Availability of nurse practitioners expanding, Nursing admins say

The battle for authority between doctors and nurse practitioners has intensified.

With the shortage of primary care doctors, nurse practitioners are seeking changes in legislation that will give them the right to take on duties that used to be exclusive to doctors. The American Medical Association, however, is outwardly against nurses encroaching on the territory once reserved for physicians.

What has really changed is the increased availability of nurse practitioners, not so much the nurse’s role, said Eileen Sullivan-Marx, associate dean for practice and community affairs at the Nursing School.

There are about 120,000 to 150,000 nurse practitioners practicing in the United States, Sullivan-Marx said. New regulations have to be made that reflect the changes, and legislators are seeing the benefits of creating these regulations, she said.

In some cases, nurses need permission in order to prescribe different levels of narcotics and are restricted from ordering wheelchairs for patients because only physicians can order them, she added.

“By 2015, most new nurses will hold doctorates or a DNP in nursing practice,” according to the Associated Press article “Doc Deficit? Nurses’ role may grow in 28 states” by Carla Johnson. This is a goal set by educators in the nursing field.

Although professionals like physical therapists and dentists are called doctors, the fact that nurses can also be addressed as doctor has added to the controversy.

The AMA argues that when the title Dr. is used to address a nurse, it creates confusion, according to the Johnson article.

All nurse practitioners need a certain amount of credit hours, Sullivan-Marx said. Some institutions say you need a master’s degree while others say you need a doctorate.

“Nurse practitioners already have authority to prescribe medications, to provide full primary care and to get paid for their services by insurance companies in most states,” Sullivan-Marx explained.

When physicians set out the original scope of their practice, the scope was broad and undifferentiated, said Ann O’Sullivan, pediatric nurse practitioner and term professor of primary care nursing. Aspects of everyone’s care was included as part of medicine.

However, no one profession has exclusive ownership over particular skills such as prescribing medications, O’Sullivan said.

Several years ago Pennsylvania Governor Ed Rendell expanded the range of nurses’ authority in Pa.

“The governor said out-dated barriers on a nurse’s scope of practice … make no sense,” according to a United States Nursing News newswire released in 2007.

Although Rendell’s plan is several years old, it is just recently becoming controversial.

“Physicians were slow to catch up on all implementation issues and are just now getting mad about it,” O’Sullivan explained.

A shortage of doctors in an area typically fosters a more authoritative nurse. Primary care doctors are poorly paid and after receiving so much training, would rather specialize in a particular area to make more money, O’Sullivan said.

However, the shortage of doctors only opens opportunities for nurses.

“People outside of nursing are saying “lift the barriers.” Nurses make excellent primary care providers,” O’Sullivan said.

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