The demand for primary care will increase greatly when 32 million Americans join the rolls of the insured with implementation of the Affordable Care Act. Advance practice registered nurses—and nurse practitioners in particular—are able to help meet that need by providing wellness and prevention services, and managing many common uncomplicated acute illness and chronic diseases as effectively and efficiently as physicians.
Yet nurses are limited to practicing to the full extent of their education, training and competency by state-based regulations. Some states are more restrictive than others and vary in their requirements for prescribing privileges, oversight and chart reviews, and ”collaboration ratios” for nurse practitioners to work with physicians. Sixteen states and the District of Columbia allow nurse practitioners to practice and prescribe independently.
Broadening nurse practitioners’ scope of practice saves money in care provision and in training. Three to 12 nurse practitioners can be educated for the cost of educating one physician. But key medical organizations oppose the idea amid professional tensions and fears of nurses being used as substitutes for doctors.
All health care professionals should support an expanded, standardized scope of practice for nurses as a way to improve health care in the United States.