policymakers, and anyone invested in building a more sustainable, patient-centered healthcare system.
Lynn Rapsilber:
Website: www.nnpen.org/Lynn-Rapsilber
Consulting Page: www.npbusinessconsultants.info/about-lynn.html
LinkedIn: www.linkedin.com/in/dr-lynn-rapsilber-dnp-anp-bc-faanp-b6238114/
Phyllis Quinlan:
Website: mfwconsultants.com/
LinkedIn: www.linkedin.com/in/phyllisquinlancoachspeaker/
Instagram: www.instagram.com/phyllisquinlanofficial/?hl=en
Tune in for this healthy conversation at TalkRadio.nyc
Frank R. Harrison opens the episode “Nurse Practitioners Need a Seat at the Table” with co-host Phyllis Quinlan and guest nurse practitioner Lynn Rapsilber, framing the conversation around how healthcare disruption is reshaping (and too often limiting) what nurses and NPs are empowered to do across different systems. Drawing from his own caregiving experience, Frank positions himself as a learner and sets up a practical exploration of what differentiates NPs from other nursing roles—and why their clinical perspective should be included in leadership and policy decisions. Rapsilber and Quinlan argue that nursing leadership and NP practice ownership both hinge on business fluency (finance, coding, billing, documentation, audits), highlighting Rapsilber’s National Nurse Practitioner Entrepreneur Network as a training-and-community model designed to equip NPs to sustainably expand access and close care gaps without losing the patient-centered core of nursing.
Frank spotlights a core tension in today’s workforce: if nurse practitioners are highly trained and widely trusted, why do legal and institutional barriers still limit their scope—prompting Lynn to argue that nursing’s long-standing fragmentation (between academia, clinical practice, and advocacy) has weakened its ability to unify around policy, even though a mobilized nursing workforce is powerful enough to move mountains. Lynn points to COVID-era emergency waivers as proof of concept—APRNs/RNs practiced with far fewer constraints to meet urgent needs, but once the public health emergency ended many states reverted, creating a “genie back in the bottle” effect that disrupts access and blocks a ready-and-growing NP workforce from filling care gaps. Phyllis then zooms out with a rapid history of nursing’s evolution—from family care and religious orders to Florence Nightingale’s data-driven foundations and the shift from hospital diploma apprenticeships to university-based education—showing how nursing became the world’s most trusted profession and how advanced practice roles (CNS/NP, and now doctoral prep) emerged as the system’s demands expanded, setting up the next discussion on NP preparation and entrepreneurship.
Frank and Phyllis tee up the NP role as a “disruptive” evolution of nursing, and Lynn traces it back to Dr. Loretta Ford’s public-health vision: NPs were designed to extend competent, community-based care, and today follow a rigorous pathway (RN licensure → population-focused graduate training → competency-based clinical preparation → national certification exam → state APRN licensure, often maintaining both RN + APRN credentials). They underline how substantial the hands-on training is—thousands of clinical hours layered on top of foundational RN education—along with advanced coursework (pathophysiology, pharmacology, assessment, evidence-based practice), and Lynn points to decades of research and the COVID era as real-world proof that NP care is high-quality, safe, and cost-effective while expanding access. The conversation then pivots to why entrepreneurship is rising among NPs: the current system’s compressed visits and compartmentalized care clash with whole-person practice, so more NPs are building sustainable models that can still serve Medicare/Medicaid and underserved populations (while using add-on services and employer/veteran partnerships), and they also highlight the growing push toward integrative, non-pharmacologic options—tempered by the practical challenge of training and reimbursement.
Frank ties the conversation to pop culture and lived experience—using M*A*S*H as a window into how wartime (and later COVID) made nursing’s value impossible to ignore—then asks directly whether nurses and NPs were elevated to “hero” status during the pandemic. Lynn confirms that public gratitude was real (she recalls New Yorkers cheering healthcare workers from their windows) and argues the moment helped move nurses from “side note” to decision-makers—if there isn’t already a seat at the table, nurses should “pull up a chair.” Phyllis expands that COVID created a true interprofessional “level playing field” where everyone adapted, and she frames the lasting takeaway as empowerment and post-traumatic growth—healthcare workers discovered deeper strength and leaders should build on that momentum rather than trying to constrain it. They pivot into advocacy and what comes next: Lynn cites a Commonwealth Fund survey (2019) where the public chose nurses as the group they trust most to fix healthcare, and Phyllis notes the growing presence of nurses in elected office as a path to more patient-centered policy. On the “better times are coming” theme, Phyllis plugs her upcoming book on workplace disruption—specifically bullying and incivility as missing pieces of healthy work environments—while Lynn shares her in-progress tutorial book to teach nursing students coding, billing, and documentation so they can understand revenue, negotiate wages, and succeed in practice. The segment closes with concrete next steps: Lynn’s business-focused NP entrepreneur conference in Tampa, and a planned Frank About Health mini-series beginning February 26 (skipping Feb 19) through roughly March 12, possibly including webinar-style educational episodes and live Q&A to help clinicians and advocates “arm themselves” with practical knowledge for the year ahead.
00:00:53.050 --> 00:01:10.919 Frank R. Harrison: Hey everybody, and welcome to a new episode of Frank About Health. It is February 12th, 2025. I'm still wearing my red for Heart Health Awareness Month, and I'm glad that you are here to meet with me and my favorite co-host, Phyllis Quinlan, in addition to our special guest today, Lynn Rapsilber.
00:01:10.920 --> 00:01:14.020 Frank R. Harrison: Both of them are nurse professionals.
00:01:14.020 --> 00:01:17.370 Frank R. Harrison: And I have to say that we're gonna get a very interesting take
00:01:17.370 --> 00:01:35.230 Frank R. Harrison: Not just from the global view of nursing, which you've heard on this show many times from Phyllis, but also in the role of nurse practitioner, which is what Lynn Rapsilber is part of, in terms of her advocacy group, her entrepreneurial network, as well as other information that you're gonna get on this particular episode of Frank About Health.
00:01:35.230 --> 00:01:48.450 Frank R. Harrison: I will issue my usual disclaimer. Any of the information you hear today are not the views of TalkRadio.nyc or of Frank About Health, but they represent what is going on in the nursing profession today.
00:01:48.450 --> 00:02:01.530 Frank R. Harrison: If this is not a topic of interest for yourself, that is fine. It's food for thought to be taken as just information to converse about with your family, friends, fellow caregivers, so forth and so on.
00:02:01.530 --> 00:02:12.050 Frank R. Harrison: That being said, I want to first take the time to tell you why I chose to name this episode, Nurse Practitioners Need a Seat at the Table.
00:02:12.250 --> 00:02:19.950 Frank R. Harrison: That's because, as you all know from my Voices of Disruption campaign, our healthcare system has been going through just that.
00:02:19.950 --> 00:02:41.579 Frank R. Harrison: total disruption. It could be political, it could be economic, it could be social, it could be new technologies or innovations that have been funded or defunded, it could be a whole host of things, but that does not change the dynamics of the individual caregivers, or doctors, or specialists, or nurses, or nurse practitioners. They all
00:02:41.620 --> 00:02:50.379 Frank R. Harrison: Have the same role, which either gets restricted or gets expanded, depending on the hospital system or the circumstances that might be involved.
00:02:50.470 --> 00:03:05.290 Frank R. Harrison: For myself, an avid caregiver for the last 4 years, especially for my father, still recovering from prostate cancer, I have seen many nurse practitioners come inside this house to view the different side effects that my father's been going through.
00:03:05.290 --> 00:03:16.569 Frank R. Harrison: to view his typical vital readings and understanding of his mobility and other kind of limitations that he has now had to adapt to. And I always come up with the question.
00:03:16.900 --> 00:03:22.650 Frank R. Harrison: What is really the difference between this nurse practitioner and the nurse that was here last month?
00:03:22.820 --> 00:03:34.969 Frank R. Harrison: So, I am going to be sitting here in this episode as a student. So, I want to spend most of this particular episode, of this segment of the show introducing both of them. I will let Lynn go first.
