The VA is proposing a rule in the Federal Register to grant full practice authority to Advance Practice Registered Nurses (APRNs). This would allow APRNs, which are nurses with advanced degrees like masters, post-masters, or doctorates to perform many of the same duties that can currently only be done by doctors. The VA says that allowing nurses to perform advanced duties will speed service to veterans.
Currently the VA has four APRN roles:
- Certified Nurse Practitioner
- Clinical Nurse Specialist
- Certified Registered Nurse Anesthetist
- Certified Nurse Midwife
The nurses usually provide primary, acute, and specialty health care as a part of their normal duties.
The VA says the rule, which is similar to rules that already exist in the military and 21 states would speed care to veterans "expanding the pool of qualified health care professionals authorized to provide primary health care". About 6,500 of VA's 93,000 nurses have advanced training and would have their duties expanded under the new rule.
The VA seeks to ease staffing problems within the organization, which is struggling to hire more than 3,800 doctors.They also currently have a shortage of more than 8,700 registered nurses, the proposed rule doesn't address how the proposed expansion of existing nurses duties would affect the existing nurse shortages. The VA has also not said what pay increases, if any, there would be for the nurses who will be facing expanded duties.
The nurses would do such things as: conduct physicals; diagnose, treat, and manage patients with both acute and chronic conditions; order and interpret diagnostic and lab tests; administer anesthesia; deliver babies; and prescribe medications. Currently, only doctors can perform these duties.
While the American Nurses Association applauds the move, several medical groups including the American Society of Anesthesiologists have expressed opposition to the rule, saying "it will permanently establish a second, lower-level of care in which physicians are not making critical care decisions."