More than a dozen states have passed legislation expanding the role of nurse practitioners (NPs) so they can help fill the shortage of primary care providers in the United States. But a study from Columbia University School of Nursing, published in the Journal of Professional Nursing, suggests that the laws are not sufficient, as the organization and culture in healt- care settings often impede the full utilization of NPs.
A research team led by Columbia Nursing Assistant Professor Lusine Poghosyan, PhD, RN, investigated how the workplace environment in primary-care settings affects the ability of NPs to deliver quality care and practice independently. The study was conducted in Massachusetts, where state health reform increased demand for primary care and subsequent legislation recognized NPs as primary-care providers. The results suggest that gains made by legislative reform can be neutralized by the formal and informal practices in place at health-care organizations. For example, the study cited instances where NPs were not allowed to see new patients or even conduct physical assessments.
The study also investigated the level of support and resources available to NPs, who reported that they were often denied the same level of personnel support and operational resources provided to physicians, including medical assistants and administrative staff, as well as sufficient exam-room space. NPs interviewed for the study also said that their role was poorly understood by senior leadership, contributing to a sense of deprecation, isolation, and poor NP-administration relations.
Read the full article on the Columbia Nursing website.