Mandi Cafasso

1. Tell us your career history. Where did it start and how did it evolve to your current situation?

I started my career as a registered nurse in 2002 working with patients awaiting Liver/Small Bowel Transplantation. I fell in love with this group of patients and went back to school in 2003 for my Masters of Science in Nursing. I loved working with this population so much that I worked full time on the weekends while I was in school. I graduated in 2005 and shortly after my graduation, I was certified as a pediatric nurse practitioner. I was subsequently hired as the only inpatient Liver/Small Bowel Transplant nurse practitioner in the facility. As I pioneered this role, I quickly realized that I had a lot to learn. Working with a fragile population in pediatrics, I encountered a lot of barriers as a nurse practitioner. There were restrictions to medications I could order, I could not write for home care post-op, there were restrictions with ordering blood products, etc.

By 2007, I had collected a list of over 200 drugs that were commonly needed to treat pediatric patients, but were considered off label medications. At that time, according to the Ohio Board of Nursing Formulary, in order for nurse practitioners to prescribe off label medications, the prescribing APN had to be able to provide peer reviewed literature supporting use of the medication for off label indication. This request is not an easy feat in pediatrics, as drug research is often limited in children. This posed a major efficiency and safety concern to my practice. After several trips to the OBN Committee on Prescriptive Governance group, language about prescribing off label medications was changed to make prescribing needed medications less cumbersome. This is when my love of health policy began.

Since 2007, I have provided education about prescriptive practice at my facility every year. This presentation has also been used by the OBN to educate NP’s new to Ohio about prescriptive practice and use of the formulary.

In 2010, I received a scholarship to attend the Nurse in Washington Internship. This opportunity gave me confidence to talk with legislators and policy makers about the changes needed to healthcare laws that would allow APRN’s to better care for patients and families.

In 2011, I began serving as the legislative chair of the Ohio Chapter of the National Association of Pediatric Nurse Practitioners. In this role I have been able to keep Ohio PNP’s updated about current legislative changes impacting care delivery.

In 2013, I was joined the OAAPN committee working on Modernization of the APRN Nurse Practice Act as a representative of NAPNAP and pediatric nurse practitioners in the state. I have worked closely with members of OAAPN to develop a training tool for APRN’s to use to become familiar with the ins and outs of professional advocacy.

Over the years, my knowledge of the vast capabilities of APRN practice has not only changed because of my clinical experience, but additionally, because of the relationships and networking opportunities I have been able to achieve. I am proud to be an APRN, it is truly an amazing profession, and I will continue to work on health policy issues until the recognition of the profession is secondary nature to those who are responsible for writing Ohio law and institutional policies regarding healthcare delivery.

2. What is your proudest professional accomplishment?

In 2013, I went back to school for my doctorate and completed my doctoral project entitled: Advocacy: A Vital Step in Attaining Full Practice Authority for the APRN. I graduated in May 2015 from Otterbein University. This project was groundwork for my desire to educate APRN’s about the importance and impact of professional advocacy. I plan to use the findings from this project to teach nurse practitioners across the state how to feel confident about and empowered by the role.

Mandi Cafasso


3. What advice would you give to a newly graduated APRN in the state of Ohio?

Get involved in your professional organizations as early as you can. The beginning of your career is the best time to begin finding mentors- and find more than one if you can. Also do not take practice laws for granted. There will always be laws that impact the care we provide, it is absolutely necessary to be knowledgeable about what you can and can’t do, not only by state/federal law, but also by your employer.

Lastly, find an employer who will allow you to grow professionally. APRN’s are trained to provide clinical care, but we also have knowledge to lead research, build programs and educate.

4. What does House Bill 216 mean to you? To the profession? To Ohioans?

House Bill 216 means allowing APRN’s to care for patients and families as the educational preparation intended. This legislation would allow APRN professionals to collaborate openly, without restriction by numbers and provider type. The legislation would simplify explanation of an ARPN to say; “I am licensed,” instead of, “I am certified”- clearer language to professionals and patients. The legislation would remove cumbersome and unnecessary restrictions to prescribing medications.

Overall, passage of House Bill 216 would allow Ohioans to have more options for healthcare, increase provider availability, decrease costs to the state and improve the health of our citizens.

 5. What do you do to relax and unwind?

I love to spend time with my family. I have two small children: Briley, 4, and Joselyn, 2. They keep me busy. Much to my husband’s dismay, I love to shop. I also have recently found a new addiction to my Fitbit! It has resurrected my love of exercise!

Mandi Cafasso Family

Current Job Title: Pediatric Nurse Practitioner, Division of Endocrinology

Employer: Cincinnati Children’s Hospital Medical Center

College/University: DNP- Otterbein University 2015; MSN- University of Cincinnati, 2005.