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Transcript of Nurse Practitioner
Nurse Practitioners in California
The demand for primary care is projected to rise over the next five years, due largely to population growth, aging, and to a smaller extent, to expanded health insurance.
The growing number and effective integration of Nurse Practitioners in our health care system could help alleviate pressures on primary care capacity.
It takes much time less to produce new NPs than new physicians – an average of six years of education and training, compared to 11 or 12 years for physicians.
Collaboration between Physician and NP
California state law requires that Nurse Practitioners practice in collaboration with a physician.
Each physician can supervise no more than four drug-prescribing NP’s.
Meanwhile, 21 states in the United States give Nurse Practitioners full practice authority.
No on-site or in-person physician oversight required
After completion of three years of collaborative practice, an NP may obtain independent prescriptive authority and practice without a formal collaborative agreement with a physician.
Why do we have Nurse Practitioners today?
In the mid 1960’s, there was a shortage of medical doctors because many doctors chose to specialize and therefore left primary care.
In 1965, Medicare and Medicaid programs were established, creating more coverage. This increased the demand for primary care services.
Meanwhile, in the years leading up to Medicare/Medicaid, many physicians across the country began mentoring and collaborating with nurses who had clinical experience.
History of Nurse Practitioners
An increase in health care coverage, the ongoing collaboration and trust between physicians and nurses, and the shortage of physicians in the 60’s opened up the door for Nurse Practitioners
In 1965, Loretta Ford (RN) and Henry Silver (MD) created the first training program for nurse practitioners.
Scope of Practice for Nurse Practitioners
Unlike RNs, NP's can diagnose and prescribe medicine, while under the supervision of a physician.
NP's follow the same scope of practice that RNs follow with a few exceptions because they are more trained and qualified.
Additional Scope of practice for NP's
May sign a physician order of life sustaining treatment
May perform an abortion by medication or aspiration in the first trimester of pregnancy if they had training.
Law does NOT authorize nurse practitioners to recommend the use of marijuana for medical purposes.
They can order blood transfusions
Nurse Practitioners in California
In 1977, the California Association for Nurse Practitioners was founded in the University of Davis.
California was one of the first states to adopt the nurse practitioner role.
Fewer than half the states permit NPs full practice authority.
California is one of 12 states that restricted NP from full practice authority. It requires physician supervision or delegation for NPs to provide care.”
There have been only 44 states that recognize NPs as primary care providers, and California is not one of them.
By: Alina Alexander, Maggie DeMeo, Pei-Yu Ho, Kailyn Marshall, An Pham, Dalia Villalobos
Standardized Procedures and NPs
Establishes policies and protocols for NPs so that they are able to perform their authorized duties
Establishes a method to continually evaluate the competence of the NP to perform specific procedures
Good procedures and work instructions provide a way to communicate and apply consistent standards and practices
Save time and and mistakes
Reduce training costs
Ensure consistent results
Support quality goals
Board of Registered Nursing. (n.d.). Nurse Practictioners: Laws and Regualtions. Retrieved February 27, 2017, from http://www.rn.ca.gov/pdfs/regulations/bp2834-r.pdf
California Association for Nurse Practitioners. (n.d.). Retrieved February 21, 2017, from http://canpweb.org/about-canp/history-at-a-glance/
National Nursing Centers Consortium (n.d.). NNCC State-by-State Guide to Laws Regarding Nurse Practitioner Prescriptive Authority and Physician Practice. Retrieved February 27, 2017, from http://www.nncc.us/images_specific/
O'Brien, J. M. (n.d.). How Nurse Practitioners Obtained Provider Status. Retrieved February 21, 2017, from http://www.medscape.com/viewarticle/464663_2
Online Health Law Library from the California Physician’s Legal Handbook. CMA Legal Counsel, January 2016. Retrieved February 23, 2017, from www.cmanet.org.
Tapping Nurse Practitioners to Meet Rising Demand for Primary Care http://kff.org/medicaid/issue-brief/tapping-nurse-practitioners-to-meet-rising-demand-for-primary-care/