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Nurse Education Key to Scope-of-Care Debate



The nursing profession is in an upheaval. Nurses want more opportunities to learn alongside doctors. But there is tension between nursing leadership and some physician groups over the scope of what advanced practice nurses, including nurse practitioners, should be allowed to do.



6 comments on "Nurse Education Key to Scope-of-Care Debate"
D. Andrews, CRNA, MHS (9/27/2011 at 10:05 PM)

Shi Zang, We do carry our own liability insurance at the same limits as physicians. The difference is, our rates have dropped over the past decade due to decreased claims. Do your homework before commenting.
Phyllis Carmichael RN, BSN (9/25/2011 at 3:05 PM)

I enjoyed your article. I am currently in an masters program. A recent discussion centered on nursing skills post graduation. I came from a diploma school in 1998. The hospital was next door to school. Thus, I was confident in my hands-on skills regarding starting IVs, inserting naso-gastric tubes, inserting urinary catheters, performing sterile dressing changes, etc. I wish that I would have gone on to obtain my advanced degree straight away. Now I see how valuable the added education is to my practice. Our discussion turned briefly to nurse residency programs. Little information exists on that subject. Part of the "upheaval" you spoke of? Phyllis
Julia Harris CRNA (9/5/2011 at 3:18 PM)

In response to the previous comment, I do in fact carry my own malpractice insurance and I am very much liable for the outcomes of the patients that I care for. With increased autonomy comes increase in responsibility and I have embraced that as part of my profession.
Rebecca Henline RN BAN MHA (8/26/2011 at 11:30 AM)

I have answer for when nurses couldn't take BP's. It was back before World War II when nurses scope of practice was extremely limited. The practice of nurses starting IV's has come into being in the last 40 years as there haven't been medical students or interns to start all the IV's. Probably both of these statements are open to variation depending on the area of the country and size of the hospital. For my own comment: I received my MHA in 2006 and have continued to be a bedside nurse (now for 31 years). I was also lucky to be able to participate (full time work for 3 1/2 years) in the design build and implementation of our very comprehensive EMR. I truely believe that my degree and experience with the EMR system has made me a better nurse and I try to explain some of these concepts to other nurses who usually think it is all a "marketing ploy" by administration. There is some validity to this interpretation since using patient satisfaction scores has become prevalent. It is really foolish to separate outcomes from patient satisfaction as they are both important parts of patient care. You really shouldn't have one without the other.
Laura Morgan (8/22/2011 at 12:32 PM)

I enjoyed reading your article. I only have a concern about Cole Edmondson's information. Did he really say at one time only a physician at one time was able to take a patients blood pressure of [INVALID] an IV into a patient? What timeframe was this? I rarely see a doctor place an IV or take a patient's blood pressure. And, nurse technicians or certified nurse assistance can take blood pressure readings!
Shi Ying Zhang (8/22/2011 at 11:15 AM)

Let the advance practice nurses carry their own malpractice insurance and be subjected to the same liabilities as physicians, and I think there will be a lot less discussions about this. Otherwise, the state of health care in America will soon turn into how it is China, where practically anyone can be a "country doctor" with minimal credentials.