00:03:34.970 --> 00:03:51.680 Frank R. Harrison: to introduce her background and her information, and what she would like all of you to have as a takeaway once this episode ends. And then Phyllis will, of course, moderate the conversation with Lynn over the segments 2 and 3 to really show the dynamic differences between the two
00:03:52.150 --> 00:03:59.820 Frank R. Harrison: Nurse professionals, because they have roles that intersect, as well as roles that are completely differentiated.
00:04:00.070 --> 00:04:06.000 Frank R. Harrison: Alright, I guess, geez, Phyllis, I think I gave a little monologue there. That's one of my first, you know?
00:04:06.030 --> 00:04:10.089 Phyllis Quinlan: No, that's okay, you did a good job, you did a great job.
00:04:10.090 --> 00:04:23.299 Frank R. Harrison: Thank you, thank you. And so, of course, welcome back, Phyllis, all the time. And Lynn, welcome to Frank About Health. Once you unmute, I'd like you to share with my audience of listeners and followers, your background.
00:04:23.880 --> 00:04:24.489 Lynn Rapsilber: Oh, thank you.
00:04:24.490 --> 00:04:35.740 Frank R. Harrison: brag about health. Oh, and by the way, thank you to Sam Leibowitz, because I know that not only did you refer me to Phyllis all those years ago, but you have also referred me to Lynn, so I want to thank you for that. Okay.
00:04:35.740 --> 00:04:53.980 Lynn Rapsilber: Yes. Thank you, Sam, and thank you, Frank, for being here, and Phyllis, it's a pleasure to meet you as well. And I… my background, I'm a nurse practitioner, and I recognized early on that nurses needed business education. We don't get education and training in this
00:04:54.030 --> 00:05:10.089 Lynn Rapsilber: field, and when I was a new nurse, I actually worked on a cancer floor, and the physicians, the oncologists, decided to tap me to run their outpatient chemo program. This was in 1985, which was unheard of at that time.
00:05:10.790 --> 00:05:22.320 Lynn Rapsilber: I basically said, you know, I'll try it, what's the worst that can happen, and I'll go back to the hospital if it doesn't work out. Well, I was there 20 years, and what I learned is that I was an entrepreneur back then, and I didn't know it.
00:05:22.320 --> 00:05:35.439 Lynn Rapsilber: But I had to find the chemo drugs, research them, how much time it took to deliver the treatment, the supplies I needed, what CPT, ICD, went to the insurance companies, negotiated the rates. I did that as a nurse.
00:05:35.490 --> 00:05:44.449 Lynn Rapsilber: And then, as the chemo program was developing and I was adding more staff, I was starting to do higher-level nursing functions, so I decided to go back to school and get my NP.
00:05:44.690 --> 00:05:56.699 Lynn Rapsilber: And from that, I actually started to think more about how can we cultivate our business brains and get more people involved in opening up their own practices so that we can start to fill the gaps in healthcare.
00:05:56.700 --> 00:06:19.359 Lynn Rapsilber: And we realized that there's no business education, so physicians, PAs, and nurse practitioners get little. And so we created the National Nurse Practitioner Entrepreneur Network so that we could coalesce all the resources to put thoroughbreds in a stable, so that we have all these resources for our NPs to be safe clinicians and to provide care in the communities that they serve.
00:06:19.360 --> 00:06:25.919 Lynn Rapsilber: But to give them the knowledge and skill set so they could be successful and sustainable, because that's what we need to change healthcare.
00:06:26.110 --> 00:06:28.839 Frank R. Harrison: I agree, I agree. Well, welcome.
00:06:29.350 --> 00:06:51.340 Phyllis Quinlan: Welcome, welcome, welcome, welcome. I couldn't agree with you more, Lynn. You know, just coming at it from, like, the administrative piece, because you went the NP route, I went the PhD route, but, you know, being a nurse executive, probably the thing that was lacking most in most nurse executive training is the financial piece, and
00:06:51.340 --> 00:06:52.939 Phyllis Quinlan: You learn in a hurry.
00:06:53.270 --> 00:07:17.140 Phyllis Quinlan: you know, I've often said to people who have asked me, should, you know, how… should I get an MBA? The first thing I tell them is, by all means, go for the MBA, because you need to have that financial background. You're going to be sitting in a room with bean counters, and if you don't know what you're talking about, they're going to take your beans, you know? So, you… you definitely need to be able to, at least understand the vernacular.
00:07:17.410 --> 00:07:31.299 Phyllis Quinlan: You need to understand the concepts, you need to be able to look at a spreadsheet, you need to be able to reconcile your spreadsheet with your staffing sheet, and then sit down and have a cup of coffee with the director of finance and say.
00:07:31.660 --> 00:07:44.589 Phyllis Quinlan: what's missing here, you know, and I want it back, you know? So, and of course, now with so many new models coming up, just from an administrative point of view, you need to be able to price out a
00:07:44.590 --> 00:07:51.930 Phyllis Quinlan: project management scheme. You need to be able to, you know, take a look at Phase 1, Phase 2, what are the, you know, the,
00:07:52.130 --> 00:08:15.329 Phyllis Quinlan: the things that we are going to need, you know, to make that work, what's staff, what's durable medical equipment, and we are now thinking in terms of business people, as opposed to, you know, you're now a nurse with an accounting background or an accounting understanding, in order to fulfill the new demand and the bandwidth of
00:08:15.330 --> 00:08:18.229 Phyllis Quinlan: What nurse executives are expected to have.
00:08:18.230 --> 00:08:25.749 Phyllis Quinlan: So I welcome this opportunity for you, certainly, to enlighten everyone as to what, you know, especially your NP colleagues.
00:08:25.750 --> 00:08:42.839 Phyllis Quinlan: As to the gap that they are having in their education, and that your organization is so very valuable in coalescing, you know, a group of like-minded people, and then fill that gap with the appropriate training, and it's not necessarily
00:08:42.840 --> 00:08:48.110 Phyllis Quinlan: staffing and such for you. It is, as you say, the coding, the billing.
00:08:48.310 --> 00:09:03.819 Phyllis Quinlan: Making sure the documentation is there so that you survive the audits, and making sure that you advocate for those things that are necessary, because I, do feel that the advanced care practitioner nurse, the nurse practitioner.
00:09:03.930 --> 00:09:13.039 Phyllis Quinlan: is here to stay. It may morph and change, as everything always does, but, having gone through COVID with them.
00:09:13.280 --> 00:09:23.480 Phyllis Quinlan: invaluable. We would not be here, many of us would not be here if it wasn't for the advanced, you know, for the nurse practitioners with advanced training.
00:09:23.480 --> 00:09:24.170 Frank R. Harrison: Absolutely.
00:09:24.170 --> 00:09:35.019 Phyllis Quinlan: So, can you just briefly tell us just a little bit about your organization? We'll save that for another thing, you know, details down the road, but, just a little overview.
00:09:36.320 --> 00:09:50.749 Lynn Rapsilber: We started the National Nurse Practitioner Entrepreneur Network and took in our first member in 2018, and we started out with a program called Office Hours, which is an hour program that we offer a CE for, and it's a hot topic
00:09:50.750 --> 00:10:06.500 Lynn Rapsilber: related to practice ownership, and all of that content from 2018 has been recorded, so we have that in our library, so there's a lot of resources for NPs to go back and review this information, and we offer, like I say, the CE for that.
00:10:06.500 --> 00:10:12.659 Lynn Rapsilber: From that, we started to develop more programs. I did coding and billing programs, and then we added
00:10:12.720 --> 00:10:20.540 Lynn Rapsilber: conferencing, so we would have a conference every year, and we also added a Business Basics Accelerator course.
00:10:20.540 --> 00:10:45.059 Lynn Rapsilber: And that is a 12-week asynchronous, so people can do their content during the week, so they can, you know, fit that into their schedule, however, and then we would meet as a cohort on Zoom once a week, so they were not building these businesses in isolation, but lifting each other up and supporting each other. The networking in the community was really invaluable. And we were going into our 12th cohort, we're just starting a new one now, so if anybody's interested, they can
00:10:45.060 --> 00:10:50.819 Lynn Rapsilber: still get in. But we… our success rate is 85% of our
00:10:50.820 --> 00:11:05.700 Lynn Rapsilber: attendees start their businesses. So, that's a good track record, and our courses are taught by content experts, so we have a marketing person, a revenue cycle, somebody doing the financials. So, you're getting it from, like I say, our thoroughbreds in the stable.
