I saw 2 notable articles in the news last week about nurse practitioner practice that I wanted to share. The first one is about two new bills introduced in Missouri that would eliminate the collaborative practice requirement between a nurse practitioner and physician and would allow NPs to prescribe controlled substances as indicated. Missouri is one of the most restrictive states when it comes to NP practice and if this legislation passes, they will move to the forefront of of autonomy. They will have substantial opposition but the bills would allow these NPs to practice to the full extent of their training and education.
The other article is about the first nurse practitioner to practice in Bermuda. She will begin this summer and work in King Edward VII Memorial Hospital. She is scheduled to be the first student to complete their NP program.
It is great to see NP practice evolve and have regulations that reflect a scope of practice that is congruent with the training and education of NPs. While there is much work to do (just look at some of the comments from the 1st article), it is becoming clear that NPs can make a meaningful difference in the health care landscape caring for patients.
Comments
The time has come for all 50 states to properly govern the licensure, scope of practice and prescribing laws for Nurse Practitioners to ensure uniformity across all states.
Nurse Practitioner Scope of Practice laws must not only be nationally uniform; they need to be broadened. Because of the shortage of primary care physicians, Nurse Practitioners will most assuredly take over that role; but they can’t practice with their hands tied.
Imagine a Nurse Practitioner coming from a state where they allowed her to practice without a collaborating physician or a supervising physician. She then relocates to a state where the scope of practice and prescribing authority are so narrow, she feels like an RN again. Some states show great respect for Nurse Practitioners while others block the NP professional advancements at every opportunity. (I suspect the latter of bowing down to the AMA lobby.)
So why is the AMA up in arms? They say the level of care will decline because Nurse Practitioners don’t have the education needed. This is false as there have been many studies in the level of care between primary care physicians and Nurse Practitioners. Nurse Practitioners came out equal in level of care, but outshone the physicians in patient satisfaction, along with reducing healthcare costs. The real reason the AMA is stinging is the imagined threat that the Nurse Practitioner practices will take money away from primary care physicians and also break up the “good ole boy” referral network.
It is in the best interest of the citizens of this country to help make this happen. Why is this important to all of us?
Care by a Nurse Practitioner reduces healthcare costs in many ways:
• Office visits are significantly less than a visit to a primary care physician.
• Because of their “nursing model” background in preventative medicine, they reduce the amount of yearly ER visits.
• Nurse Practitioners have a higher rate of prescribing generic medication.
• Patients have fewer hospitalizations under Nurse Practitioner care.
What can we do?
We can sign a petition (that we just started) asking for our state and federal legislators to do as we ask for the advancement of healthcare costs reduction in regards to Nurse Practitioner professional advancement.