Nurses should have more say in how to fix healthcare

Much like Johns Hopkins Medicine CEO Ed Miller's declaration that reform offers an opportunity for caregivers other than doctors to fill in the gaps, New York Times contributor Pauline Chen, M.D.--a practicing surgeon--says that nurses, as the "largest sector of healthcare providers," must be a part of the national debate on how to fix healthcare in America.

"In all the discussions about adjusting the number of medical schools and training slots, rearranging physician payment schedules and reorganizing practice models, one group of providers [the nurses] has been conspicuously missing," Chen writes. "[F]ew have led or even been involved in the formal policy discussions regarding the future care of patients." 

Chen calls last month's Institute of Medicine report on the future of nursing a proverbial step in the right direction, pointing out its use of data compiled over the last half-century. She lauds its for not defining caregivers by their roles, particularly focusing on the educational aspect of training nurses. 

"The term 'registered nurse' can refer equally to graduates of two-year associate's programs, four-year baccalaureate programs, and advanced master's or doctorate programs," Chen writes. "In addition to proposing the addition of postgraduate clinical training, or residency programs, similar to what physicians currently go through, the panel recommended increasing the number of nurses with baccalaureate degrees to 80 percent from 50 percent and doubling the number of nurses with doctorate degrees over the next 10 years." 

Chen knows that changing the doctor-nurse dynamic in hospitals won't be easy. She cites the American Medical Association's official statement on the matter as proof. Still, she believes it to be vital to the future of care giving. In her article, she recalls a conversation she had with a senior surgeon while she was still in training. 

"‘When the ship seems to be going down, you've got to get all hands on deck,'" she remembers her elder advising her. "We might do well to remember that surgeon's advice right now." 

For more:
- read Chen's full post