Top Nurse: Gina Bryan advocates for others

Bryan was awarded the leadership award
Top Nurse: Gina Bryan advocates for others
Ruthie Hauge

Gina Bryan wears a lot of hats. While she’s a full-time faculty member at the University of Wisconsin-Madison School of Nursing, she also works at Rock County Mental Health and advocates for advanced practice registered nurses, or APRNs, on state and national levels.

Bryan, who has been a nurse for 18 years, spent all of her higher education at the UW-Madison School of Nursing, where she now teaches. After finishing her undergraduate studies, she returned for her master’s of science degree with a focus in psychiatric nursing. She became a clinical nurse specialist and an advanced practice nurse prescriber. Eventually, she went back to earn a doctor of nursing practice in health policy.

While working in community psychiatry for 16 years at the Mental Health Center of Dane County — which is now known as Journey Mental Health Center — Bryan helped those experiencing adversity, such as transient housing, food insecurity and opioid addiction.

She pursued her doctorate with a focus on health policy, inspired by the people she was serving who were unable to get equitable health care.

After working as an APRN for years and seeing the problems with restrictive laws firsthand, she now advocates for all advanced nurses and those they serve to ensure communities throughout Wisconsin can receive the psychiatric and physical health care they require.

“There’s a huge shortage of psychiatric providers,” Bryan says. “I work in an area of community psychiatry, where I always worked, with the most intense, severe and persistent mental illness.”

Compared to the rest of the state, Bryan says, Dane County doesn’t have a provider shortage, but she says the state has restrictive laws preventing APRNs from working in ways that would improve health care practices, especially in rural areas.

Nurse practitioners, clinical nurse specialists, certified nurse midwives and certified registered nurse anesthetists are all classified as APRNs. All need master’s degrees to work in these roles.

Bryan says 28 states allow independent practice for APRNs, though this number can differ based on their roles. Wisconsin requires a collaborative agreement with physicians, but Bryan says the rules do not specifically describe what this entails. Each collaborative pairing might be different. Bryan says some APRNs are able to work independently day-to-day with a collaborative partner, but other collaborative agreements might require the paired physician to sign every prescription an APRN gives a patient.

“If there’s not a psychiatrist or a physician somewhere [with whom] to collaborate, that advanced practice nurse can’t practice, and so it restricts the ability for sometimes whole parts of the state to have access to a provider in that way,” Bryan says.

As a nurse, Bryan says it’s part of her role to advocate for patients and improve access. Often, she says, policymakers don’t have a background in health care, so she tasked herself with the challenge of communicating effectively with politicians about the issues.

Today, she is part of the Wisconsin APRN Coalition which works on health policy throughout the state. Bryan also says she’s part of many Wisconsin task forces and meets with state lawmakers to advocate for APRNs.

“Why would you take any provider that’s educated and trained to do this work and not allow them to do their work to their full capacity?” Bryan says. “It’s really about people having access to high quality health care, and some of our current statutes [and rules] in Wisconsin get in the way.”

Because of the restrictions in the state, APRNs are leaving Wisconsin for states that don’t have the same obstacles.

As a professor, Bryan educates her students early on about the importance of health care policy. For her, advocacy and nursing go hand in hand.

“Because I love what I do, it makes you want to try to support other people doing this work,” Bryan says.