Let's Talk Nursing Now

02/13/2026

In January 2026, New Jersey took a regressive step in healthcare policy by enacting Executive Order 415, which terminated pandemic-era waivers that permitted Advanced Practice Nurses (APNs) to practice independently. By requiring a return to mandatory "joint protocols" and physician supervision for prescribing, this action heavily disadvantages nurse practitioners (NPs) and harms patient access to care. This reversal forces independent, often female-owned, practices into a corner: they must either hire physicians at substantial, often exploitative costs to manage the medical aspects of their businesses, sell their practices, or risk losing their licensure.
The dismantling of independent practice is, at its core, an anti-competitive maneuver that ignores the evolution of healthcare delivery. Currently, 27 states, along with Washington, D.C., authorize full independent practice for nurse practitioners. Studies have shown that in states where these restrictions are removed, healthcare access increases, particularly in underserved, rural, or Health Professional Shortage Areas (HPSA). Furthermore, evidence demonstrates that malpractice rates are consistently lower for nurse practitioners compared to physicians, reinforcing that independence does not equate to a decrease in safety.
Forcing APNs to return to supervision under physicians creates a financial burden that often borders on extortion. Physicians have historically abused these mandated supervision provisions by charging excessive, "usurious" fees for little to no direct supervision, effectively acting as middlemen who extract profits from the labor of nurses. These forced collaborations often become a barrier to care, particularly when physicians are unavailable in underserved areas, as they force NPs to limit their practice despite having the expertise to provide it.
The Federal Trade Commission (FTC) has long maintained that state laws mandating physician supervision are often anticompetitive and work against the public interest. These laws stifle innovation and prevent creative solutions to providing care, particularly when physician shortages are widespread. The FTC’s position is that such restrictions restrict the ability of NPs to provide care, thus undermining the efficiency of the healthcare system.
By restricting independent practice, New Jersey is prioritizing professional protectionism over patient safety and access. Unless state governments allow the evolution and expansion of practice for nurses, the United States will remain a country with high educational standards for health professionals but also persistently high,, and preventable, chronic disease and mortality rates. Promoting, rather than restricting, full practice authority is crucial for a modern, accessible, and high-quality healthcare system.

02/12/2026

01/29/2026

The VA Office of Inspector General (OIG) initiated a healthcare inspection at the VA Central Texas Healthcare System (system) in Temple to assess allegations that two pain management advanced practice registered nurses (pain management APRNs) were not appropriately supervised and were unqualified

01/29/2026

https://www.instagram.com/p/DTMKt8fjM-J/?igsh=MW80NWswNms3Mzhn

01/28/2026

The post-Dobbs landscape in the United States has birthed a complex legal and logistical battleground centered on reproductive healthcare, specifically regarding abortion pills like mifepristone and misoprostol. As states move to ban or severely restrict abortion, and others act to protect access, a developing clash has emerged over the transmittal of these pills across state lines [1, 2]. This conflict is not merely about medication; it is a fundamental test of federalism, threatening to reshape telemedicine, mail-order pharmacy operations, and multi-state licensure laws, while delicately balancing on the precipice of infringing upon established state rights [3, 4].
At the heart of this dispute is the conflict between "shield laws" passed in pro-choice states and enforcement efforts by anti-abortion states. States like New York, Massachusetts, and California have enacted laws to protect providers who mail pills into restricted states, arguing their sovereignty allows them to regulate commerce and healthcare within their borders [1, 5]. Conversely, conservative states are seeking to block these shipments, asserting their right to enforce criminal statutes within their jurisdiction, even if the action originates elsewhere [2, 6]. This creates a constitutional standoff where one state’s protected health activity is deemed a criminal act in another.

The delicacy of this issue lies in the potential infringement on state rights. If anti-abortion states succeed in stopping interstate mail services, they effectively project their laws into pro-choice states, undermining those jurisdictions' authority to govern health policy [3, 4]. On the other hand, allowing unrestricted shipment could render state-level bans functionally obsolete, nullifying the legislative will of voters in restrictive states. This clash risks violating the principle that states should generally manage their own internal affairs, setting a dangerous precedent for future interstate legal warfare [4, 6].
Furthermore, this battle extends far beyond the physical pill, threatening to dismantle modern healthcare delivery models. The fight directly targets telemedicine—a cornerstone of remote abortion access—by questioning whether a virtual visit across state lines constitutes practicing medicine in the patient's state, potentially exposing providers to prosecution [3, 5]. Consequently, this conflict forces a reevaluation of multi-state licensure laws. If states begin targeting out-of-state doctors, compact agreements that streamline licensure could collapse, limiting patient access to specialists for all types of care, not just reproductive services [4].

Finally, the battle threatens to reshape the regulatory framework for mail-order pharmacies. Anti-abortion advocates are exploring ways to hold these entities liable, which could force pharmacies to cease operating in certain states altogether, affecting the delivery of non-abortion-related medications [2, 5]. Ultimately, this clash is not just about abortion; it is a transformative legal struggle that threatens to fracture interstate commerce, diminish telemedicine, and reorder the balance of power between the states and federal authority [3, 6].

01/28/2026

Suit against Debra Lynch is latest from Texas’s Republican attorney general amid ongoing attacks on abortion pills

01/25/2026

In January 2026, a MedPage Today article reopened the debate: Are nurse strikes ethical?. While ethicists often focus on the potential for short-term patient harm, the 15,000 New York City nurses currently on strike point to a deeper, more pervasive ethical failure—one rooted in systemic hospital decision-making that prioritizes profit over professional safety.

