American Society of Registered Nurses
American Society of Registered Nurses

There Is More To Nursing Than Just Following Doctors Orders

Research has demonstrated that the nurse practitioner's expanded role has resulted in comparable and sometimes better patient outcomes than those of physicians. States with full practice authority have a statistically significant higher percentage of women than those with restricted practice.

By Jill Harpst-Rodgers, Donna Falsetti, and Joyce Penrose

The contemporary nurse performs patient assessments, develops care plans, communicates with and educates patients and families, administers medications, manages medical technology, and serves as a patient advocate.

The nurse practitioner's role varies widely from the traditional and contemporary nurse. Nurse practioners are educated to serve as independent comprehensive "practitioners" and "providers" of primary care services.

Nurse practitioners complete a master's degree, and for many, a doctoral degree that educates them to conduct history and physical examinations, diagnose illnesses, order lab tests, prescribe treatment plans and medications, and perform office procedures such as suturing and colposcopies.

Research has demonstrated that the nurse practitioner's expanded role has resulted in comparable and sometimes better patient outcomes than those of physicians.

American society views nurses historically as women, givers of care that has been ordered by a physician, a typically subservient role fueled by the historic duties and roles of a nurse.

Although this is accurate when considering traditional nursing practice, the role of nurses, specifically nurse practitioners, has changed dramatically over the past years.

No longer subservient, nurse practitioners assume responsibility for the overall health care of patients without the requirement of physician orders and direction.

With the aging workforce and the elderly retiring baby boomer population, it is estimated that the country will need 40 percent, or roughly 50,000, more providers by 2025.

A recent study by the Physicians Foundation found that 81 percent of physicians describe themselves at full capacity or over-extended, thus unable to add more patients to their practices.

Today, politicians are oppressing nurse practitioners by preventing them from fully performing to the advanced level of their training and education.

The state elected officials who fail to move bills that call for updates to outdated laws regarding the scope of a nurse practitioner, are not only contributing to the social injustice of these nurses but are also failing to provide the resources associated with healthcare to their citizens.

This lack of action prevents society from obtaining and receiving timely primary care, also unjust.

The update in nurse practitioner legislation allowing for full practice authority is supported by the AARP, Federal Trade Commission and the Institute of Medicine as well as many other organizations.

Some state lawmakers have updated their laws to allow nurse practitioners to practice to the full extent of their education and training; however, many lawmakers have allowed Bills, proposing full practice authority for nurse practitioners, to die in committee or they fail to support the passage of such bills.

Those states with full practice authority NPs have a higher percentage of women in legislature who are voting on bills supportive of women.

In 2015, states with full practice authority had an average of 29.29 percent representation of women in their state legislature and those states without full practice authority had 20.87 percent representation of women in their state legislature.

States with full practice authority have a statistically significant higher percentage of women than those with restricted practice.

Would we see the same phenomena in restricted states if nurse practitioners were primarily men? What is the real reason that these legislative restrictions continue to be imposed on nurse practitioners' practice, thus failing to support America's healthcare system?

Is it really about concern over a patient's care or the social injustice directed toward a profession primarily dominated by women?

It is obvious in states with fewer women in the position to make legislative changes in support of women that these bills are less likely to pass.

Without legislative support, these vital changes in the practice of nurse practitioners cannot be made.

Social justice calls for nurse practitioners to be permitted to practice to the full extent of their education and training.

Jill Harpst-Rodgers and Donna Falsetti are respectively an assistant professor of Graduate Nursing and an associate professor of Graduate Nursing at Carlow University in Pittsburgh. Joyce Penrose is professor emeritus at Slippery Rock University.