TBT: Turf versus Access to Care

This week’s TBT post was written during last year;s National Nurses Week. Although the situation has improved there still is a ways to go. The post is a good reminder of what nurses do and how an expanded role for them would improve the health care system.

This is Nurses Week, often a time when health care organizations patronize nurses with free food and tchotchkes. We’d rather have the right to be able to contribute our talents and expertise to improving the health of people by being able to practice to the full extent of our education and training. Last week, the New York Times published a commentary on The Opinion Pages by cardiologist Sandeep Jauhar that continued to prop up the old and inaccurate message by organized medicine that nurse practitioners must be supervised by physicians. It perpetuates turf battles instead of focusing on improving access to safe, quality, affordable care. At a time when the Affordable Care Act has provided millions of people with coverage for care, building our primary care capacity is essential.

The NYT published four letters to the editor—two from nurses and two from physicians. A number of letters were not published, and here is one that is particularly compelling because one of its co-author is a legal scholar who has studied the scope of practice issues across health disciplines. Full transparency: these authors are fellows in the American Academy of Nursing, for which I am the current president.

Missing the point—the real gold standard for safe effective primary care

In his April 30, 2014, New York Times op-ed, “Nurses are not Doctors,” Dr. Sandeep Jauhar misses the point. The relevant issue is whether licensed competent health care professionals can provide primary care in a safe and effective manner without physician supervision.

The evidence is clear from more than four decades of research: Advanced practice nurses (such as nurse practitioners and nurse-midwives) functioning as primary care providers have equivalent safety and quality care records, as well as the same professional obligation and commitment to the well-being of their patients, as do physician primary care providers.

Outdated state supervision provisions do not acknowledge the regulatory and professional accountability that is already in place for nurse-midwives and nurse practitioners, who must meet rigorous competency standards as well as the required ethical responsibility to collaborate with physicians and other health care providers in the best interest of their patients. Rather, legislated practice restrictions, especially for primary care providers, have been found to only increase costs (more ER visits), decrease health outcomes (more chronic illness), and reduce access to licensed qualified primary care providers.

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This article was co-authored by Diana Taylor, RNP, PhD, FAAN Fellow, American Academy of Nursing, and Professor Emerita, UCSF School of Nursing and Barbara Safriet Honorary Fellow, American Academy of Nursing, and Professor, Northwestern School of Law, Lewis & Clark College.

SOURCE: Disruptive Women in Health Care – Read entire story here.