VA nurses aren't equipped to act like doctors: Column
Posted almost 8 years ago by Nicholas M Perrino
Yikes. The repeated claim from some physicians and physician groups that a couple more years of formal coursework and more clinical training from structured residency programs MUST lead to superior quality of care appears to make sense on the surface. However, given scores of published research comparing APRNs (and sometimes PAs) to MDs/DOs, over the course of 30+ years, no scientific study has ever found APRNs--particularly NPs--to have any less than equivalent clinical outcomes; in some metrics, NP outcomes have been shown to be better than their physician counterparts.
"Fueled by pressure to cut costs and improve veteran access to medical care, the Veterans Administration plans to allow certain types of registered nurses to practice medicine without physician oversight. This move implicitly assumes that doctors and nurses are interchangeable, that their medical training and ability are equivalent.
But those assumptions are wrong. Simply empowering nurses to play the role of doctors effectively admits that second-class care is acceptable for our nation's veterans.
What congressman or VA administrator would choose to have a nurse rather than a doctor solely oversee their care? But now the VA seeks to impose that decision on veterans who have no other choice. In a new regulation open for public comment until July 25, it proposes to extend such authority to advanced practice registered nurses (APRNs), who have earned at least master's degrees.
While nurses may be part of the bigger picture of fixing the VA's broken health care system, the broader issue is how to ensure that APRNs who independently practice medicine have the same kind of training as doctors."