00:11:06.360 --> 00:11:21.080 Phyllis Quinlan: I think that's just amazing. I remember when I first started my company 32 years ago, you know, the purist in our profession, looked at me in shock and horror, you know, you're departing from…
00:11:21.080 --> 00:11:30.110 Phyllis Quinlan: You know, advocating for the patient, and you're gonna get money hungry, and all of, you know, the negative connotations that might come with
00:11:30.770 --> 00:11:50.380 Phyllis Quinlan: just maybe a fixed mindset about the profession as it was 32 years ago. You know, clearly, things have changed, things have expanded. And as you get more education, how do you keep them down on the farm? You know, they're going to think of other ways in order to practice and expand and increase access.
00:11:50.380 --> 00:12:02.159 Phyllis Quinlan: And there was never a time, regardless if you're hospital-based or an entrepreneur, there's never a time that the patient isn't at the center of everything, you're just approaching them from a different point of view.
00:12:03.010 --> 00:12:11.850 Lynn Rapsilber: Exactly, and that's… that's what's the differentiation of a nurse practitioner is. The patient is at the forefront, and the care is built around their needs.
00:12:11.850 --> 00:12:12.640 Phyllis Quinlan: Yeah.
00:12:12.720 --> 00:12:37.690 Phyllis Quinlan: you know, I share, Frank, with you, when, you know, you have the NPs come to the house to take care of your dad, you know, I can relate to that, because my parents would go to the doctor's office, and I would give them a list, you know, on a card of, here's the questions to ask, and then I would have to, you know, say a quick prayer that they remembered to bring the card, you know, that type of thing, and they would never let me go
00:12:37.690 --> 00:12:41.030 Phyllis Quinlan: with them, because that just was unthinkable.
00:12:41.180 --> 00:13:03.630 Phyllis Quinlan: So then their visit… their doctor's visit would be completed, and, I would call and say to my, you know, my mom, well, what did the doctor say? Oh, he's fine, he's doing good, his grandchildren are good. No, what did the doctor say about you? And, you know, and I… after a few minutes of frustration, I wasn't going to get much anywhere. He's going to keep me on the blue pill.
00:13:03.630 --> 00:13:14.550 Phyllis Quinlan: God only knows what that was. You know, that I finally would have to call the practice, and the practice, thank you, God, had a nurse practitioner who I had a relationship with.
00:13:14.550 --> 00:13:16.340 Frank R. Harrison: And I would say, Mary?
00:13:16.340 --> 00:13:27.629 Phyllis Quinlan: Jack and Madeline were in the… in the… oh, I saw them this morning, aren't they cute? You know, and I… she says, you're here for the update? Yeah, she didn't… she forgot the question. She didn't… she forgot the card on the kitchen table. I'm like, okay.
00:13:27.790 --> 00:13:39.110 Phyllis Quinlan: So then I would find out from Mary, you know, what the point was. And, you know, it's just the way you have to be able to navigate things to keep body and soul and frail elderly parents together.
00:13:39.340 --> 00:13:41.429 Lynn Rapsilber: You have to meet the patients where they are.
00:13:41.430 --> 00:13:45.039 Phyllis Quinlan: how to meet the patients where they're at. Nurses are excellent at that.
00:13:45.040 --> 00:13:45.860 Frank R. Harrison: Yes. Yep.
00:13:46.260 --> 00:13:52.149 Frank R. Harrison: Well, we're about to take our first break, but then we're gonna really delve into a lot of what we just covered in this first segment.
00:13:52.250 --> 00:14:11.789 Frank R. Harrison: Lynn, I already do have one question, but I will introduce the second segment with that question. And, I just want to tell everybody, if you are watching right now on YouTube, Facebook, or LinkedIn, and have any live questions that you'd like to share with Phyllis, Lynn, or myself, by all means, just go into your chatbot.
00:14:11.790 --> 00:14:29.480 Frank R. Harrison: And we will have it, read out loud through our, panel right here, and our engineers' support. So, that all being said, please stay tuned right here on talkradio.nyc and on our social media platforms, Facebook, LinkedIn, Twitch, and YouTube, and we'll be back in a few.
00:15:41.480 --> 00:15:54.279 Frank R. Harrison: Hey, everybody, and welcome back. So, Lynn, let me ask you one question that came to my mind when Phyllis was just going over her experience over the last 32 years.
00:15:54.400 --> 00:16:00.830 Frank R. Harrison: If nurse practitioners are trusted and trained, which I know that they are, Why are they still restricted?
00:16:02.440 --> 00:16:04.290 Frank R. Harrison: You have to unmute first.
00:16:08.900 --> 00:16:09.980 Lynn Rapsilber: about that.
00:16:10.130 --> 00:16:10.820 Frank R. Harrison: No problem.
00:16:11.720 --> 00:16:22.660 Lynn Rapsilber: That's a great question, and I think, you know, I think a lot about our profession as a whole, and I don't think that we've really had a time when we've really gotten together
00:16:22.750 --> 00:16:35.360 Lynn Rapsilber: academics, clinicians, and really, you know, work together for policy and advocacy and our profession. And I think that fragmentation has led to opportunities where
00:16:35.770 --> 00:16:53.979 Lynn Rapsilber: barriers to practice have been put up, or things like that. So, I think that that's been one thing that's been, I think, a little bit of a concern. I'm very excited, though, because I think some of the things we're hearing in the nursing world right now with nursing not a professional degree for loans.
00:16:53.980 --> 00:16:56.700 Lynn Rapsilber: It really kind of coalesced us and fired us up.
00:16:56.700 --> 00:16:59.240 Phyllis Quinlan: just start working together, and I think that…
00:16:59.240 --> 00:17:05.599 Lynn Rapsilber: That kind of spark is really what we need to do, because, there's 5 million nurses, and that is a big
00:17:05.730 --> 00:17:11.430 Lynn Rapsilber: Voice, a big vocal presence, and if we can mobilize that, boy, we can move a lot of mountains.
00:17:11.960 --> 00:17:13.079 Frank R. Harrison: Amazing.
00:17:13.359 --> 00:17:29.620 Frank R. Harrison: So, I know that, you know, there's just, like I said in the beginning of the show, there's just been a lot of disruption that I personally, and I think, Phyllis, you agree with me, it's just unnecessary. But, on one level, it does spark the entrepreneurial aspect of your career, which…
00:17:29.770 --> 00:17:33.670 Frank R. Harrison: At the end of the day, is always admirable, but at the same time.
00:17:33.830 --> 00:17:39.270 Frank R. Harrison: Do you see that the restrictions have been because of that increased…
00:17:39.400 --> 00:17:46.789 Frank R. Harrison: Disruption that's been going on, or is it just more related to what has historically been happening in the profession?
00:17:47.970 --> 00:18:05.409 Lynn Rapsilber: Well, it's interesting because during COVID, the public health emergency happened, and as Tephyrus described earlier, is that, you know, APRNs and RNs were able to move about the country to go where the needs, the crisis needs were, whether it was Washington State or New York, for example.
00:18:05.410 --> 00:18:19.479 Lynn Rapsilber: And two and a half years, we had full practice, where we could go wherever we needed to, we could move about the cab and deliver that care. And then all of a sudden, the pandemic ends, and the public health emergency waivers are gone, and it just…
00:18:19.490 --> 00:18:30.829 Lynn Rapsilber: all of a sudden, everybody's trying to stuff that genie back in the bottle, and that has been very disruptive for us. And I'll give you an example in New Jersey, for example.
00:18:30.840 --> 00:18:41.550 Lynn Rapsilber: before the public health emergency, the governor signed an executive order, and they had full practice authority for about 6 years. And then now, because there's a new governor.
00:18:41.550 --> 00:18:45.029 Lynn Rapsilber: the executive orders are no longer in place. So now.
