A Nurse Practitioner's View

ABC News recently sat down with President Obama for their "Prescription for America" forum. You can read the transcript here . It is a wonderfully transparent and thorough conversation on the major issues of health reform today. They address the primary care and nursing shortages, comparative effectiveness, putting an emphasis on prevention/wellness and even discuss nurse practitioners and physician assistants as being part of the solution. I truly believe we will see steady, incremental progress regarding health reform because all of the stakeholders are/will be part of the process. This has started with a dialogue where respect for each other is paramount. We all know that it is rare for everyone to agree and that's ok . But if we can respect one another's views and roles we are well on our way to addressing this ailing system. This is a prescription that must be 'dispensed as written.'

Once again, a debate is reignited about physicians versus nurse practitioners over at A Happy Hospitalist's blog. I'm not getting into a contest of who is smarter than who. I have always acknowledged that a physician's education is longer than that of a nurse practitioner's. My education and training has prepared me for a career in primary health care - a field that I am passionate about, am constantly trying to increase access to and one that I'm good at. Primary care is part of that vision of primary health care. There are many definitions of what "primary health care" is and the one that I use is not made up by me in my fairy tale world - it is the one that the World Health Organization defines as: reducing exclusion and social disparities in health (universal coverage reforms) organizing health services around people's needs and expectations (service delivery reforms) integrating health into all sectors (public policy reforms) pursuing collaborati...

Today, legislation has passed Congress and is on its way to President Obama that will allow the F.D.A. for the first time to regulate tobacco products. This truly is a huge step. As a health care provider, I see the harmful effects of cigarette smoke, not only on my patients, but on their families and on unsuspecting members of the community. Just recently I spoke with a patient that at one point in his life was smoking 4 packs a day. He now enjoys regular trips to his pulmonologist and annual arterial blood gas draws from his wrist - not fun nor painless. (If you ever thought having blood drawn from a vein is uncomfortable, as is the case with most labwork , drawing blood from an artery is a completely different ballgame). Unfortunately in this legislation, nicotine (the highly addictive "feel good" substance found in cigarettes) isn't banned altogether but some chemicals in tobacco products are and there are restrictions put on advertising. It still amazes me whenever ...

I love this. Fellow blogger (and I mean fellow only that he blogs, not that I can ever approach the level of "care" that he provides) just loves to rant about NPs . We aren't smart enough, we don't know what we don't know, provide good "nursing education" to our patients, we believe what we do is "good", are good at kissing boo-boos and holding hands, is at it yet again. (I think when his traffic is down, he decides to post about NPs and how "inadequate" he "thinks" we are to drive his blog traffic up.) It's really interesting - he harps on about how bad NPs are (i.e. we are mindless monkeys that can code a good level 5 visit) - he even has an "anonymous" NP post comments that claims their education didn't prepare her for the real world. I am so over it. I've left respectful comments on his blog only to get shot down. He continues to denigrate NP practice and gets his fellow "colleagues" t...

Representative Allyson Schwartz along with nearly 100 cosponsors recently introduced House of Representatives Bill 2350, Preserving Patient Access to Primary Care Act of 2009. The legislation will improve access to primary care and increase the number of primary care providers in part by allowing the Nation's nurse practitioners to lead the Patient Centered Medical Home. Here is the full text of the Bill. This has the potential to be monumental legislation for our nation. In addition, an unprecedented number of physician (American Academy of Physicians & American Academy of Family Physicians) and nurse practitioner organizations (American College of Nurse Practitioners & National Association of Pediatric Nurse Practitioners) are supporting this bill. Though it seems that the AAFP is begrudgingly "putting up" with the inclusion of NPs as evidenced by AAFP Chairperson Jim King, M.D.: The legislation also would allow nurse-practitioner-managed practices to serve ...