March 26, 2013

Source: Vanderbilt University School of Nursing; www.nursing.vanderbilt.edu
Source: Vanderbilt University School of Nursing; www.nursing.vanderbilt.edu

Today, Diane Rehm’s radio program included an hour-long discussion on the role of nurse practitioners with Reid Blackwelder, MD, family physician and president-elect of the American Academy of Family Physicians; Mary Agnes Carey, senior correspondent for Kaiser Health News; Ken Miller, PhD, RN, CFNP, nurse practitioner and associate dean of The Catholic University of America School of Nursing; and Sandra Nettina, MS, ANP, nurse practitioner at Columbia Medical Practice in Columbia, Md., and past president of Nurse Practitioner Association of Maryland.

There was one thing missing from this otherwise great discussion of the issues related to nurse practitioners being able to practice with full authority (without legally mandated physician collaboration or supervision). Nurse practitioners bring additional knowledge and skills to their practice that are just what primary care needs. They understand patient-centered care, listening carefully and responding to what patients and families say they need and want. They are experts in health education and counseling, as well as care coordination. These skills matter when we’re trying to transform our health care system into one that emphasizes health promotion, wellness, and chronic care management.

Most discussion of nurse practitioners’ roles center around their ability to diagnose and treat disease. They are prepared to do so with common acute and chronic conditions, and they know when to refer patient with symptoms of uncommon diseases to physicians–and without a legal mandate to do so, as has been shown in about a third of the states in the U.S. But we need a primary care system that can focus more on preventing diseases, promoting health, and helping patients to be knowledgale about and capable of promoting their health.

Diana J. Mason, PhD, RN, FAAN, Rudin Professor of Nursing