Nurses could ease physician shortage

Michigan faces a future shortage of doctors, and a bill by state Sen. Mike Shirkey would take a big step toward heading off the shortage and bring better over-all health care to Michigan.

Michigan faces a future shortage of doctors, and absent a sudden influx of new physicians into the state, it has to get creative in forging a solution.
Legislation introduced by Sen. Mike Shirkey, R-Clark Lake, who chairs the Senate Health Policy Committee, would take a big step toward heading off the shortage and bring better over-all health care to Michigan.

The bill would clarify the duties of advanced practical registered nurses, those professionals who not only have a bachelor’s degree in nursing but also have completed a graduate degree in a specific, specialty field.

Currently, state public health codes do not have definitions for APRNs. The new descriptions would be based on the National Council of State Boards of Nursing Consensus Model for APRN Regulation. Lack of such definitions has created unnecessary barriers for the advanced nurses to practice in Michigan.

Critics of the bill have expressed concerns about allowing advanced nurses to prescribe medication. Their worry would be valid if the nurses were given a completely free hand in writing prescriptions.

That’s not the case, says Cynthia McCurren, dean of the college of nursing at Grand Valley State University. She says APRNs would only be allowed to practice within the scope of their specialties.

Also, in countering concerns from some imaging specialists, McCurren says advanced nurses can only act on the results of diagnostic tests based on a radiologist’s interpretation and within that APRN’s training.

A nurse practitioner is licensed by the state and any medical treatments or actions outside their area of expertise would be illegal and subject to prosecution.

Nationally, APRNs’ reputation is excellent. Over the past 40 years, their record is of safe, quality, cost-effective care, with positive patient outcomes.
In addition, the professionals have earned support for defining the scope of their practice from many national and state organizations. These include the Federal Trade Commission, the Institute of Medicine, AARP, Michigan Primary Care Association and the Economic Alliance of Michigan, among others.

Michigan would not be the first state to recognize APRNs. Twenty states plus the District of Columbia allow them to practice to the fullest extent of their graduate education and national certification.

Benefits of approving this legislation include increasing the access to health care by state residents by making more primary care providers available to them. It would also help cope with the shortage of physicians and the aging population of practicing doctors. Michigan’s APRN working environment would also be enhanced and the state would attract more such professionals.

Providing medical care and treatment not only involves a patient’s quality of life but often life and death itself. So debate on this bill is warranted.