Nurses and the Reinvention of Primary Care

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Institution

Introduction

The importance of nurses in cannot be underestimated as far as the sustainability of the healthcare sector is concerned. Indeed, nurses make up the single largest proportion of healthcare provider in the U.S, not to mention that they make up the first contact point for the patient in a large number of settings (Naylor & Kurtzman, 2010). They work in varied healthcare settings usually taking the lead in management, accountability and clinical roles pertaining to creative primary care models. However, the primary care system in the United States has been experiencing a myriad of problems including shortage in the workforce that jeopardizes the provision of services. Indeed, there has been a steady decline in the number of medical residents and students that enter the primary care or pursue careers in family practice or general internal medicine. Naylor & Kurtzman (2010) examined literature pertaining to nurse practitioner’s participation in the healthcare workforce so as to quantify and comprehend their roles in primary healthcare. The research revealed that patient outcomes such as satisfaction, social, emotional and physical functioning, and mortality rates for those that see nurse practitioners were equivalent to that of those who see physicians (Naylor & Kurtzman, 2010). Further research showed that patients who see NP had higher levels of satisfaction, longer consultations, more tests, with deficiency in appreciable variations in processes of care, patient outcomes or resource us.

However, nurse practitioners face a number of barriers in their effort to practice optimally. First, state laws limit the scope within which the nurse practitioners can operate and prevent them from offering the all-inclusive primary care services that their educational preparation and licenses allow them to offer. In addition, nurses are under disparate payment policies that ensure that their remuneration is lower than that of physicians despite doing similar work. On the same note, there exists professional tensions from varied healthcare professionals for the control of the compensation and professional practice, which has hindered efforts b nurses to be independent.

Nevertheless, the effectiveness of nurse practitioners can be enhanced through removing unnecessary restrictions so as to allow for independent practice that is devoid of regulatory requirements for supervision, collaboration and direction (Naylor & Kurtzman, 2010). In addition, payment structures should be reviewed so as to equalize their payments, which should be complemented by holding nurses accountable for their contribution to enhancing the value of primary care. On the same note, nurse-managed centers should be increased and professional tensions addressed through reinforcing inter-professional teams (Naylor & Kurtzman, 2010). Lastly, it is imperative that pipeline expansions are funded so as to increase the overall workforce in primary care.

While this article encompasses a lot of information, the fundamental point revolves around irreplaceable nature of nurse practitioners in enhancing primary care. Unfortunately, their optimal functioning is usually hindered by institutional bottlenecks such as unequal payment structures and professional tensions. While issues such as payment structures have to be changed through policies, it is imperative that all the professionals in the healthcare sector collaborate so as to create a conducive work environment, as well as ease tensions between the groups.

The information incorporated in this paper, therefore, would not only be crucial to nurse practitioners themselves but also to the policy makers especially with regard to payment structures. However, nurse practitioners can use this information in determining the areas to which they can expand their services such as the rural areas. On the same note, it underlines the importance of respectful collaboration between the varied healthcare professionals for the enhancement of the quality of primary care.

References

Naylor, M.D & Kurtzman, E. T (2010). The Role of Nurse Practitioners in Reinventing Primary Care. Health Affairs, 29, no.5:893-899