Need for Family Nurse Practitioners in Community Health

Q&A with Dr. Sophia L. Thomas, DNP, APRN, FNP-BC, PPCNP-BC, FNAP, FAANP, a certified family and pediatric nurse practitioner at the DePaul Community Health Center in New Orleans

by Reneé Hewitt

Family nurse practitioners (FNPs) are essential to the healthcare landscape, providing wellness guidance and necessary care to patients in need. FNPs help manage patient caseloads at hospitals, clinics, and medical practices, working alongside physicians and specialists to care for sick, injured, and healthy patients. As patients struggle to access care resources in some areas of the United States, the role of the FNP has become increasingly important to directly and meaningfully impact communities.

Minority Nurse chatted with Dr. Sophia L. Thomas, DNP, APRN, FNP-BC, PPCNP-BC, FNAP, FAANP, a certified family and pediatric nurse practitioner at the DePaul Community Health Center in New Orleans, about the critical role FNPs play in the community, what’s to come for the nursing profession in 2023, and her time as president of the AANP.

spectrum. We’re a multi-specialty clinic, but we care for the most vulnerable in the Greater New Orleans area. Our patient population is diverse. We have a lot of immigrants from various places around the world. We take patients with Medicare, Medicaid, and private insurance, as well as those uninsured.

How are you helping to make a difference in your community as an FNP?

As an FNP, I pride myself on the care I provide to my patients because they’re quite vulnerable when faced with multiple cultural challenges that impact their health status.

Dr. Sophia L. Thomas, DNP, APRN, FNP-BC, PPCNP-BC, FNAP, FAANP

Talk about the DePaul Community Health Center and its patients?

DePaul Community Health Center is a federally qualified healthcare center with 11 locations in Greater New Orleans. We care for a diverse population of patients, from newborns to the very elderly, treating diseases and diagnoses that span the healthcare

So as I practice and take care of patients, I’m not just, “You know that you have diabetes, here’s a prescription.” I’m using that nurse practitioner holistic approach, and taking it a step further and making sure the patients can afford their medications, making necessary referrals for their social determinants of health, discuss food insecurities, help people who have housing problems or @ transportation issues, etc. In our practice, we have community health navigators that help patients. We assess their social determinants of health and have community health navigators that help me. They see social challenges and try to meet the needs of the community. So, as a nurse practitioner, looking at patients with that holistic approach is very important, especially when patients are so vulnerable.

Was there ever a thought about being an MD instead of an NP? Or did you always want to be a nurse practitioner? There was never a doubt. So I decided when I was 13 to become a nurse. And that was after I had an emergency appendectomy in the hospital. So, unfortunately, I was very sick and hospitalized for a week, and the nurses at this county hospital in Warwick, Rhode Island, were so caring and compassionate. And then, as I was a nurse practicing in the intensive care unit, I saw patients who faced multiple health challenges. They were suffering from complications of diabetes and heart disease, and kidney failure. And then I realized we need more prevention for these patients. They would end up in the ICU there and were being treated for the things that could have been prevented. I focus on health promotion and disease prevention in the outpatient setting as a family and pediatric nurse practitioner. So that’s my journey as to how I evolved from wanting to be a nurse at a very young age to several years later and deciding that being a nurse practitioner was my goal.

What do you like best about being an FNP?

The connection with my patients is key. I’m certainly proud of the work that we do as nurse practitioners. It’s an honor to serve my community. What I love the most about being a nurse practitioner is impacting the lives of others and positively influencing their health, and looking at it with that holistic nursing approach that we do so well. Nurse practitioners start as nurses, so we have that four-year nursing background dedicated to our education before we even go to nurse practitioner school, which is very focused on the role we will practice. I went to FNP school to become a family nurse practitioner and got my master’s and, ultimately, my doctorate. Others decide they want to work in mental health. So they focus their education solely on becoming mental health or start getting prepared for the medical modeling positions with a bachelor’s degree and in pre-med and then go to medical school and get exposed to many different areas of medicine before finally focusing on their residency. The educational model is different, but the outcomes are the same. And one of the things we’re very proud of as FNPs is that our healthcare outcomes are equivalent to those we see from our physician colleagues.

Full practice authority is gaining ground now in 26 states. Where do you see the role of the nurse practitioner going in 2023?

More states are instituting regulatory language that allows nurse practitioners to have full practice authority, which is the ability to practice to the full scope of our education and certification without any regulatory restrictions. And each year, we see more states moving this way. What’s important to note is that states that institute practice authority are growing the workforce. They’re creating an attractive place for nurse practitioners to practice. They’re going into rural areas and what we call healthcare deserts, where Americans lack access to care. For example, they used to institute a full practice authority in Arizona in 2001. Five years later, the nurse practitioner workforce doubled statewide, growing 70% in rural areas. And so when we have nurse practitioners practicing at the fullest extent of their education and training, that’s a stable, permanent law. It allows nurse practitioners to decide to go into these areas where patients lack access to healthcare. It’s almost 100 million Americans lack current access to add primary care. It’s a 20% jump from a year ago. So with these healthcare shortages, we must have all healthcare providers practicing at the top of their education to meet those healthcare needs.

You’re a past president of AANP. What does it mean to you to hold this role? It was such an honor for me to be able to serve as president of the largest national professional association for nurse practitioners in the world. When you talk about 120,000 members, and just in the United States, over 355,000 nurse practitioners, providing care to millions of patients each year, it was important for me to serve in this role, especially throughout COVID, when rapidly changing guidance seems to change constantly and the news was coming out very quickly. So I made it a point in my presidency to be sure that we were providing nurse practitioners access to all the latest information related to COVID-19, immunizations, and how the disease processes were going. But in addition, you know, at the same time, we saw that providers were becoming increasingly burned out. And so, we focus resources on our members related to provider burnout. So being responsive to our members’ needs was crucial as I served as president.

What are your words of wisdom for nurses who want to become FNPs? With almost 100 million people living in healthcare deserts, this is a great time to become an FNP. Especially for those willing to move into those rural areas and ensure these patients have adequate access to healthcare. We have to prepare the next generation of nurse practitioners to meet the healthcare demands and prepare our healthcare workforce for the next pandemic. Whatever that means. And acting for practice authority to meet these patient outcomes is so essential. I encourage young nurse practitioners to get involved in health policy in their state, advocating for patients and patient services that can improve healthcare. The demand for nurse practitioners is growing along with other healthcare professionals. I was living in a small, rural community when I decided to become a nurse practitioner. I graduated, and I practiced in that small rural community. Ten nurse practitioners and five physicians were in that community then. Now, 26 years later, there are five nurse practitioners and physicians. And that shows you our plight in predominantly rural areas, getting healthcare providers to care for those patients. And the tides are shifting, and nurse practitioners are there to meet the needs of those communities wherever they may be.

Reneé Hewitt is the editor and content strategist for Minority Nurse . When enjoying life unplugged from the digital world, you’ll find her on a trail taking wildlife photos or birdwatching.