00:18:45.030 --> 00:19:06.809 Lynn Rapsilber: they are trying to go ahead and get that full practice authority, but they're being challenged. And it's like, I don't understand. We were able to provide this care for two and a half years, and people need access to care, and we fill gaps in care and go to places a lot of physicians probably don't go to, generally, rural areas and things like that.
00:19:06.870 --> 00:19:19.859 Lynn Rapsilber: And we're growing. We're 461,000 nurse practitioners, and we're continuing to grow. So, you know, you have a workforce here that's ready, and we need to utilize it as best we can to help solve the healthcare crisis.
00:19:20.120 --> 00:19:21.100 Frank R. Harrison: Absolutely.
00:19:21.200 --> 00:19:22.860 Phyllis Quinlan: Frank, can I just jump in?
00:19:22.860 --> 00:19:23.530 Frank R. Harrison: Sure, absolutely.
00:19:23.530 --> 00:19:48.289 Phyllis Quinlan: I think it's really important for your listeners right now to understand the evolution of nursing, and how that started, and really just have some background, because to your point when you opened up, you know, what's the difference between an RN and a nurse practitioner? And, you know, how does this happen? Is a nurse practitioner more of a nurse than a physician, or a physician more than a nurse? So, I'm just going to
00:19:48.290 --> 00:20:04.939 Phyllis Quinlan: take a minute and just really go through a very brief overview of the profession of nursing history, and just, you know, a little bit about the academic preparations. So, I think most people realize, if we went back to ancient times.
00:20:05.710 --> 00:20:11.059 Phyllis Quinlan: You know, in earlier times, you know, care was rendered essentially by your family.
00:20:11.060 --> 00:20:29.389 Phyllis Quinlan: All right, so… and of course, we… there were shamans, there were religious orders, and that was really the group, because the physicality and the illnesses were viewed in various cultures as one thing or another, so there was a specialty group that treated that.
00:20:29.390 --> 00:20:33.619 Phyllis Quinlan: And, you know, it was really the foundation of
00:20:33.640 --> 00:20:49.000 Phyllis Quinlan: caring. It was the foundation of taking a look at, you know, really hit and miss, what works, what doesn't. A lot of holistic approaches to healing back then in various countries. The Chinese medicine at that time
00:20:49.000 --> 00:21:13.279 Phyllis Quinlan: again, you know, back… way, way back in time was far more advanced than some of the Western approaches. But slowly but surely, the modern era did develop, and I think if we're really talking about nursing, most of us would agree that the modern era of nursing started with Florence Nightingale, and that was really… she was there in the late 1800s, early 1900s.
00:21:13.990 --> 00:21:36.980 Phyllis Quinlan: And of course, she's very much connected with the Crimean War, but very few people realize the reason… what made Florence Florence was that she was the daughter of a British banker, and she had an aptitude for math, and her father homeschooled her in math, which of course was unheard of, but women were not, you know, allowed into academic settings.
00:21:36.980 --> 00:21:53.229 Phyllis Quinlan: Back in that time. So she went into nursing, but she really started the whole idea of epidemiology and statistics, so that when she did care, and she would talk about very fundamental things, she would talk about fresh air, she would talk about
00:21:53.230 --> 00:22:18.219 Phyllis Quinlan: Sunshine. You know, and she actually did statistics to back what she was doing, and that's how she captured the attention of the British military leaders at the time, and that's how she got her funding. She was able to start a school, the first school of nursing, and again, I'm sure there are other references, but we're gonna go with… we're going to stick with Florence for now.
00:22:18.220 --> 00:22:30.820 Phyllis Quinlan: We're going to say the first school of nursing was started around 1860 in London by Florence, and it was more of an apprenticeship program than anything else.
00:22:30.860 --> 00:22:46.099 Phyllis Quinlan: this really started something very different. It started to shift the nursing away from, religious organizations into more secular, largely female-dominated professions, and it started to become an
00:22:46.100 --> 00:22:55.010 Phyllis Quinlan: an absolute choice for women, at that time. In fact, in many… in some of Florence Nightingale's writings, she actually talks about
00:22:55.010 --> 00:23:08.240 Phyllis Quinlan: Women setting aside a portion of their… nurses, rather, setting aside a portion of their salary, in savings so they don't become a burden on society as they age.
00:23:09.030 --> 00:23:23.159 Phyllis Quinlan: She even had the vision of Social Security, or, you know, I guess her version of a 401, you know, or a 403B. Retirement plan. But you can see the banking piece in her head at that point.
00:23:23.190 --> 00:23:39.320 Phyllis Quinlan: You know, we smile about this, and we talk about Florence, but really, you know, she is really the shoulders that we stand on, and, you know, nursing is, I think now, probably for about 18 or 19 years, considered the most trusted profession.
00:23:39.320 --> 00:23:50.449 Phyllis Quinlan: in the world. And, you know, it's an honor, but it's also a lot of stewardship that goes with that, when you want to make sure we never drop that ball. So, again.
00:23:50.700 --> 00:24:07.590 Phyllis Quinlan: how did we develop from an education, you know, from an education standpoint? So, really, in and around the late 19th centuries, we started to see something called the hospital-based diploma schools, where nurses would affiliate with a particular hospital.
00:24:07.710 --> 00:24:32.220 Phyllis Quinlan: And so, you may remember St. Vincent's Hospital in New York City, back in the 60s and 70s, was considered the creme de la creme. It was world-class. Other schools of nursing, again, hospital-based and affiliated. And it was an apprenticeship model, very similar to the Florence Nightingale model, where the students came and applied for the program, they lived.
00:24:32.220 --> 00:24:38.439 Phyllis Quinlan: In the hospital, in dorms, and they worked very long shifts, so they went to school days.
00:24:38.850 --> 00:25:03.550 Phyllis Quinlan: Perhaps they, did schoolwork, but they were essentially the night shift and maybe the evening shift for the hospital, so there was a little indentured servitude there, going. But that was in, you know, they actually worked and took care of patients. Their skills were amazing. They knew exactly what was expected of them by the time they graduated. These were 2- and 3-year programs, depending on the
00:25:03.690 --> 00:25:16.110 Phyllis Quinlan: on the school itself. But it was, you know, a work-study program, and it paid for the room and board and your training, and in exchange, you took care of patients, and you worked for the hospital.
00:25:16.340 --> 00:25:26.149 Phyllis Quinlan: Then, of course, the wars started to happen, so when we're thinking about World War, World War I and World War II, mostly I want to talk about
00:25:26.150 --> 00:25:43.709 Phyllis Quinlan: in and around World War II. The nursing staff, they started with Skormans, and of course they were nurses. But when they came back from World War II, what really happened is these nurses were extremely skilled. They had seen things, you can only imagine what they saw.
00:25:43.710 --> 00:25:50.770 Phyllis Quinlan: So they started to realize that hospital-based programs were just not going to be enough, and there was a slow shift
00:25:50.770 --> 00:26:09.080 Phyllis Quinlan: Towards academia. That started post-World War II, but it really took off with Korea and Vietnam. When those nurses came back from Korea, especially Vietnam, in the 60s, you know, mid-60s, they really… everything shifted to the college sites.
00:26:09.420 --> 00:26:33.340 Phyllis Quinlan: And we started with the two-year programs. The transition was slow. Again, as I say, it started in World War II. It continued in after Korea, and then, of course, after Vietnam. The associate degree programs slowly started in the 50s, and then they were, you know, considered, you know, pretty radical.
00:26:33.340 --> 00:26:57.530 Phyllis Quinlan: at the time. But in 1965, the American Nurses Association put out a position paper saying that they were advocating for all nursing education, to be at a higher education institute, cementing the need for us to be trained at universities. And that's really when the modern nursing programs began. So you're looking at 1965. Clearly.
