 Provided by Clinician 1
I was reading a blog written by a pretty well known NP, Steven Ferrara who pointed out that if you listen to the medical organizations generally talk about NPs (and I will add PAs), the same rhetoric has been used for decades. I guess those of us that are old enough just look at much of what they say as the ramblings of guild workers, NOT evidence based clinicians and have become immune to the never changing message. Twenty three years ago in the NY Times there was an article about some of my close friends in New York (NPs who I actually knew personally) trying to gain prescriptive practice in NY State. If you read this almost quarter century old article, it seems like you are reading about Florida today. The only huge exception is the medical society and the state nursing association were working TOGETHER to defeat NP prescribing in New York. The nursing association did not want to admit that NP training entitled these specially trained RNs to prescribe, as it would then create two levels of nurses. I think they wanted all RNs to gain this ability. Interestingly, PAs in NY State had been prescribing since 1976 (twelve years earlier than this article) and as is done today, both professions make each other invisible, in this case it would have been cool to point out that non-physician prescribing had already been shown to be pretty safe in the Empire State. Like today, the medical establishment was saying that NPs did not have the education to prescribe and generally would be a hazard to patients if allowed to do so. One thing puzzles me though; if physicians are so evidence based and so “smart”, how come they still believe that? Really, it’s time to put this argument away from both NP and PA professions perspective, as they really sound silly. Together, we scary clinicians now prescribe millions of prescriptions EVERY DAY and I know it is amazing, but people get better. Like all of the arguments they use, this one has shown itself to be only self serving and should be retired. In any case, here is a link to the NY Times story. Every NP and PA student should be reading the original stories of their profession’s historical advances. We should also ask for stories from the original clinicians. Maybe we should do that on C1? Much more interesting than learning from a textbook.
Here is the article:
Health
Wider Powers Backed For Nurse Practitioners
By ELIZABETH KOLBERT, Special to the New York Times
Published: July 01, 1988
Specially trained nurses will be able to prescribe drugs for the first time in New York State outside of hospitals under a bill that has been passed by the State Legislature.
The bill, whose passage marks the end of a legislative battle that has lasted almost a decade, would allow nurse practitioners in the state -registered nurses who have an additional two years of training - to make some medical diagnoses and prescribe treatment in collaboration with a physician.
Advocates of the bill, which was passed over the objections of the major doctors’ and nurses’ organizations in the state, say that it will lead to improved health care in rural and poor urban areas that are now underserved by physicians.
‘’What this means is that thousands upon thousands of medically underserved people may finally have quality health care,’’ said the Assembly sponsor of the bill, Arthur O. Eve, a Buffalo Democrat. The Assembly approved the measure today, 85 to 54. The measure passed the Senate on Tuesday, 45 to 12. No Decision From Cuomo
Because of the opposition by powerful doctors’ and nurses’ groups, the bill is politically sensitive. The State Health Commissioner, Dr. David Axelrod, supports the measure, but a spokesman for the Governor, Francis Sheehan, said the Governor had not yet decided whether to sign it.
If the Governor approves the measure, New York would join 44 other states in allowing an expanded role for nurse practitioners. Estimates of how many nurse practitioners there are in the state range from 400 to 4,000.
Under current law, nurse practitioners may be certified in New York State but they may not legally perform functions beyond those of registered nurses except in hospitals. Under state regulations governing hospitals, nurse practitioners are allowed to perform some additional functions, such as taking patient histories, but the rules in most areas are vague.
Many nurse practitioners say that despite the law, they perform additional functions outside of hospitals anyway.
‘’The bill actually legalizes a situation that’s been going on for some time,’’ said Elaine Gelman, president of the state’s Coalition of Nurse Practitioners.
Under the new bill, those who want to expand their practices would have to enter into a written agreement with a physician, although the two would not have to work in the same office. The physician would be required to review the patient records of the nurse practitioner at least once every three months.
The New York State Nurses Association, which represents registered and practical nurses in the state, has objected to the bill because, the group says, the measure limits the practices of other nurses by suggesting that without a nurse practitioner’s certificate, nurses are not competent to diagnose and treat illnesses. Also, they say, the requirement that nurse practitioners must have a collaborating physician is too restrictive.
In contrast, the Medical Society of the State of New York, which represents doctors, has opposed the bill on the grounds that it does not assure adequate supervision of nurse practioners by physicians.
Dave has been a PA, and later NP, leader for thirty years. He strongly believes that NPs and PAs must work together to insure a better future for both professions. Most recently Dave has been busy launching another dream; Clinician 1, the first internet community for PAs and NPs. In October 2008, Dave was honored by the New Jersey State society of PAs with its “Lifetime Achievement Award”.
The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.
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