Full practice authority for Nurse Practitioners (NPs) is an opportunity, not a threat. Some PA physician associations believe nurse practitioners should not be allowed to practice without a doctor providing oversight. NPs believe that this is a counter- productive approach, and believe that the system works better when we work together.
According to the Pennsylvania Academy of Family Physicians and the PA Department of Health, there are currently only 5,000 family doctors in the commonwealth with 1,300 of those planning to leave practice by 2015. PA has 8,000 nurse practitioners who could ease this burden. Under the current system, if a collaborating physician retires, moves out of state, or ends a contract, that NP that he/she works with (if there is one), must also leave practice until there is another physician found to “consult with”, regardless of whether or not that physician periodically sees that patient. This results in disruption in patient care and obviously puts the NP’s practice at risk.
Physicians or their associations sometimes argue that the education of a nurse practitioner is not sufficient to make the critical clinical decisions necessary for patient safety. To be an NP in Pennsylvania requires, at a minimum, a Master’s Degree in Nursing as well as certification in one’s clinical specialty or population focus. The majority of nurse practitioners work for years as Registered Nurses (RN) prior to getting an advanced degree (eg, I had worked 10 years with an advanced degree prior to going back and getting a second master’s so that I could become a nurse practitioner).
The current law mandating physician oversight was drafted in 1976. Since that time, NPs (wanting to “do no harm”) have been scientifically measuring the outcomes of their care and dozens of studies have shown that patient outcomes are at least as good under NP care when compared to physician care.
The best form of patient care is a team-based approach. Research shows that putting patients at the center of a full team of practitioners and caregivers is the best way to provide effective care. That means collaboration in the true sense of the word (as opposed to a piece of paper), a give and take of ideas, questions, and answers, and then allowing the team member with the most appropriate experience to provide care. Nurse Practitioners know they are not doctors and they do not want to be doctors. They want to be able to practice without being limited by outdated, burdensome laws which do little to provide for safety but which restrict patient access to care.
Now retired, Judie Much is certified as an Advanced Oncology Nurse Practitioner (AOCNP). She is an active member of the BCWAC Health Care Committee and the Soroptimist International of Bucks County.