Current Weather
The Spy FM

California Weighs Expanded Role For Nurse Practitioners

Filed by KOSU News in US News.
May 9, 2013

As states gear up for the Affordable Care Act, they’re trying to figure out if there will be enough providers of health care to meet demand from the newly insured.

California is one of 15 states expected to consider legislation this year that would give advanced practice nurses more authority to care for patients without a doctor’s supervision.

Tina Clark is a nurse practitioner at Glide Health Services, a clinic in San Francisco’s Tenderloin district, a low-income section of the city.

Anastacia Casperson, who has struggled with homelessness and drug addiction, came to the clinic because she was alarmed about swelling in her legs. Clark spends a half-hour with Casperson, gives her a prescription for a diuretic and talks to her about quitting smoking. Casperson says she’s been coming to this clinic for a few years.

“They have compassion for a client. They have understanding for a client,” Casperson says. “I like the nurses here because they’re like one big family, and they all work together.”

Glide is run by nurses with advanced training. Even under current law, nurse Clark can see patients without a doctor in the room. But a physician visits the clinic 12 hours a week to sign forms and consult on difficult cases.

Right now, California law says nurses must follow procedures set after consulting a doctor. But lawmakers are considering eliminating that requirement. That idea doesn’t sit well with some doctors.

“Nurses and nurse practitioners are a very, very important part of the health care team, but they are part of a team,” says Dr. Paul Phinney, president of the California Medical Association.

Phinney’s group is opposed to allowing more independence for nurses. He says they are an important part of the health care team, but they don’t have as much training, and may not know as much about testing and technology.

Plus, he says, there’s nothing in the bill that would require the empowered nurses to go where they are needed most.

“I would be very surprised if should this bill pass that all of a sudden you’ll see a massive egress of nurse practitioners out into medically underserved areas. I just don’t see that happening,” he says.

But University of California, San Francisco, health care economist Joanne Spetz says research shows otherwise.

“Nurse practitioners are more likely to practice in settings that serve large shares of Medicaid patients, and they’re somewhat more likely to practice in rural communities,” Spetz says.

Nurse practitioners can be trained much more quickly than a physician, and their compensation is lower, Spetz points out.

“So when a legislature is looking at the insurance of hundreds of thousands of people and the demand for care that those people are going to have, getting health professionals to meet their needs as quickly as possible and as cost-effectively as possible is a real need,” she says.

The next step for the California bill on nurses is a hearing Monday in the state Senate Appropriations committee.

This piece is part of a partnership between NPR, Capital Public Radio and Kaiser Health News. [Copyright 2013 Capital Public Radio]

Leave a Reply

12PM to 1PM The Moth Radio Hour

The Moth Radio Hour

The Moth Radio Hour features true stories told live on stage without scripts, notes, props, or accompaniment.

Listen Live Now!

1PM to 2PM Seasonal Shows

Seasonal Shows

View the program guide!

2PM to 3PM The Dinner Party

The Dinner Party

Think NPR meets Vanity Fair. In each episode, hosts Rico Gagliano & Brendan Francis Newnam talk with some of the world's most interesting celebrities, and along the way equip you with bad jokes, fresh drink recipes, hot food finds, odd news stories... and etiquette tips from the likes of Henry Rollins and Dick Cavett. It's all you need to get an edge in your weekend conversations. Past guests include Michelle Williams, Judd Apatow, Kid Cudi and Sir Richard Branson. Wallpaper magazine calls The Dinner Party one of the Top 40 Reasons To Live In The USA.

View the program guide!

Upcoming Events in your area (Submit your event today!)

Streaming audio and podcasts

Stream KOSU on your smartphone

Phone Streaming

SmartPhone listening options on this page are intended for many iPhones, Blackberries, etc. with low-cost software applications available to listen to our full-time web streams, both News on KOSU-1 and Classical on KOSU-2.

Learn more about our complete range of streaming services

We're perfecting the patient experience - Stillwater Medical Center