Independent Role of Nurse Practitioners

Nurse Practitioners Should Work Independently of Physicians

One of the problems facing health care is the inadequate number of primary-care physicians, more so among the rural population. There are fears that shortages will only get worse as a rising number of patients look for care Under Affordable Care Act. Besides the provision of advanced nursing care, nurses have licenses to offer clinical care, including the ordering of X-rays and lab work, and are particularly helpful in helping patients having chronic conditions like high blood pressure and diabetes cope (Holmes, 2013).

Nearly one third of states now permit nurse practitioners to practice in the absence of physician supervision. Nursing groups as well as health-care interests are however lobbying that nurses be granted the same level of autonomy in all states as in the other states that do not require physician supervision. Some interest group, while still appreciating the efforts put forth by nurses, argue that teamwork instead of autonomy would do more for our health-care than granting nurses autonomy. Angela Golden, an assistant professor at Northern Arizona University and the president of the American Association of Nurse Practitioners, is one of those arguing for the case of autonomous practice without physician supervision. She practices in rural Arizona (Holmes, 2013).

In some of the states nurses are allowed to serve without physician supervision for almost 20 years. Other states should consider granting nurse practitioners the same level of independence. Research has indicated that nurses spend more time with patients than physicians, giving counseling, health education and co-coordinating care. They are best suited for the rising number of Americans that battle chronic ailments like asthma, hypertension and diabetes. Studies carried out by independent researchers indicate that there is always equal or higher satisfaction among patients receiving care from nurse practitioners against those who receive care from physicians. Similar clinical outcomes can be produced by both groups as has been indicated by Health Affairs, a health-care practice peer reviewed journal. It is therefore not clear why there are still restrictions placed on autonomy on two-thirds of American states. The possible explanation is always political or incorrect information (Holmes, 2013).

It is indeed true that the states have varying certification requirements. Yet, because of good graduate education, most nurse practitioners are adequately prepared for the provision of primary care without the need of physicians supervision at all times. There are instances where the services they deliver matter more than those delivered by physicians. Their health-care education takes place over a period of at least 6 years. Right from the induction, the focus is always one area. In contrast, students in medical school go through extensive rotations which are always peripheral to care that they finally deliver (Holmes, 2013).

It follows that, nurse practitioners are compassionate and skilled professionals ready to serve independently as the sole primary caregivers in rural areas to populations that are uninsured and underserved medically. Having a statutory requirement that they be supervised by physicians, leads to unnecessary and costly redundancies, that can be better utilized for overall efficiency in the healthcare domain. The situation can only worsen if remedial steps are not taken now. With the Affordable Care Act taking shape, a higher number of patients are poised to seek Medicare and an inadequate supply of caregivers there could be difficult times for both the patients as well as the caregivers (Holmes, 2013).

Critics allude to a study implying that nurse practitioners contribute to the health-care system's burdens, resulting in an increased number of hospitalizations and trips to see physicians than is the case when the patients are attended to by physicians. The research is not statistically significant as other studies over the years have proven the cost effectiveness of nurses as primary caregivers. That study does not account for the fact that nurses often see patients having chronic illnesses that typically require more care. Evidence shows that nurses are well capable of giving good care to patients suffering from multiple chronic conditions. For instance, a 2000 study published by the American Medical Association revealed that, there are hardly any differences in satisfaction, physiologic measures, health status or inpatient or emergency room visits in the utilization of resources between physicians and nurse practitioners (Holmes, 2013).

Explain what would happen to the level of competition in the physician services market if all statutes limiting activities of physician assistants and nurse practitioners were eliminated.

Ironically, though several physicians are heavily dependent on physician assistants (PAs) and nurse practitioners (NPs) in the provision of their services, yet several of them hold conflicting views on nurse practitioners being autonomous. On one hand, Dr. Jauhar, a New York cardiologist observes that he trust no one like the NP who assists him in his practice and says that the relationship is mutual. On the other hand, he makes it apparent that they are not clinical equals. He notes that the nursing practitioner must check with him and he was worried when New York legislation gave more autonomy to nurses. The law, he says, underestimates how important the expertise of the physicians is and overestimates the how cost effective nurse practitioners are. While just a small fraction of nursing practitioners practicing independently, a huge number of physicians fear that such changes would bring massive changes to the whole healthcare system. For instance, notions of equality could complicate the relationships between nursing practitioners and physicians (Page, 2014).