00:26:57.530 --> 00:26:58.610 Phyllis Quinlan: post…
00:26:58.610 --> 00:27:23.560 Phyllis Quinlan: career, and post-Vietnam. The associate programs were two years in the making, and then slowly but surely, the four-year programs came up, so there was a lot of back and forth in political pieces, and of course, economics played a part. And again, for women, it was not just going to school and having a career, it was going to school, getting married, and having a career, and having children, and then trying to
00:27:23.560 --> 00:27:48.519 Phyllis Quinlan: figure out a way not only to get an associate's degree, but a baccalaureate degree. So, you know, it's always been, you know, a little bit like Fred Astaire and Ginger Rogers. We dance the same steps, and we do it in high heels and backwards. You know, it's, you know, it's just a little bit more challenging, and it's certainly, they were early pioneers, and, you know, I give them all the credit in the world for seeing the vision
00:27:48.520 --> 00:27:53.240 Phyllis Quinlan: of where nursing could be from an academic perspective.
00:27:53.240 --> 00:28:15.130 Phyllis Quinlan: But… and then doing that. The key drivers really started to be when we… we started in the 70s, and we started to see some of the CNSs, clinical nurse specialists, master's prepared nurses, and nurse practitioners, and we needed them because we needed them to go back to college and teach nurses the baccalaureate programs, the academic and the baccalaureate programs.
00:28:15.180 --> 00:28:31.580 Phyllis Quinlan: Yes. It really is important to understand that prior to, you know, around the 1970s, nurses were going, for advanced degrees, but they weren't going for advanced degrees in nursing. They were going into law and other things, teaching.
00:28:31.580 --> 00:28:46.969 Phyllis Quinlan: And finally, we were able to get enough nurses prepared, that they were able to swing back and then join academic groups and start Department of Nursing Education at the academic level.
00:28:47.390 --> 00:28:48.200 Phyllis Quinlan: the…
00:28:48.200 --> 00:29:13.140 Phyllis Quinlan: the… once we had the baccalaureate program in place, and we've tried for years, and there's probably still a lot of debate going on, is that is the gold standard for entry into the profession. And again, then the advanced practice started. So, it was the… really, in the late… in the 70s and 80s that we had the shift to clinical nurse specialists, nurse practitioners, and then, ultimately, we're looking at people
00:29:13.140 --> 00:29:30.369 Phyllis Quinlan: being… nurses being prepared at the doctorate level. Of the 5 million nurses that Lynn referenced, about 7% are prepared at the doctorate level today. So, what does it take to be an NP? I'm going to let Lynn, explain that, but the…
00:29:30.370 --> 00:29:31.980 Frank R. Harrison: We return from our break.
00:29:31.980 --> 00:29:33.310 Phyllis Quinlan: Sure, okay.
00:29:33.700 --> 00:29:37.709 Frank R. Harrison: And then, of course, at the same time when we return, not only after you explain
00:29:38.010 --> 00:29:46.090 Frank R. Harrison: what is going on in the future. There's the entrepreneurial side that we want to also uncover. Everyone, just stay tuned, we'll be back in a few.
00:29:53.920 --> 00:29:54.739 Frank R. Harrison: Okay, we're.
00:30:52.650 --> 00:31:08.929 Frank R. Harrison: Okay, everybody, welcome back. Now, Lynn, what Phyllis was just talking about is a very interesting history on the growth of the nursing profession, and I… I guess, Lynn, you were now going to talk about how the nurse practitioner was able to evolve out of that.
00:31:09.880 --> 00:31:17.710 Lynn Rapsilber: Yes, actually, we often refer to the founder of the nurse practitioner profession as the great disruptor.
00:31:17.760 --> 00:31:35.929 Lynn Rapsilber: Dr. Loretta Ford, who just passed away last fall, an amazing woman. She was… I've gotten to meet her several times, and she always would ask, you know, how are you doing? And, you know, keep up the fight, and she had all these wonderful pearls of wisdom, but she recognized
00:31:35.940 --> 00:31:52.339 Lynn Rapsilber: that nurse practitioners need to go out into the community, and she had a strong focus in public health. And that's where the roots of nurse practitioners evolve. Her and Dr. Silver created the nurse practitioner role, and it has evolved over time. It started out
00:31:52.370 --> 00:32:11.759 Lynn Rapsilber: and then the programs expanded depending on adding pharmacology and other pieces to the program. So now, the programs are such that they're very robust in education and training, nurses in the higher level functions. So, basically, you have to have your RN
00:32:11.780 --> 00:32:28.790 Lynn Rapsilber: license, and then you're working for a period of time, and then many times when you're working, you decide, hey, I think I might want to go on for an advanced degree. And there's different opportunities for nurse practitioners because we're population-focused, so you can go into adult,
00:32:28.850 --> 00:32:43.350 Lynn Rapsilber: adult GRO, which is adult cradle to grave, pretty much. Pediatric nurse practitioner, there's a family nurse practitioner, psych mental health nurse practitioner, women's health nurse practitioner, all of them are population-focused.
00:32:43.410 --> 00:32:50.270 Lynn Rapsilber: So you start out as a nurse, then you apply to NP school, and you get into the NP,
00:32:50.740 --> 00:33:04.289 Lynn Rapsilber: program. And from that, you have your course curriculum, so you have your didactic preparation and your clinical, so you do get the opportunity to specialize in that population focus area. So we can…
00:33:04.610 --> 00:33:21.789 Lynn Rapsilber: get trained in assessing, diagnosing, treating, prescribing, ordering tests, all those facets of healthcare that we can provide to our patients. Along the way, we're all… it's all competency-based, so you can't go on to the next level until you make sure that you're competent in the level that you're at.
00:33:21.940 --> 00:33:32.569 Lynn Rapsilber: When you complete your coursework, then you have to sit for a certification exam, so you actually have to prove that the education you received, provides you with the certification to go out and practice.
00:33:33.250 --> 00:33:53.979 Lynn Rapsilber: And then from there, you apply for your licensure, whatever state you're in, and that varies depending on the state. So, we don't have it easy, no matter how you look at it. So we all… and most of the states, we have to maintain our RN license and our APRN license, so we're responsible for maintaining two degrees, or two licensures, I'm sorry.
00:33:54.010 --> 00:34:01.049 Lynn Rapsilber: But, but our education and training does prepare us when we leave the profession to go out and deliver care to our patients.
00:34:01.690 --> 00:34:07.350 Phyllis Quinlan: Which is great. Could you… could you share the clinical hours that go with the didactic, please? I think, because they're impressive.
00:34:07.790 --> 00:34:16.370 Lynn Rapsilber: Yeah, so when we start out with baccalaureate, we get 750 hours of clinical training, so that's carried over into our APRN training.
00:34:16.370 --> 00:34:30.599 Lynn Rapsilber: And when you get to be a master's prepared, you get another 750 hours of clinical training. And then when you go on, you can get additional 4 hours. It really depends on whether you decide to do the program full-time or part-time.
00:34:30.600 --> 00:34:35.870 Lynn Rapsilber: how much clinical you actually get. But by the time an APRN graduates.
00:34:35.870 --> 00:34:48.639 Lynn Rapsilber: If they've been a full-time student, they'll have 4,300 hours of clinical practice. If they've done… Right, and if they've done, part-time, then they'll have 6,500 hours.
00:34:48.730 --> 00:34:58.250 Lynn Rapsilber: So, you know, that's a lot of training, so we're building… we're basically building on the framework of our RN education and getting the skill set in the APRN training.
00:34:58.250 --> 00:35:07.229 Phyllis Quinlan: I think it's so essential for your listeners, Frank, to understand that the nurses are not just sitting in the classroom and going to take care of patients.
00:35:07.230 --> 00:35:32.230 Phyllis Quinlan: That when we're looking at thousands of clinical hours of training that goes with this, very similar to, you know, a medical student graduating in their first year of practice as what we used to say in intern, we now call a postgraduate one, PGY1. You know, these are comparable hours to what's going on with the competencies, the licensure, and the
00:35:32.230 --> 00:35:40.740 Phyllis Quinlan: certifications. I remember back in the day, I think it might have been the late 80s, late 70s, early 80s, the first advanced care
00:35:40.800 --> 00:35:47.900 Phyllis Quinlan: role that I became aware of was a nurse anesthetist role. Am I right? Is that the first one?