The True Ethical Crisis: Systemic Negligence
The ethical question shouldn't begin with the strike; it must begin with the conditions that force it. When hospital administrations chronically understaff units, they create a "hospital creep" on nursing time. Nurses are compelled to forego legally required breaks to ensure patient stability, a practice that subsidizes hospital margins with nurse well-being. This environment doesn't just "feel" unsafe—it is clinically dangerous. Research from early 2026 confirms that understaffing increases surgical mortality rates by up to 7% for every additional patient added to a nurse’s workload.

Misuse of Skilled Labor
A significant ethical lapse lies in the misuse of nursing expertise. Hospitals frequently cut support staff, forcing highly trained RNs to perform manual, nurse-aide tasks like transporting linens or emptying trash. This diversion of skilled labor creates a "documentation debt," where nurses must stay hours after their shifts—often unpaid or under-scrutinized—just to complete patient notes. When a nurse is too busy with manual labor to monitor vital signs, the administration has already violated its ethical duty to patient safety.

Leadership and Compensation
The exclusion of nurses from leadership teams is a deliberate choice that silences the frontline. Without nursing voices on hospital boards, decisions are made by "suits in high-rise offices" who prioritize spreadsheets over bedside realities. In 2026, as the national nursing shortage reaches 8%, underpaying staff while demanding they act as the ultimate safety net is unsustainable.

Conclusion: The Strike as an Ethical Imperative
Striking is a last resort, but in a system that directly harms patients through understaffing, it becomes an ethical imperative. Nurses are not walking out to "get more"; they are walking out to ensure they can provide the level of care their licenses—and their patients' lives—require. The real ethical failure is not the picket line; it is the administration’s refusal to treat nursing as a vital clinical resource rather than an exploitable overhead cost.

01/24/2026

Colorectal cancer (CRC) is no longer a disease exclusively associated with aging. Over the past two decades, researchers have observed a concerning, rapid rise in early-onset colorectal cancer—diagnoses in individuals under 50 years of age. While this trend is global, it is particularly pronounced in the United States, where colorectal cancer is projected to become a leading cause of cancer death for young adults by 2030. Mounting scientific evidence points to two major environmental and dietary contributors to this crisis: the high consumption of ultra-processed foods (UPFs) and the infiltration of microplastics into the food chain. Significantly, these risks are not distributed equally, with people of color, particularly African Americans, experiencing higher rates of exposure and earlier, more aggressive diagnoses.
Ultra-processed foods—industrial formulations containing additives, preservatives, high-fructose corn syrup, and hydrogenated oils—now make up nearly 60% of daily caloric intake for American adults. Studies, including those analyzing data from 30,000 women, show that high consumption of UPFs increases the risk of developing precancerous adenomas by 45%. These foods trigger chronic gut inflammation, disrupt the gut microbiome, and promote obesity, creating an ideal environment for tumor development. Furthermore, these products are often packaged in plastics that leach chemicals like BPA and phthalates, contributing to the ingestion of microplastics. Microplastics have been identified in human colorectal tissue, where they are believed to damage the intestinal barrier and promote tumorigenesis.
The disproportionate impact on communities of color is a direct result of environmental injustice and systemic factors. Structural inequalities, including the prevalence of food deserts, limit access to fresh, healthy, whole foods, forcing many to rely on more affordable and accessible UPFs. Research has shown that Black women are particularly affected by the life cycle of plastic pollution, encountering higher levels of environmental toxins and packaged foods. Furthermore, studies found that while African American households may purchase a lower proportion of certain processed foods than white households, they have higher purchases of processed sugary beverages, contributing to higher, more severe disparities in health outcomes.
The consequence of this, paired with genetic and environmental factors, is the alarming reduction in the age of CRC diagnosis for African Americans. African Americans are 20% more likely to be diagnosed with colorectal cancer than white Americans, and they are twice as likely to be diagnosed before age 50. Furthermore, they are often diagnosed at a more advanced stage, with a higher prevalence of aggressive, right-sided (proximal) colon cancers. Due to this trend, the American College of Physicians recommends that screening for African Americans should begin at age 40, or 10 years earlier than the general population.
In conclusion, the rise of early-onset colorectal cancer is intrinsically linked to modern dietary habits and environmental exposure to plastics. The disproportionate exposure of communities of color to these risks, driven by systemic inequality, has resulted in a public health crisis that manifests as earlier, more lethal diagnoses for African Americans. Addressing this requires not only earlier screenings but also systemic, structural changes to food access and environmental regulation to mitigate these risks.

01/24/2026

Federal Agents Kill Registered Nurse in Minneapolis

01/12/2026

Look at our LTNN interview with tech guru and financier Jonathan Nelson, RN, an emergency nurse.

01/06/2026

The nursing community is mourning the loss of Dr. Janell Green Smith—a midwife, educator, and leader who dedicated her life to improving maternal care and supporting families through pregnancy and birth.

Dr. Green Smith passed away following complications after childbirth. Her passing has deeply impacted nurses, midwives, patients, and colleagues across the country.

As we honor her legacy, her loss is also renewing conversations nurses know too well—about maternal safety, postpartum care, and the importance of listening when something doesn’t feel right.

We hold her family, loved ones, and the communities she served in our hearts.

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12/01/2025