October 6, 2010

Nurses Could Help Alleviate Doctor Shortage: Report

As healthcare reform places an ever-increasing strain on doctors, the US Institute of Medicine said Tuesday that nurses should be given more education and authority to take on more medical duties, saying they can handle much of what doctors deal with on a daily basis.

A report released by the institute calls for an overhaul in the both the training and responsibility of nurses. Giving nurses more medical responsibilities is a key measure to improving the fragmented and expensive healthcare system in the US.

Dr. Risa Lavizzo-Mourey, president and CEO of the nonprofit Robert Wood Johnson Foundation, said at a recent news conference: "we are re-creating nursing in America."

"We believe that this report and the implementation of its findings is vital to the strength of healthcare in this nation."

But the American Medical Association quickly criticized the report, stating that "Nurses are critical to the health care team, but there is no substitute for education and training. With a shortage of both nurses and physicians, increasing the responsibility of nurses is not the answer to the physician shortage."

Nurses already handle a wide range of duties, often delivering babies, counseling patients and caring for dying cancer patients. The report says these roles should be expanded nationally and paid for by both public and private insurers.

The brainchild of the Obama administration, the US healthcare reform law passed in March is expected to add more than 30 million Americans to health insurance plans. Several groups, including the Institute of Medicine, are forecasting a widespread shortage on doctors to provide care.

The Association of American Medical Colleges released an estimate last month that suggests 63,000 more physicians will be needed by 2015 to handle the increase in Americans with insurance coverage.

"We evaluated the evidence which has been accumulating now for decades as to the capability of nurses to bridge that gap," Dr. John Rowe of the Columbia University Mailman School of Public Health told Reuters.

"There have been concerns in the past that nurses could provide the quality and safety for some areas of primary care. The committee concluded that it was very clear from the evidence that nurses can very effectively and safely ... deliver those primary care services," said Rowe, one of the authors of the report.

There are more than 3 million nurses in the United States, making them the single-largest segment of the workforce in the healthcare system, said the institute, which advises the federal government on medical issues.

It said that so-called "scope of practice" barriers that limit what nurses can do should be removed by healthcare agencies and organizations. The US government and non-profit organizations should fund grants and scholarships to allow nurses to further their education so they can take on more and bigger responsibilities.

By 2020, eighty percent of nurses should have a bachelor's degree and 10 percent of them should also go on to get their doctorate degree, the report recommends. Most nurses today practice with only a two-year certificate.


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