A proposed rule by the Department of Veterans Affairs, which would dramatically expand the authority of nurses to treat patients without a doctor's supervision, is drawing attention to a bitter debate over the relative roles of doctors and nurses. This plan would give broad “new authority to its most trained nurses to order and read diagnostic tests, administer anesthesia, prescribe medications and manage acute and chronic diseases — without a doctor's oversight”.
The agency says it is acting to meet a growing demand for care from veterans, both from the Vietnam era and the wars in Iraq and Afghanistan, amid a shortage of physicians on its staff. These nurses, who have advanced degrees, could practice independently even in the 19 states that still restrict what they can do, as long as they work for VA.
But while groups that represent nurses praised the plan, it came under immediate fire from some of the country's largest doctors' groups, which said VA would be lowering the standard of care for veterans. Nurses lack training and skills to administer anesthesia and diagnose complicated illnesses by themselves, opponents said, particularly in a population with a vast array of medical issues.
The president of the AMA was quoted as saying "All patients deserve access to physician expertise, whether for primary care, chronic health management, anesthesia, or pain medicine."
The American Society of Anesthesiologists, which plans to hold a press conference Wednesday to denounce the VA plan, states "removing anesthesiologists from surgery and replacing them with nurses" would be "lowering the standard of care and jeopardizing Veterans' lives."
What are your thoughts about this proposal and the opposing viewpoints?
For more on this story read, Doctors rip VA plan to give some nurses more authority
Jun 6, '16
If NP education was as rigorous as CRNA education, no problem. Yes, there are good and bad MDs and there are good and bad NPs; however, I think the percentage of bad NPs far exceeds bad MDs when first starting out. The application requirements, th education, and the training prior to full scope of practice must be much more rigorous than it is now. If anything, all theses things are LESS rigorous then they were 10 years ago.
A dozen of my coworkers are going to NP school. I know many more of my nurse friends and school mates who are going. Medicine is a bit more than treating by algorithm, which seems to be the thing to do among newer NPs, as if that protects them from malpractice and wrong choices. I heard the newer acute care NP talking to her supervising physician about her recommendation for an minimally invasive procedure. The physician said, "No! Why would you do that!?" The NP answered, "That's what UpToDate said!"
As many have opined, there will be a glut of NPs in a few years. Once independent practice NPs start getting sued for malpractice, we'll see a change in the education requirements. It's sad that it will have to come to that.
Last edit by dudette10 on Jun 6, '16