Nurse Practitioners and the Call for Independence

Did you see the CSPAN story about nurse practitioner's role in healthcare?  I didn't either.  My TV seems to gravitate more toward celeb gossip channels (I wonder why?).  Fortunately, an astute reader alerted to this story featuring Susan Apold, board member of the American Association of Nurse Practitioners.

The news story explores the role of the nurse practitioner, especially in relation to independent practice.  Nursing organizations are pressing lawmakers to pass new legislation increasing NP's scope of practice.  Currently, 16 states allow nurse practitioners to practice independently.  Nursing advocacy organizations such as the AANP would like to see all nurse practitioners gain this ability making laws more consistent between states.  

Opponents of independent nurse practitioner practice still have questions.  Are nurse practitioners adequately prepared to work on their own?  Can the shorter NP education really confer enough medical knowledge to practice competently?  Is the nursing model under which NP's are trained as good as the medical model of physicians?

The news clip is 42 minutes long, so in case you don't have time to view it in it's entirety, let me break it down.  Susan Apold, AANP board member and practicing NP believes state laws preventing nurse practitioners from practicing independently are a barrier to patient care.  With the primary care physician shortage and healthcare reform, Apold comments that NP's must be able to practice to the full extent of their license.  As 88 percent of nurse practitioners are employed in primary care, NP's can solve many of the nation's healthcare problems if given more legislative freedom.

After a brief interview with Apold, the news anchor welcomes comments from callers.  Enter Richard, a physician.  He rants about the inadequacy of nurse practitioners to practice calling NP's "Dumber than dog doo" saying we are not well enough trained and must be closely supervised (about 18 minutes into the video clip).

Although Richard's diatribe errs on emotion rather than reason, he represents the feelings of those opposing NP independent practice.  While most opponents of this legislation wouldn't call nurse practitioners "Dumber than dog doo", we must respond to these criticisms.  What do we say to those opposing the independent practice push?

Apold's response to this naysayer is perfect.  She notes that some states have allowed nurse practitioners to practice independently for 20 years and they aren't turing back.  Granting nurse practitioners a larger scope of practice hasn't caused them problems.  Additionally, multiple studies demonstrate the safety and efficacy of nurse practitioners.  Let's not turn this into a turf war, Apold recommends.  Nurse practitioners are not intending to take the place of physicians but simply to gain the ability to practice to their full capabilities across all states. 

Whatever your position on independent practice laws, the nurse practitioner career deserves respect.  The quality of our profession must be defended from individuals like Richard, referencing NP's in relation to "dog doo".  

Comments

Richard must be dumber than dog doo. Clearly, he missed the multitude of studies including the recent one from IOM showing that there is no difference in care for patients seen in primary care by an NP or an MD.

Victoria