Letters to Politicians

In Colorado there has been a big flap about the Colorado Nurse Practice Act....it seems that the Colorado Medical Society wants to have some say in defining the role of advanced practice nurses...I would be one of those nurse practitioners and I have a pretty strong opinion about my role. Thus, I sent the following to some of the Colorado Senate...


Betty Boyd
Health and Human Services, Chair
200 E. Colfax Denver, CO 80203

Dear Senator Boyd:

I am writing to you as an Advance Practice Nurse who is gravely concerned about the implications of the CMS’s request to define Advance Nursing Practice. I see the two professions as separate, but collaborative. My concern is that there is a serious potential to limit the autonomy of APN’s and to do so would be a disservice to the population as a whole.

I am currently the coordinator for the Neonatal Nurse Practitioners (NNP) at The Children’s Hospital. We provide services to hospitals, families and newborns throughout the Denver metropolitan region. If our autonomy were to be limited, it would be probable that many of the hospitals where we currently practice would no longer be able to provide level II nursery service to their clientele. This would mean that the cost of health care would increase as more infants would have to be transported to a higher level of care in the urban centers. For some hospitals, this could have tremendous financial implications as NICU’s or Special Care Nurseries often supply the greatest revenue. Furthermore, this would create hardships for families whose infants’ medical management could not be provided close to home.

I think it is important to consider the potential impact of the CMS’s request. I recently attended a perinatal meeting at a local hospital. During this meeting there was a review of a case in which a very sick neonate was stabilized and transported to a higher level of care. It was the NNP who stabilized the infant. To a man, all who had worked at the hospital for several years acknowledged that had it not been for the NNP, the infant would have died. Thus, I would argue, that it is not just about providing care, it is about saving lives. APN’s need to have autonomy so we can do what we do……for some of us, that is saving infants.

Respectfully,



E. Welch-Carre, MS, NNP