UCLA Nursing School Dean Calls for Removal of "Outdated Barriers" So Nurse Practitioners Can Help Fulfill America's Growing Healthcare Needs
One of the nation's leading voices in patient care and safety is calling on lawmakers and regulators to remove “outdated barriers” and allow nurse practitioners to practice to the full extent of their experience and education.
“There are more than 155,000 nurse practitioners in the United States who provide high-quality, cost-effective primary care to patients across the country,” said Courtney H. Lyder, dean of the UCLA School of Nursing. “As America confronts a growing shortage of primary care physicians, it is more important than ever that these nurse practitioners be allowed to fully use their skills and compassion to help serve the country's increasing healthcare demands.”
Nurse practitioners are registered nurses who have completed graduate-level education (either a master's or a doctoral degree) and who are able to deliver some a wide range of primary, acute and specialty care services. This includes prescribing or renewing prescriptions for most drugs; ordering blood tests; performing routine medical examinations; monitoring chronic conditions; counseling patients about prevention; and treating colds, sore throats and the flu.
In a policy briefing published in October by the Robert Wood Johnson Foundation and Health Affairs, which addresses the scope of practice issues, currently 18 states and the District of Columbia allowed nurse practitioners to diagnose and treat patients and prescribe medications without a physician's involvement, while 32 states required physician involvement to diagnose and treat or prescribe medications or both. For example, Montana allows nurse practitioners to work without any doctor supervision. By contrast, Texas requires a doctor's direct (on-site) supervision at least 20 percent of the time.
“Nurse practitioners not only have advanced academic credentials, but on average have already worked 10+ years as registered nurses; so they have practical, bedside experience to complement what they've learned in the classroom,” says Lyder. “And studies have shown no difference in outcomes when patients are treated by a nurse practitioner or a physician.”
The confidence that Americans have in nurse practitioner-delivered healthcare is evidenced by the more than 600 million visits made to nurse practitioners every year. “Nurse practitioners work as partners with their patient, emphasize the health and well-being of the whole person, and help patients make educated healthcare decisions and healthy lifestyle choices,” says Lyder.
Lyder, a nurse practitioner himself, points out that the addition into the healthcare system of as many as 35 million newly insured individuals under full implementation of the Affordable Care Act will create “enormous demands that the current system is simply not prepared to handle unless we look to nurse practitioners to fill the gaps in providing needed care.”
The influx of newly insured patients will also have a profound effect on where people receive care. When appropriate, some patients may prefer to receive treatment for minor conditions in a more convenient setting, such as a retail clinic with evening hours. Nurse practitioners are now filling this important role in places such as the Minute Clinic at CVS stores where there have been more than 12 million patient visits since their launch in 2000. And with a greater national focus on prevention rather than just treatment, Lyder believes nurse practitioners offer the best cure for the physician shortage.
“As we celebrate these vital healthcare providers during National Nurse Practitioner Week, November 11-17, it is also a great time to truly acknowledge their growing importance within the changing healthcare landscape,” said Lyder. “Removing outdated barriers and allowing nurse practitioners to practice to the full extent of their experience and education will serve the industry, the profession and most important the patient in the best possible manner.”
The UCLA School of Nursing is redefining nursing through the pursuit of uncompromised excellence in research, education, practice, policy and patient advocacy. For more information, visit nursing.ucla.edu.
UCLA School of Nursing
Laura Perry, 310-794-4022