Guest column: Nurses can ease crisis

Consider how long you may be in the waiting room for a visit for your child and consider how long it will take to get an appointment. The average wait time in an emergency room in 2011 was 64.3 minutes. Some experts expect that to double soon, especially in rural areas. Why? Because folks who cannot access primary care use the emergency room for primary care.

We are in a state of crisis. We need to serve more people with fewer physicians. The American Medical Colleges Center for Workforce states that there will be a national shortage of about 63,000 primary care physicians by 2015. South Carolina already ranks 33rd for lowest ratio of those physicians.

According to a 2012 article in Medical Care magazine, the number of nurse practitioners in the U.S. will increase by 94 percent by 2015. We have 2,592 Advanced Practice Registered Nurses (APRNs) already in South Carolina. Among these APRNs are Nurse Practitioners (NPs) and Certified Nurse Midwives (CNMs), who hold at least a master’s degree in nursing with advanced education and clinical training to assess, diagnose and manage a patient’s health care at the primary care entry while working collaboratively in teams for the optimal patient outcome. Allowing a patient the option to select an APRN as their primary provider could give people access to over 3,000 additional primary care providers when this crisis hits.

The problem deepens for the patients who will desperately need access to care. Currently, the barriers to practice for these advanced level nurses include: the inability for APRNs to order handicapped placards, the inability to order durable medical equipment, inability to refer patients for diagnostic care, limitations on prescribing certain medications for pain and more. An APRN cannot provide care for a patient or prescribe any medication for them unless they have permission and the “supervision” of a physician within a 45 mile radius. This archaic constraint means that patients struggle to get the care they need in a timely and safe manner.

In a rural setting, accessing care is even more burdensome for patients because of fewer providers and transportation options and higher unemployment, affecting health insurance eligibility. Accessing care is difficult and barriers exist everywhere.

The Institute of Medicine in their 2010 report, “The Future of Nursing,” calls for the removal of barriers for APRNs so access to primary care is improved. According to the Washington Post, about 6,000 APRNs have already opened independent practices. Nineteen states have already removed barriers and now allow APRNs to practice to the fullest extent of their education and training. There is no longer an excuse for South Carolina to have an “F” in the healthcare rankings.

We hope our policy leaders will take action and allow our qualified APRNs to provide the care that so many South Carolinians need before the burden on our healthcare system becomes even greater. Research shows that APRNs deliver safe, cost-effective, high quality autonomous care to manage a patient or population’s health, while working collaboratively in teams for the optimal outcome.

Source: Greenville Online

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