Are Advance Practice Nurses Pushing Too Far?

Some physicians say that allowing nurse practitioners to prescribe narcotics would put more of them on the street, something they are trying to avoid. Is this a legitimate concern?

Advance practice nurses (APNs), nurse practitioners (NPs), nurse anesthetists and nurse mid-wives, are moving to be able to do more within the scope of their practice. For Currently, NPs — for example – are licensed to practice in all states in the United States and the District of Columbia. With their advanced training, they can diagnose and treat, as well as prescribe certain types of medications while under the supervision of a practicing physician.

According to a recent article in American Medical News, advanced- practice nurses are seeking to expand their scope of practice in 24 states. The APNs believe that the need is there as the predicted doctor shortages of the future draw closer. APNs often practice where doctors are not as available, as well as in full clinics where all professionals are represented.

Physicians are not in favor of this, however, saying that this could actually put patients at risk. One of the main arguments seems to focus on issues such as prescribing narcotics, something that only physicians can do now.

Prescribing narcotics

With the on-going war on drugs, some physicians say that allowing nurse practitioners to prescribe narcotics would put more of them on the street, something they are trying to avoid. Is this a legitimate concern on behalf of the physicians or a desperate bid to keep that role?

In Pennsylvania, nurse midwives are now allowed to prescribe narcotics — does it make sense that APNs can prescribe in one state and not another? It’s been suggested that APNs be allowed to practice more advanced skills in under served or under privileged areas. Is that a true solution? Either an APN can do a task or can’t. It shouldn’t be they can do it here but not there.

More programs = more advance-practice nurses wanting to practice?

Is it possible that this push to be able to do more is because more nurses are moving into these advance fields? After all, less than 50 years ago, the field didn’t exist. Now that it does and the APNs feel they can provide the services, it does make sense that they would want to provide them.

But — the question is, are APNs qualified to provide such care without physician supervision? There’s no doubt that they receive extra education and training and their pool of knowledge and skills are broad, but without the educational background that physicians have, can they truly give the same quality of care? What is your take on all this?