00:35:48.310 --> 00:35:53.289 Lynn Rapsilber: they actually came out of the war. Yes. They were giving anesthesia.
00:35:53.290 --> 00:36:01.519 Phyllis Quinlan: They were doing that, exactly. So, again, my reference to, it's amazing the silver lining that war produced, you know.
00:36:02.020 --> 00:36:18.279 Phyllis Quinlan: You know, the… certainly all of the nurses with just incredible skills and incredible training, and they were… they were cross-trained literally in the field by physicians because the… unfortunately, the soldiers, you know, were coming in far more rapidly than the staffing could handle.
00:36:18.900 --> 00:36:33.310 Phyllis Quinlan: But, you know, from there, you know, we now get all these specialties. And I think it's, you know, it's really important, again, to share that, you know, we've all done anatomy and physiology, but I'm looking at the core curriculum for
00:36:33.310 --> 00:36:53.769 Phyllis Quinlan: any advanced care program, and you're looking at advanced, you know, patho… excuse me, advanced physiology, advanced pathophysiology, advanced pharmacology, because you do have the ability to prescribe at the end of this, advanced health assessment, and then, of course, everything you need to know about evidence-based
00:36:53.770 --> 00:37:07.020 Phyllis Quinlan: practice, because at this point, in the evolution of nursing, we realize that you just can't say, well, you know, I used to put my lantern on a pressure ulcer, and it changed the pH, and it worked.
00:37:07.020 --> 00:37:22.199 Phyllis Quinlan: You know, we have to have evidence, rhyme, and reason, and the science, you know, to put behind what we do, because nursing is an art and a science. And just to do it because it seemed to work last time is just not good enough.
00:37:22.610 --> 00:37:23.040 Frank R. Harrison: Right.
00:37:23.040 --> 00:37:40.290 Lynn Rapsilber: And to your point, bringing up the research, the patient care research, there's over 50 years of studies that show that nurse practitioner care is cost-effective, comparable quality with physicians. So, you know, we're par for what
00:37:40.330 --> 00:37:59.999 Lynn Rapsilber: services, how we're delivering that service to our clients, and getting them to their optimum level of wellness. You know, so the studies show that we just do it a different pathway, but, you know, the outcomes are good. So that should reassure folks that, from a safety perspective, and again, two and a half years of
00:38:00.170 --> 00:38:01.110 Lynn Rapsilber: COVID.
00:38:01.110 --> 00:38:08.200 Phyllis Quinlan: of COVID, and we would not have gotten through COVID without you guys. I think it's, I think it's, you know.
00:38:08.200 --> 00:38:32.029 Phyllis Quinlan: interesting that the NPs, of course, you know, had their basis in community health, or, you know, and now, really, I see a lot of telemedicine that's being driven by the nurse practitioners. Again, a modern-day spin on community health, if you will, but what I think is so important for everyone to understand is not just the history, not just the credentialing.
00:38:32.160 --> 00:38:38.600 Phyllis Quinlan: The academic preparation, the clinical hours, but what it means to the patient, because
00:38:39.260 --> 00:38:42.490 Phyllis Quinlan: How many nur… how many nurse practitioners now, Lynn?
00:38:43.310 --> 00:38:45.320 Lynn Rapsilber: 461,000.
00:38:45.320 --> 00:38:52.590 Phyllis Quinlan: And every one of them ensuring more access to people who otherwise may not have good primary care.
00:38:53.330 --> 00:39:04.090 Lynn Rapsilber: Well, and it's interesting, too, because from the national nurse practitioner perspective, a lot of NPs will see needs in their communities, and they want to build a practice around that.
00:39:04.090 --> 00:39:11.539 Phyllis Quinlan: They're getting frustrated with the current healthcare system because it's compartmentalizing them into shorter visits, 15 minutes.
00:39:11.540 --> 00:39:29.270 Lynn Rapsilber: you know, you're lucky if you can get a half an hour. Our brains are hardwired to deliver whole-person care, and you can't do that in 15 minutes without burning yourself out. So I think a lot of these nurse practitioners are saying, well, there's got to be a better way to do this. How can I get the care I want to deliver to patients and
00:39:29.270 --> 00:39:43.340 Lynn Rapsilber: Starting your practice is the best way to do that. And many do it as a side hustle. They're keeping their day job and transitioning into the NP, to the business side, and doing it, you know, gradually building that up.
00:39:43.340 --> 00:39:51.070 Lynn Rapsilber: But they're seeing the needs in the communities, and I think that's fascinating. I mean, the types of practices we're seeing them start are amazing.
00:39:51.340 --> 00:40:06.420 Phyllis Quinlan: Right, and I know that there's a lot of chatter, if you will, around, you know, they're serving a concierge population, if you will, but I think, you know, the pendulum has always been it swings one way.
00:40:06.420 --> 00:40:12.429 Phyllis Quinlan: far away, then it swings back far the other way, and I think for…
00:40:12.560 --> 00:40:28.270 Phyllis Quinlan: you know, the… to be able to start your own practice, regardless of the population you are serving, is so vital to bring awareness to what you offer, the industry, and the profession and the patients at large. And I do think as
00:40:29.370 --> 00:40:47.179 Phyllis Quinlan: for lack of a better term, concierge patients, become, as that patient population grows, then I seek the third-party payers are going to have to say, wait a second, we're missing out on a huge population here, perhaps we should now start to
00:40:47.340 --> 00:41:03.069 Phyllis Quinlan: Develop the coding and the billing, and of course, the legislature to support the practices so that they can… we can see… you can see more patients, than just those that are fortunate enough to be able to pay fee-for-service.
00:41:03.750 --> 00:41:12.830 Lynn Rapsilber: And it's interesting, too, because a lot of the baby boomers are aging, and now we're all in the Medicare space, and we want to stay healthy!
00:41:13.230 --> 00:41:17.350 Lynn Rapsilber: I can't tell you how many older folks want to be healthy. We don't…
00:41:17.350 --> 00:41:20.399 Phyllis Quinlan: We don't see ourselves going into a nursing home, but…
00:41:20.400 --> 00:41:21.000 Frank R. Harrison: me.
00:41:21.000 --> 00:41:37.689 Lynn Rapsilber: A lot of what nurse practitioner care delivers is that ability to do prevention and health promotion and keep those folks healthier. Or if they have chronic diseases, identify them early and get them into the proper treatment so we can prevent the long-term complications that happen.
00:41:38.220 --> 00:41:44.459 Frank R. Harrison: So is that part of the entrepreneurial mindset that the nurse practitioner has in order to do nursing home prevention?
00:41:45.200 --> 00:42:02.790 Lynn Rapsilber: It's embedded in our brains, that's how we're hardwired, you know, to look at that person. And it's interesting, too, because a lot of nurse practitioners, 80% of us are seeing Medicaid patients, 74% are seeing Medicare, and 77% see private insurance.
00:42:02.790 --> 00:42:14.339 Lynn Rapsilber: But our concern is with the ACA subsidies going away, and people paying a lot more for health insurance that people are going to go without. And concierge is great if somebody can afford to pay…
00:42:14.340 --> 00:42:15.020 Phyllis Quinlan: it, yep.
00:42:15.020 --> 00:42:19.300 Lynn Rapsilber: Right, so I think what we're looking at in our… our…
00:42:19.400 --> 00:42:28.569 Lynn Rapsilber: entrepreneurial network is, how can we take care of the Medicare and Medicaid, the underinsured, uninsured, the populations that really need us? But then also.
00:42:28.570 --> 00:42:43.919 Lynn Rapsilber: support our practices with add-on services, and so aesthetics is one area that we can provide some additional service. We can do, VA disability physicals. There's a backlog of veterans who need these disability
00:42:43.920 --> 00:42:56.859 Lynn Rapsilber: There's also opportunities to work with employers in our community. So there's a lot of different ways to add services for an MP practice owner, in addition to taking care of the patients we need to be taking care of.
00:42:56.860 --> 00:43:20.100 Phyllis Quinlan: And I honestly find the nurse practitioner more willing to have the conversation about integrative practice as well. Yeah. Integrative medicine, holistic, you know, really body, mind, and spirit treatment, as opposed to just Western approaches to treating disease. It's more of an approach, a complete approach, holistic approach to staying well.
