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The IOM Report: The Future of Nursing

The big news this week in the world of nurse practitioners and health care was the release of the Institute of Medicine's (IOM) Report, "The Future of Nursing: Leading Change, Advancing Health." It's a logical read and echos what NPs, patients, and some other professions have been saying for years: let NPs do the work they are already educated and trained to do without arbitrary and archaic state and/or federal barriers. This is not a "scope of practice" issue, it is allowing us to practice to the full extent of our education.

For example, when I reflect back on my NP education, there was no course entitled, "How to sort of take care of chronic conditions but when you get in over your head, make sure you have your collaborating physician's number on speed dial." We were taught to function as primary care providers that included acquiring the knowledge base to evaluate, diagnose and treat our patients and their conditions using the skill sets and tools needed to care for our patients. NPs don't practice witchcraft or voo-do - we are providing high-quality, cost-effective and culturally congruent care.

Predictably, organized medicine is playing the "patient safety" and "quality of care" card. Bad outcomes occur when there are breakdowns in communication and from care that is uncoordinated - not usually because the clinician is incompetent.

The bottom line is (at least in NY where I practice), without a collaborating physician on record, the 14,000 or so NPs are unemployed and can't legally do anything that we were trained or educated to do. It is time to remove these non-evidence based barriers and retrospective reviews and allow us to function as true partners on the health care team. Collaboration among providers would still continue to happen and I promise pigs wouldn't start to fly. Fourteen states have already transitioned to to an autonomous model of practice model for NPs. Lawmakers must not cave to special interests and make the tough decisions that will enable greater access to care.
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Comments

NPO said…
As an NP student I hope some of these laws are changed by the time I graduate. Hopefully more NP's will become involved in getting these things changed in their States. I will support them.
October 7, 2010 at 1:53 AM
Anonymous said…
I am an NP in the South who recently opened a family practice clinic. I agree that restrictive, archaic barriers such as collaborative practice agreements must be removed, so that we can max out our full potential as primary care providers. As it is now, NPs in most states cannot practice if they do not have a collaborative practice agreement w/ a physician. The 2 disciplines can collaborate and work together without an archaic collaborative practice agreement in place. Asking for all Legislators to support Nurse Practitioners and REMOVE restrictive collaborative practice agreements. If an NP cannot find a physician to sign her/his collaborative practice agreement, then she/he cannot work as a Nurse Practitioner which may force him/her to unemployment.
October 10, 2010 at 3:01 PM
FastandEasyHealth said…
Nurse practitioners are a valuable resourse to primary care. More of these walls need to come down to help improve access to care for many Americans. Unfortunatly, the AMA is a powerful organization with a lot of money that is holding up a lot of legislation that would promote NP independence.
October 14, 2010 at 10:44 PM
kracela said…
I have to say this is the most exciting thing I have heard in the profession of nursing. I hope that these recommendations come to fruition quickly.
October 16, 2010 at 9:17 PM
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