VHA Scenarios

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Discussion
Providing exceptional care to U.S. veterans ought to be a priority for our nation and its health care providers. The VHA is approaching the 50-year mark of utilizing the nurse practitioner as a vital provider of primary care. With an increasing number of veterans, at home and abroad, now is the time to set up a universal scope of practice for providers throughout the system. It does not go unnoticed how difficult the creation of a national standard will be. While the VHA is a federal organization, its providers are all licensed by state entities. Unless the roles are defined on a national level it appears there will always be some discrepancies within the VHA system. Even so, that should not curtail the VHA from affording the primary care providers within its system the opportunity to practice to the furthest level of their training while notifying their colleagues of these expectations and roles.
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The discussion needs to focus on creating a system that can further facilitate the success of the NP in this role and must include educating practitioners of the role each other performs within the system. As the profession-specific primary care delivery approach begins to change, the VHA has begun to seize upon this educational opportunity to create an inter-professional, team-based, patient-centered care delivery paradigm in its Centers of Excellence in Primary Care Education model (Rugen et al., 2013). In this way, new providers can gain a multidisciplinary insight into primary care and the system can begin to utilize its members more efficiently without compromising on safety or patient outcomes. If the system remains fractured by role confusion and an unwillingness to provide support for each other a significant opportunity opens up for more negative health outcomes and reduced patient

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