Report: Nurses must up leadership, physician group disagrees

Rapport : Les infirmières doivent lever la conduite, médecin que le groupe est en désaccord

par Astrid Fiano, DOTmed News Writer | October 07, 2010
Nurses should assume leadership roles and partner with physicians in redesigning the U.S. health care system, according to a report from the Institute of Medicine, published Wednesday.

In the report, "The Future of Nursing: Leading Change, Advancing Health," the IOM writes that strong leadership on the part of nurses and other health care professionals will be required to help design and implement the changes to increase quality, access and value of patient care. Therefore, leadership-related competencies need to be promoted during nursing education, and leadership development and mentoring programs need to be made available for nurses at all levels.

"The report's recommendations provide a strong foundation for the development of a nursing workforce whose members are well-educated and prepared to practice to the fullest extent of their training, meet the current and future needs of patients and act as full partners in leading advances in the nation's health care system," said committee chair Donna E. Shalala, president of the University of Miami, Fla., in prepared remarks.

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According to the report, nurses should practice to the full extent of their education and training. For instance, the report notes that nurses often face significant regulatory barriers. Scope-of-practice limitations for nurse practitioners vary widely by state. The majority of state laws are lagging -- due to political decisions -- in addressing the problem of restrictions that limit an advanced practice registered nurse's authority to prescribe medications, admit patients to the hospital, assess patient conditions and order and evaluate tests, according to the report.

Hours after the IOM released the report, the American Medical Association issued a statement in response, emphasizing the team approach to care - a team that's led by a physician.

“The AMA is committed to expanding the health care workforce so patients have access to the care they need when they need it. With a shortage of both nurses and physicians, increasing the responsibility of nurses is not the answer to the physician shortage," Dr. Rebecca Patchin, AMA board member, said in a statement. "Research shows that in states where nurses can practice independently, physicians and nurses continue to work in the same urban areas, so increasing the independent practice of nurses has not helped solve shortage issues in rural areas. Efforts to get health care professionals in areas where shortages loom must continue in order to increase access to care for all patients.”