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States may give advanced-practice nurses wider scope

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A wave of bills are working their way through state legislatures that would expand the scope of practice for advanced-practice nurses. In fact, at least 24 states are either considering such bills or expecting to see such measures filed this year, according to political researchers. The bills address a broad range of issues, including independent practice, doctor supervision, prescribing authority, or extended prescribing to include controlled substances. Many of these measures are opposed by the AMA and its state affiliates, who say they have safety concerns. But observers say such legislation likely will have some momentum, given the growing physician shortage and a growth in advanced degree programs for nurses.

These bills follow the establishment of a similar law in Pennsylvania, which expanded the scope of practice for nurse practitioners, clinical nurse specialists, nurse midwives, physician assistants and dental hygienists. The new law, which was enacted in 2007, gave nurse practitioners the right to order medical equipment and refer to physical therapists and related practitioners. It also gave nurse midwives prescribing privileges that include permission to prescribe controlled substances.

To learn more about this trend:
- read this AMNews piece

Related Articles:
Trend: MO nurses create rural clinics. Report
PA law will expand nurse-practitioner role. Report

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The biggest impact of NP will be on doctors of the future. Today, no teaching hospital can survive without residents and fellows. Hospitals are not stupid. They are perennially running short of money and are looking at creative ways to save money. They will of course hire NPs to do the resident's work and satisfy the bean counters, who just love lengthy documentation ( NP's do this really well) . People who want to enter medical profession ( typically 5+3+4 years of training after 4 year college)will be thoroughly discouraged. If there is any lesson to be learned from our war in Iraq, it to act thoughtfully as it is hard to put the toothpaste back in the tube. The people who should really be protesting against tinkering with Medicine are not the doctors practicing today, but the citizens and doctors of tomorrow. Would it ever be possible for a paralegal to take on the case to the judge in this country? AMA and doctors in general have screwed up and allowed the medical profession to be irreparably debased.

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