Petition Obama to remove restrictions on APRN practice!

Specialties NP

Published

You are reading page 2 of Petition Obama to remove restrictions on APRN practice!

chudder

141 Posts

Specializes in SICU.

I did include the link to the HealthAffairs Health Policy Brief from which I took the quote....

Here are some more articles to whet your appetite:

Horrocks, S., Anderson, E., and Salisbury, C. “Systematic Review of Whether Nurse Practitioners Working in Primary Care Can Provide Equivalent Care to Doctors,” BMJ, April 6, 2002, Vol. 324, No. 7341, pp. 819-23.

Jackson, D.J., Lang, J.M., Swartz, W.H., et al. “Outcomes, Safety, and Resource Utilization in a Collaborative Care Birth Center Program Compared with Traditional Physician-Based Perinatal Care,” American Journal of Public Health, June 2003, Vol. 93, No. 6, pp. 999-1006.

Laurant, M.G., Hermens, R.P., Braspenning, J.C., et al. “An Overview of Patients’ Preference for, and Satisfaction with, Care Provided by General Practitioners and Nurse Practitioners,” Journal of Clinical Nursing, October 2008, Vol. 17, Issue 20, pp. 2690-698.

Lenz, E.R., Mundinger, M.O., Kane, R.L., et al. “Primary Care Outcomes in Patients Treated by Nurse Practitioners or Physicians: Two-Year Follow-Up,” Medical Care Research and Review, September 2004, Vol. 61, No. 3, pp. 332-51.

MacDorman, M.F. and Singh, G.K. “Midwifery Care, Social and Medical Risk Factors, and Birth Outcomes in the USA,” Journal of Epidemiology and Community Health, May 1998, Vol. 52, No. 5, pp. 310-17.

Mundinger, M.O., Kane, R.L., Lenz, E.R., et al. “Primary Care Outcomes in Patients Treated by Nurse Practitioners or Physicians,” Journal of the American Medical Association, January 5, 2000, Vol. 283, No. 1, pp. 59-68.

Naylor, M.D. and Kurtzman, E.T. “The Role of Nurse Practitioners in Reinventing Primary Care,” Health Affairs, May 2010, Vol. 29, No. 5, pp. 893-99.

Needleman, J. and Minnick, A.F. “Anesthesia Provider Model, Hospital Resources, and Maternal Outcomes,” Health Services Research, April 2009, Vol. 44, No. 2, pp. 464-82.

Pine, M., Holt, K.D., and Lou, Y. “Surgical mortality and Type of Anesthesia Provider,” American Association of Nurse Anesthetists Journal, Vol. 71, No. 2, pp. 109-16.

Silber, J.H. “Anesthesiologist Direction and Patient Oucomes,” Leonard Davis Institute of Health Economics Issue Brief, October 2000, Vol. 6, No. 2.

Wilson, I.B., Landon, B.E., Hirschhorn, L.R., et al. “Quality of HIV Care Provided by Nurse Practitioners, Physician Assistants, and Physicians,” Annals of Internal Medicine, November 15, 2005, Vol. 143, No. 10, pp. 729-36.

Susie2310

2,121 Posts

I downloaded the second and seventh articles you referenced as they relate to primary care. The second article is 11 years old and the seventh is 13 years old. Have you read them? Both studies propose that nurse practitioners can provide care of an equal quality to that of physicians, and suggest the study findings indicate this. The second study, which took place in the UK, attempted to measure patient satisfaction with their provider, patient health status, and quality of care. The authors refer to important limitations in the study that reflected the difficulty in measuring changes in health outcomes after single consultations primarily about MINOR illnesses. The seventh study compared outcomes for patients randomly assigned to nurse practitioners or physicians for primary care follow-up and ongoing care after an emergency department or urgent care visit. The main outcome measures were patient responses to measure multiple health concepts. Patient satisfaction was measured by a questionnaire. Disease specific clinical measurements were taken by a research nurse at a follow up appointment. The authors refer to several aspects of the study that limit the generalizability of the results, one of them being that it was conducted within the facilities of one particular medical center.

