States passing laws to allow nurses more freedom to treat patients in areas with doctor shortages

Some largely rural states that lack doctors are changing laws to make it easier for residents to receive the care they need, Sabrina Tavernise reports for The New York Times. In March, Nebraska became the 20th state—last month Maryland became the 21st—"to adopt a law that makes it possible for nurses in a variety of medical fields with most advanced degrees to practice without a doctor’s oversight." (NYT photo by Brian Lehmann: Psychiatric nurse Murlene Osburn treating patients online from her home)

Previously, psychiatric nurses like Murlene Osburn, of Wood Lake, Neb., were required to have a doctor "sign off before they performed the tasks for which they were nationally certified," Tavernise writes. In Osburn's case, the only willing psychiatrist she could find was seven hours away and wanted to charge $500 a month.

But now, "nurses in Nebraska with a master’s degree or better, known as nurse practitioners, no longer have to get a signed agreement from a doctor to be able to do what their state license allows—order and interpret diagnostic tests, prescribe medications and administer treatments," Tavernise write. Eight more states are considering similar legislation, according to the American Association of Nurse Practitioners.

Even though the new laws are helping areas with severe doctor shortages, "groups representing doctors, including the American Medical Association, are fighting the laws," Tavernise writes. "They say nurses lack the knowledge and skills to diagnose complex illnesses by themselves."

"Nurses say their aim is not to go it alone, which is rarely feasible in the modern age of complex medical care, but to have more freedom to perform the tasks that their licenses allow without getting a permission slip from a doctor—a rule that they argue is more about competition than safety," Tavernise writes. "They say advanced-practice nurses deliver primary care that is as good as that of doctors and cite research that they say proves it." And nurses also charge less than doctors, which can be a major benefit in poverty-stricken areas. (Read more)