A recent Gallup poll found that nurses are the most trusted professionals in America. Three in four people consider nurses “highly honest and ethical,” whereas only 53% would say the same for doctors. Despite that, nearly half of our states do not trust our most advanced nurses to practice to the full extent of their training.
Advanced practice registered nurses are nurses who have gone beyond the requirements to attend nursing school or obtain a bachelor’s in nursing. These are men and women with master’s degrees or doctorates who work in specialized areas of patient care. This includes nurse practitioners, certified registered nurse anesthetists, clinical nurse specialists, and nurse midwives. You very well may have been diagnosed, been prescribed medication, been administered medication, or received a minor surgery from an APRN without even knowing she was not a doctor.
If that concerns you, it might be helpful to know that not only is seeing a nurse practitioner, the most common type of APRN, just as safe and effective as seeing a doctor, but nurse practitioners often exceed physicians in patient education and satisfaction. Some people, including myself, prefer to see nurse practitioners due to better bedside manners and a more holistic approach to medicine.
In a little over half of states, APRNs are given full practicing authority, which means they can work autonomously without the supervision of a physician to the full extent of their training. These states are benefitting from increased access to cost-effective healthcare. However, many states reduce or restrict APRNs’ ability to practice by requiring them to have a “supervising/collaborative physician” or by limiting the services they can provide. Twenty-three states are guilty of this occupational discrimination, including many of America’s most populous states such as California, Texas, and Florida.
For example, in North Carolina, one of the states most resistant to expanding APRNs’ practicing authority, nurse practitioners must obtain a “supervising physician.” For the nurse-practitioner skeptics, this may sound like a valuable form of checks and balances to ensure quality care. However, these “supervising physicians” do almost no supervising. As North Carolina APRN Stephanie Brinson revealed to the Carolina Journal, supervising physicians meet with nurse practitioners for as little as 15 minutes a year, yet they charge $30,000 annually to “supervise” their practice.
With rates like that, it’s no wonder that one of the only groups opposed to granting nurses full practicing authority is physician associations.
To be clear, no one is suggesting that we replace a brain surgeon with a nurse midwife. APRNs are trained in specific fields of practice, and full practice authority would grant them autonomy in their specialty — not free rein over the medical field. And if being seen by a nurse practitioner concerns you, that’s fine. You still have the option to choose a doctor for your care, but that preference is not an evidence-based reason to restrict APRNs from treating other patients.
America has a primary care shortage, an anesthesiologist shortage, and higher maternal mortality rates compared to other first-world countries.
APRNs can help alleviate all these pressing problems. Not only do they improve patient outcomes, but APRNs improve patients’ satisfaction. That fact should be appreciated in a country increasingly losing trust in our medical system.
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The United States has a healthcare shortage. We need more healthcare professionals to meet people’s needs. Restricting the ability of APRNs to do the jobs they were trained to do decreases access to healthcare, increases costs, and is a barrier to improving the health of our nation. It is time every state dropped government paternalism and granted APRNs full practicing authority.
People trust nurses. So why doesn’t our government?
Brenée Goforth Swanzy is the communications manager at the John Locke Foundation.