The studies above have not demonstrated to me that nurse practitioners provide similar quality of care to physicians. Sorry.

chudder

141 Posts

Specializes in SICU.

Feel free to perform a literature search on the subject and present the evidence yourself, or go ahead and continue to rely on your opinion. I have read only the articles pertaining to CRNA practice.

It is not my goal, however, to correct your bias with evidence. This inquiry is one you need to undertake on your own, when you are ready.

Susie2310

2,121 Posts

I'd say you did a very poor job of making your case.

chudder

141 Posts

Specializes in SICU.

Susie2310, I started the thread to share a petition, not to bring you literature on a platter. I presented the results of a very cursory literature search, you snipe at the results, present no evidence to support your biased opinion, and then pass judgment on my "case." Get back to me when you have some evidence to share.

lrnrobbins

3 Posts

Thank you for your support, we need 100k. As of today we have 5,724 signatures. We need to stand together as APRNs.

Patti_RN

353 Posts

Specializes in ..

I'm not sure of the intent of this petition. Scope of practice restrictions are state level decisions, not federal.

goodknight44

3 Posts

The purpose is to increase public awareness. It accomplishes nothing of a binding nature.

Trauma Columnist

traumaRUs, MSN, APRN

88 Articles; 21,249 Posts

Specializes in Nephrology, Cardiology, ER, ICU.

Will merge with pre-existing link....

Trauma Columnist

traumaRUs, MSN, APRN

88 Articles; 21,249 Posts

Specializes in Nephrology, Cardiology, ER, ICU.

Will merge with pre-existing thread

forrester

197 Posts

Specializes in ER, ICU, Administration (briefly).
Quote

Those restrictions are there for a good reason. There is a good reason doctors spend many years training to be doctors, and all those years of education and training add up to the ability to provide medical care at a level far beyond that of advanced practice nurses or physician assistants. Advanced practice nurses have their place in the delivery of health care, but not in an unrestricted, independent role. The public deserves to have access at a primary care level to primary care and internal medicine doctors who are trained in managing complex medical conditions. I want no less for my family and myself.

Well, the evidence and studies do not support you in this .

great radio show on this

My Florida News- Follow the Florida Roundtable link- Podcast with John Silver Sound arguments are presented based on the evidence.

8 states now allow unrestricted practice------no bad results

48 states allow prescriptive authority for NP's to their scope of practice (not Florida or Alabama)

Over 40 years of studies documenting outcomes, compliance, and/or prescribing patterns (even in NEJM and JAMA)

Federal government allows for DEA numbers for NP's (not PA's or anyone else commonly disparaged as "physician extenders).

Federal Government allows direct billing to Medicare

Both of the federal laws were passed in 1997!

Plummeting numbers of GP's and a horrible distribution of both medical resources and specialists.

The Florida medical association has 3 essential arguments:

1) No NP is qualified to prescribe drugs listed as schedule 2 drugsd.

Obviously not true based on, you know, facts.

2) We already have a major prescriptive drug abuse problem in Florida.

Essentially saying = I speed so you can't drive.

Again, absolutely no evidence to support this.

3) It will decrease the quality of care to Floriidians.

Here we go again, in fact the evidence directly contradicts this.

SO, we either believe the evidence and start moving healthcare into the 21st century, or we keep going with basically guild laws from the 1800's.

It's important to understand, however, given the topic of this blog, that the STATES regulate medical and nursing practice. There is no national regulation even though all of us take national exams.

There is not even a way to track these practitioners from state to state. It is relatively easy to quack your way around the country.

thenursemandy

276 Posts

Specializes in Med-Surg, LTC, Psych, Addictions..
\ said:

I started the thread to share a petition, not to bring you literature on a platter. I presented the results of a very cursory literature search, you snipe at the results, present no evidence to support your biased opinion, and then pass judgment on my "case." Get back to me when you have some evidence to share.

I'm glad you stood up for yourself. She was beyond rude

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