The shortage of primary care providers in this country has impacted our access to care.
Advance Practice Registered Nurses (APRN) make up a large group of highly qualified medical professionals that could help minimize this deficit. Nurse practitioners’ scope-of-practice laws should be changed in order to meet the growing needs of the population.
Scope-of-practice laws differ in each state. Currently in Connecticut, APRNs are allowed to practice in collaboration with a physician. This limitation prevents nurse practitioners from working to their full potential. The state Board of Nursing is responsible for establishing scope-of-practice laws in each state. In 2012, only 18 states and the District of Columbia allowed nurse practitioners to diagnose, treat and prescribe without the involvement of a physician (Cassidy, 2013).
The pressure and stress among health care providers is increasing. I work for a Connecticut hospital that prides itself on providing excellent, safe, high quality care to all. The hospital demands high quality care for their patients because the medical care they are giving is extraordinary.
My personal experience working with APRNs has been in critical care.
As a bedside nurse, I have spent time with these providers collaborating on and planning patient care. The professionalism demonstrated by this group of nurse practitioners is exceptional. Patient-focused care is their top priority. They continually seek advice from attending physicians and specialists when needed. Their excellent assessment skills and specialized knowledge guide them in making safe and logical decisions.
The role of the nurse practitioner in critical care is well established and respected at my facility. Patients and families feel comforted to know that in addition to their attending physician, a nurse practitioner is also helping to manage their care.
APRNs have also been providing primary care for decades. Their role is critical to the primary care workforce and they impact the high-quality, patient-centered care provided to a wide range of health care consumers (AANP, 2013). Research studies have compared primary care provided by APRNs and physicians. The evidence has shown that care provided by APRNs is equivalent to physicians.
The American Medical Association’s opposing arguments state that patients’ health is at risk if they see nurse practitioners instead of primary care physicians (Cassidy, 2013). They also highlight the differences in education. A physician attends four years of medical school and a minimum of a three year residency compared to four years of nursing school and two years of graduate school for APRNs (Cassidy, 2013).
As a current graduate student, I am working toward my goal of becoming a family nurse practitioner. The program that I am enrolled in requires one year of clinical experience prior to applying. It is also designed to attend part time or full time, which allows nurses to continue to gain experience while attending graduate school. The majority of my fellow classmates have years of nursing experience to build upon. We are trained to be advanced practice nurses, not doctors. The profession of nursing brings an important dynamic to health care. There is a strong emphasis upon creating an advanced practice that is evidence-based as well as training in nursing theory and ethics.
Changing the scope-of-practice laws for nurse practitioners will increase the number of primary care providers. Availability and access to primary care is related to decreased mortality rates, reduced emergency department visits and hospitalizations (Cassidy, 2013). These actions will ultimately help to improve cost, quality and access to care.
Our nation is undergoing a health care revolution, and it is crucial to optimize the use of our medical workforce.
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References
AANP. (2013, October 20). Legislation/Regulation. Retrieved from American Association of Nurse
Practitioners Web site: http://www.aanp.org/legislation-regulation/policy-toolbox
Cassidy, A. (2013, May 15). In L. H. Aiken (Ed.), Health Policy Brief: Nurse Practitioners and
Primary Care. Retrieved October 1, 2013, from www.healthaffairs.org
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