00:43:20.870 --> 00:43:34.879 Lynn Rapsilber: Actually, you brought up an interesting point when you talked about that, because I had attended a conference in Washington State, and I met a gentleman who actually is an acupuncturist. He practices it, and he said it's a dying art. People are not going in to do this.
00:43:35.310 --> 00:43:55.170 Lynn Rapsilber: And he's actually developing a program to train nurse practitioners in the delivery of acupuncture treatments, because it has benefits for pain management, headaches, mental illness. I mean, there's just so many wonderful uses, and it gets us out of that pill prescribing mode, and other modalities that we can offer patients.
00:43:55.170 --> 00:44:15.210 Phyllis Quinlan: It's funny that the regulatory bodies will say you have to have, you know, a certain percentage of non-pharmacological approaches to this, that, and the other thing, but who's going to pay for that? I mean, we all want to do best practice, okay? But then you have to give us the ability to not only train in those things, but to build when we bring those practices in.
00:44:15.600 --> 00:44:16.610 Frank R. Harrison: Exactly.
00:44:16.660 --> 00:44:21.769 Lynn Rapsilber: We're about to take our final break, and then we're gonna wrap up and talk about the future of…
00:44:21.770 --> 00:44:32.470 Frank R. Harrison: the nursing profession in its entirety, as well as the future of the nurse practitioner, and making sure they have a seat at the table. And, of course, a little surprise that
00:44:32.470 --> 00:44:43.239 Frank R. Harrison: the three of us have concocted that we will share with all of you, in a few minutes. So, that being said, please stay tuned right here on talkradio.nyc, and on all of our socials, and we'll be back in a few.
00:45:55.930 --> 00:46:15.540 Frank R. Harrison: Okay, everybody, and welcome back. Now, I gotta say, just sitting here for the last half hour and really seeing the whole history of the nursing profession, I couldn't help but reference a little pop culture, thinking about the show MASH, and how the Korean War was really highlighting the value that Loretta Switt's character, Major Margaret Houlihan, had
00:46:15.540 --> 00:46:31.020 Frank R. Harrison: In advocating and fighting for the nurses and their female independence, and being able to stand for something that not only were they in the business of healing, but they were also showing that they were essential workers even without a pandemic, or in that case, it was wartime, but…
00:46:31.100 --> 00:46:44.799 Frank R. Harrison: still, that show resonates to me, not as a measure of fiction, which it was, but it was also representative about how the nursing profession was growing, especially, like you said, post-World War II.
00:46:44.800 --> 00:46:58.850 Frank R. Harrison: You know, so on that level, when I then got the comparison from you, Lynn, about the nurse practitioner, I can truly see that during COVID, for example, the essential worker was considered anyone who was in the healthcare space. That I realized.
00:46:58.850 --> 00:47:16.580 Frank R. Harrison: But I would imagine that the nurses were elevated, whether nurse practitioner or RNs, were elevated to a hero type of status at that time, correct? I mean, that's my takeaway, but I wanted to know if that was going through and resonating with all of you in the field.
00:47:16.970 --> 00:47:35.989 Lynn Rapsilber: Well, I just remember the pictures on TV of the New Yorkers leaning out their windows and clanging their pots and pans, celebrating the healthcare heroes who were going to work. Yeah, and it's just interesting, too, because there was just a nursing strike in New York as well, so, you know, it…
00:47:36.010 --> 00:47:51.050 Lynn Rapsilber: I think nurses are becoming in the forefront and being part of the discussion now instead of a side note. And I think that that's where we need to be. We need to be at the table with a seat, and if not one there, we should pull up a chair.
00:47:52.070 --> 00:48:07.539 Phyllis Quinlan: You know, Frank, the COVID thing was such that, you know, Lynn and I have gone to school, and we've heard about interprofessional collaboration, and we've read about interprofessional collaboration. We probably wrote about interprofessional collaboration.
00:48:07.540 --> 00:48:32.420 Phyllis Quinlan: But we never saw it until COVID. You know, and when you say that nurses were elevated, everybody was elevated. You know, everybody was on a level playing field. You know, some of us had to kind of grin, and… because everything was mostly medicine. And, you know, the surgery was just really… it wasn't even elective surgery, it was emergent surgery.
00:48:32.480 --> 00:48:44.920 Phyllis Quinlan: So the surgeons were relegated into the medical floors. Well, if you want to see a swan come out of the water and waddle like a goose, you know, you put surgeons on a medical floor, and, you know, they're like, which way do I go?
00:48:44.920 --> 00:48:52.649 Phyllis Quinlan: And it was funny because, you know, we were trying to say, well, what do you do? And they go, what do you mean, what do we do? We're surgeons, you know, we…
00:48:52.650 --> 00:49:04.819 Phyllis Quinlan: We do invasive things, so do invasive things, you know? So they joined in and intubated, and put in central lines, and put in the chest tubes that were necessary, and found their way. Everybody found their way.
00:49:04.820 --> 00:49:17.469 Phyllis Quinlan: The silver lining that came out of the COVID experience, and I know now a lot of people want to say we're dealing with burnout, we're dealing with mental health issues, and I'm not saying that some of our population isn't…
00:49:17.470 --> 00:49:25.520 Phyllis Quinlan: But the people I coach nationwide are telling me that they are stronger than they ever thought they could be because of their COVID experience.
00:49:26.640 --> 00:49:43.200 Phyllis Quinlan: And, you know, that is the work… that's the… that's the language of growth. That's not the language of traumatic stress. And what leaders need to understand, and legislature needs to understand, and our collective caring professions need to understand.
00:49:43.430 --> 00:49:54.059 Phyllis Quinlan: is that when people go through a transformative experience as COVID was for so many, there's no going back.
00:49:54.290 --> 00:50:11.600 Phyllis Quinlan: You are… you… there's a sense of competence, confidence, and empowerment. There's no going back. And if you're a smart leader, legislator, or professional colleague, you capitalize on that. You don't try to stamp it down, or corral it, or hold it in check.
00:50:11.800 --> 00:50:24.090 Phyllis Quinlan: You say, okay, let's take this new, new empowered whatever for a ride and see where we can go to make the industry of healthcare better and our collective caring professions that much stronger as well.
00:50:24.420 --> 00:50:30.809 Frank R. Harrison: Absolutely. And as you know, Phyllis, Frank About Health, it actually began as an epilepsy show, but…
00:50:31.220 --> 00:50:33.839 Frank R. Harrison: really went full force during COVID.
00:50:33.840 --> 00:50:35.010 Phyllis Quinlan: It sure did, yeah.
00:50:35.010 --> 00:50:37.970 Frank R. Harrison: It was just seeing… seeing the whole…
00:50:38.690 --> 00:50:45.700 Frank R. Harrison: crisis we went through in New York alone for 5 months on lockdown, it… there was just… it had to be expressed, and.
00:50:45.810 --> 00:50:48.660 Phyllis Quinlan: There's just so much need.
00:50:48.660 --> 00:51:06.490 Phyllis Quinlan: You know, I mean, just pure and simple. I mean, you'd have to be deaf, dumb, and blind not to realize that there is so much need. So, if we have ways of being able to serve those needs in creative new ways by very, very highly trained
00:51:06.490 --> 00:51:10.020 Phyllis Quinlan: competent professionals, why would we push back on that?
00:51:10.230 --> 00:51:17.189 Frank R. Harrison: Absolutely. I just find it disheartening that when you have a certain administration just tear apart
00:51:17.520 --> 00:51:22.350 Frank R. Harrison: the 5 or 6 years of what we had built. It, it, it per… it…
00:51:22.350 --> 00:51:27.220 Phyllis Quinlan: personally affects me on an emotional level, but I do my best to continue.
00:51:27.220 --> 00:51:28.980 Frank R. Harrison: To fight and advocate, so that.
00:51:29.350 --> 00:51:33.399 Frank R. Harrison: At least own our healthcare, because that's what we all do during crisis points, so…
00:51:33.790 --> 00:51:40.069 Frank R. Harrison: if every day is becoming a crisis, we just have to stay vigilant and… and continue to use our resources.
