U.S. consumers still like to see a doctor, but if they have to wait, they are happy to see a nurse practitioner or a physician assistant. Two studies out this week indicate both patients and doctors are "open to a greater role" to primary care professionals who are not medical doctors at a time when physicians are in short supply and doctors will become even more scarce when the Affordable Care Act broadens health care benefits in less than seven months. The law will bring additional coverage for millions of Americans along with an influx of business to doctors that they may not be able to handle.
SAN FRANCISCO — Several members of the California Supreme Court appeared wary Wednesday of requiring public schools to provide licensed nurses to administer insulin injections and other medications to schoolchildren. The powerful California Nurses Assn. has argued that state law requires licensed nurses to provide insulin injections and other medicines, and two lower courts have agreed. The American Diabetes Assn. appealed. During a hearing, some justices on the state high court appeared skeptical of the nurses' arguments. Justice Ming W. Chin, noting that few schools have full-time nurses, questioned why districts should have to call in a licensed practitioner to administer a shot that a child's parents and physician have agreed could be given by an unlicensed but trained employee.
SAN JOSE (KCBS) – A large group of registered nurses walked off the job Thursday morning at two hospitals in San Jose. Instead of changing IVs and administering medication, nurses at Good Samaritan Hospital and Regional Medical Center were walking the picket line in a dispute over wages, benefits, pension and staffing levels. The union represents 1,400 members of the California Nurses Association/National Nurses United. "What we're asking for is that the hospital has sufficient staff to staff for all patients that are coming into the hospital and also to staff for all patients that are going to be discharged, but haven't left yet," said Malinda Markowitz with the California Nurses Association.
As nurse practitioners lobby to expand their authority and scope of practice in many states, a New England Journal of Medicine study released Wednesday documents a deep chasm between doctors and nurses on that issue. The study found the two groups overwhelmingly agreed that nurse practitioners should be able to practice to the full extent of their schooling and training. But doctors were less likely to concur that advanced practice nurses should lead medical homes, which deliver team-based, coordinated care to patients. Only 17 percent of the 505 primary care physicians surveyed agreed with that notion, compared to 82 percent of the 467 nurse practitioners surveyed.
As state governments get ready for the Affordable Care Act coverage expansion, some are taking a close look at their networks of health care professionals to make sure they will be able to meet increased demands as more people gain health insurance. California is one of 15 states expected to consider legislation this year that would give advanced practice nurses more independence and authority. Tina Clark is a nurse practitioner at Glide Health Services, a clinic in San Francisco's Tenderloin district, a low-income section of the city. Glide is run by nurses with advanced training. A physician visits the clinic 12 hours a week, to sign forms and consult on difficult cases.
As our nation prepares to implement the bulk of the provisions of the Affordable Care Act, the issues of access to care and unsustainable cost continue to loom large. What can we do about an aging population with increasing chronic health issues and millions more needing care? How can we meet the increasing demand, maintain quality and not break the bank? Legislators looking for solutions to these questions can unleash the skills of nurse practitioners by removing regulatory barriers that prevent them from practicing to the top of their education and training. Studies find that Advanced Practice Registered Nurses who provide preventive care are as effective as primary-care physicians in accuracy of diagnosis and prescription.