In the second national survey from the American Association of Nurse Practitioners (AANP) that aims to understand how coronavirus disease 2019 (COVID-19) is affecting clinical practice, NPs report both significant progress in care as well as lingering challenges that may include delays in COVID-19 testing and barriers to effective telehealth consultations.1
Federal telehealth waivers aimed at temporarily suspending practice barriers and expanding access to NP-provided care have been extremely beneficial in fighting COVID-19, noted a majority of survey respondents. When asked about the kinds of policy and organizational-level actions that have been most beneficial, the top 3 responses included federal telehealth waivers (76%), expansions to services covered (68%), and reimbursement rate increases (62%). However, NPs still report barriers to practice in telehealth such as patient connectivity issues (73%), patient access to technology and internet (69%), and patient comfort with technology (58%).2
As of August 2020, the number of NPs who had tested positive for COVID-19 has increased three-fold despite marked progress in practice readiness and the availability of personal protective equipment (PPE). In the early days of the pandemic, less than 2% reported being infected.
The lack of viral testing and timely test results continues to be the greatest barrier to effectively responding to COVID-19 in communities, according to the survey. Approximately 33% of NPs reported having patients turned away from testing sites for failure to meet predetermined criteria, and 78% of NPs reported delays in receiving patients’ viral test results. Test result delays ranged from 7 to 10 business days to up to 20 days.
Compared with the onset of the pandemic, NPs felt better prepared in August 2020 to deal with COVID-19 (82%). The majority of NP practices have the means to accommodate patients for non-COVID-19 in-person care. About 35% of NPs stated they felt as though their practice is ready for a surge in COVID-19 cases; about 31% felt their practice is ready for a surge in issues related to delayed or deferred care, and 34% for a surge in influenza cases.
The pandemic continues to affect job security. Since March, nearly 17% of NPs have experienced a furlough. According to the survey, the majority of furloughed NPs have returned to their positions; however, 4% were still furloughed at the end of July, 3% continued to experience a layoff or termination, and about 1% stated their practices remained closed.
When asked about changes to their employment, approximately 40% of those surveyed indicated decreases to their overall income, and 31% had decreases in hours worked. Since the start of the pandemic, nearly 15% of NPs applied for unemployment benefits, 8% applied for personal loans, and 58% looked for other NP positions.
Over the next 6 months, a majority of NPs would like to see more funding for COVID-19 research (87%), continued investment in vaccine development (84%), and additional funding for health care providers and support staff (84%).2
“As providers working at the forefront of this pandemic, we urge our policymakers and health care systems to work together to continue strengthening access to viral testing and bolstering the supply chain to shorten wait times for test results — which are vital to limiting outbreaks and achieving better patient outcomes,” stated AANP President Sophia L. Thomas, DNP, APRN, FNP-BC, PPCNP, FNAP, FAANP.
1. AANP National Survey Reveals Progress, Challenges as Nurse Practitioners (NPs) Combat COVID-19 [news release]. Austin, Texas: American Association of Nurse Practitioners (AANP); August 17, 2020. Accessed October 20, 2020. https://www.aanp.org/news-feed/aanp-national-survey-reveals-progress-challenges-as-nurse-practitioners-nps-combat-covid-19.
2. Nurse Practitioner COVID-19 Survey. Executive Summary. American Association of Nurse Practitioners (AANP) website. August 2020. Accessed October 20, 2020. https://www.aanp.org/practice/practice-related-research/research-reports/nurse-practitioner-covid-19-survey-2