00:51:40.070 --> 00:51:49.739 Phyllis Quinlan: Maybe, maybe I, you know, the whole idea, you know, the thinking behind this, and I'm talking very spiritually here, the thinking behind this.
00:51:49.740 --> 00:52:13.010 Phyllis Quinlan: You know, is to shake us up a little bit and not take things for granted, and for us to be far more aware of what our health needs are, and far more aware of how we have to own it ourselves, and not just let somebody else take it over, and really advocate for yourself first, and of course, advocate for others. And I do think, as Lynn suggested before.
00:52:13.010 --> 00:52:20.730 Phyllis Quinlan: There are periodic rallying points that are indeed happening, and the genies are not going back in the bottle.
00:52:20.730 --> 00:52:30.979 Phyllis Quinlan: People, you know, if you really want to coalesce people, give them one single thing to focus on. And I think that is indeed happening.
00:52:30.990 --> 00:52:43.549 Phyllis Quinlan: And I know, I feel like I'm in hip boots marching uphill in tar sometimes right now, you know, from a body, mind, and spirit perspective, but I do think
00:52:43.600 --> 00:52:46.300 Phyllis Quinlan: Better times are coming.
00:52:47.180 --> 00:53:01.329 Lynn Rapsilber: It's interesting… can I just add something? On that note, in 2019, Commonwealth did a survey, and they surveyed the public to see who they would trust to fix healthcare. Who did they pick?
00:53:01.710 --> 00:53:02.690 Lynn Rapsilber: Nurses.
00:53:02.690 --> 00:53:03.330 Phyllis Quinlan: Yep.
00:53:03.700 --> 00:53:04.550 Frank R. Harrison: Yep.
00:53:04.550 --> 00:53:07.059 Lynn Rapsilber: That was in 2019, like, before COVID, so…
00:53:07.720 --> 00:53:13.829 Lynn Rapsilber: And then only our stock went up… Yeah. …through COVID. And I think… I think you're seeing now…
00:53:13.830 --> 00:53:27.719 Phyllis Quinlan: I don't know the exact number, but there's gotta be at least 10 or 12 political figures now holding national offices, whether at the state or the federal level, that are nurses.
00:53:28.270 --> 00:53:47.939 Phyllis Quinlan: once we start having nurses in places where, you know, policy and decisions are being made. We can all rejoice on that, because we're… the… the… the input is not going to be so much economic, it is going to be patient-focused as well.
00:53:48.500 --> 00:54:01.010 Frank R. Harrison: Absolutely. But to piggyback off of what you said, Phil, is better times are coming, I wanted you both to share what you both are working on to show and reflect on those better times that are coming, whether they're books or podcasts.
00:54:01.010 --> 00:54:25.940 Phyllis Quinlan: Well, I'll just jump in real quick. I think those of us who have listened to… those of your listeners who have listened to the show know that I've been writing a book forever, and I finally finished it. And, you know, the book is going to be addressing disruptive behavior in the workplace. It's going to be the missing puzzle of a healthy work environment, really understanding and effectively managing
00:54:25.940 --> 00:54:28.620 Phyllis Quinlan: Managing Bullying and incivility in the workplace.
00:54:28.730 --> 00:54:36.899 Phyllis Quinlan: And I'm hoping, fingers crossed, it's coming out in May, so thank you for the moment to let me plug that. But, Lynn, tell us.
00:54:37.620 --> 00:54:41.269 Phyllis Quinlan: You have an article coming out, and you also have a book coming out.
00:54:41.710 --> 00:55:00.000 Lynn Rapsilber: Yes, so I'm working on a book. It's going to be a tutorial for nursing students to learn about coding, billing, and documentation, because it's not very well taught in school. The curriculum is so dense, but this is such an important piece, because we have to understand how we generate revenue.
00:55:00.000 --> 00:55:01.899 Lynn Rapsilber: For the places that we work.
00:55:01.920 --> 00:55:10.140 Lynn Rapsilber: And how we can negotiate better wages, better opportunities, and this book will help to do that.
00:55:10.140 --> 00:55:21.920 Lynn Rapsilber: And we're also having a conference in Tampa for the nurse practitioners through the National Nurse Practitioner Entrepreneur Network, and that is going to be a business-focused conference, so we'll have
00:55:21.920 --> 00:55:35.920 Lynn Rapsilber: topics that are really relevant, legal, financial, practices, and vendors that specialize in NP, information. So, we're hoping that a lot of people will take advantage of that as well.
00:55:36.400 --> 00:55:49.309 Frank R. Harrison: Nice, and I guess I can say that, not next week, but starting with the week after that, for about 3 weeks, the three of us have agreed to do a mini-series on the nurse practitioner, or the nursing profession as a whole.
00:55:49.670 --> 00:56:01.989 Frank R. Harrison: Probably, if it's doable, you know, based on what is being released in the near future, we could actually create one of those three episodes as a webinar, and teach the coding, or teach…
00:56:01.990 --> 00:56:13.130 Frank R. Harrison: Some of the aspects of the nursing… nurse practitioner field that, could also access your audience of nurse practitioners who could learn a lot.
00:56:13.200 --> 00:56:29.760 Frank R. Harrison: with, both you, Phyllis, and myself helping moderate things. We could have live interaction with those people who may ask questions. So, I'm looking forward to, using the Frank AboutHealth platform from about, what is it, the,
00:56:30.090 --> 00:56:35.080 Frank R. Harrison: the 26th, I believe, till about, March 12th, something like that, around that.
00:56:35.080 --> 00:56:38.659 Phyllis Quinlan: Something like that. Let me, very quickly hear…
00:56:38.880 --> 00:56:44.540 Phyllis Quinlan: So, we are going to skip the 19th and start on the 26th, yes.
00:56:44.540 --> 00:56:45.260 Frank R. Harrison: Yes.
00:56:45.260 --> 00:56:53.790 Phyllis Quinlan: I'm not sure if we're going to be able to get a webinar format going, but we certainly can give highlights and overviews and maybe answer some.
00:56:53.790 --> 00:56:56.249 Lynn Rapsilber: So little pearls of wisdom. Pearls of wisdom.
00:56:56.250 --> 00:56:58.070 Phyllis Quinlan: Some great questions, you bet.
00:56:58.070 --> 00:57:15.900 Frank R. Harrison: And so, of course, we will be talking about that together offline over the next week or so, so we can prepare for that. But, ladies and gentlemen, we are literally one minute to ending, so I just want to say thank you so much for this, for attending this, special episode of Frank About Health.
00:57:15.980 --> 00:57:34.450 Frank R. Harrison: Frank About Health is doing what it can to continue on the fight towards managing disruption, as well as educating everyone out there about how to own your healthcare. And I think what you saw tonight is an example of how we are pivoting the show into little spin-offs with… in controlled blocks, but
00:57:34.620 --> 00:57:49.379 Frank R. Harrison: to be more educational and informative. 2026 is the year you need to arm yourself, whether you are a patient, or a nurse, or even a doctor, for that fact. So, that being said, we… I will come back next week with another episode of Frank About Health.
00:57:49.380 --> 00:58:08.270 Frank R. Harrison: And, just everybody, if you have any questions for me, you can reach me at frankrharrison1 at gmail.com, or on my social media, I'm available on LinkedIn, I have my YouTube channel, where my documentary, where Phyllis is in it, is also, available to be seen, Being Frank for a Healthy Future.
00:58:08.380 --> 00:58:17.310 Frank R. Harrison: And, also, I'll just see you all next week. Thank you both, Phyllis and Lynn, for being here, and we will see you both in two weeks.
00:58:17.650 --> 00:58:18.620 Phyllis Quinlan: Thank you, Lynn.
00:58:18.910 --> 00:58:19.750 Lynn Rapsilber: Thank you.
00:58:19.890 --> 00:58:22.280 Frank R. Harrison: And thank you, Jesse, behind the scenes for engineering the show.
00:58:23.400 --> 00:58:24.340 Frank R. Harrison: Take care.
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