Message from the Chief Strategist: Nurses as Partners in Primary Care

Nurses as Partners in Primary Care

There is an inextricable link between increasing access to health care and nurses, but we don’t hear about it much. Web pages, airwaves and newspapers are filled with reports about health care reform, but rarely about the role of nurses in a reformed health care system.

You know the story. Over the next two decades the U.S. population is projected to grow by 20 percent; those 65 years and older will increase by 79 percent. Additionally, Americans increasingly will experience multiple chronic diseases, placing serious demands on an already stressed health care system. Add to that the potential influx of millions of health consumers into the system and we’re in a pickle. Meeting these demands will become all the more difficult given the significant shortage of primary care providers in the nation’s health care workforce today, and the gloomy projections for the future primary care workforce.

Nurses can be a significant part of the solution, but we’re not fully engaging them as partners in increasing access to care, particularly primary care.

Nurse practitioners already are providing common primary care services to diverse patients in a range of health care settings. They conduct physical exams; prescribe medicine; diagnose and treat common acute illnesses and injuries; provide immunizations; manage high blood pressure, diabetes, and other chronic problems; order and interpret X-rays and other lab tests; and counsel patients on adopting healthy lifestyles and health care options.

Nurses are key partners poised, along with physicians and other providers, to make a significant contribution to serving Americans’ health care needs. But in some states, a number of barriers prevent our access to highly-skilled nurses. While laws in 23 states permit advanced practice registered nurses (APRNs) to practice independently, 20 states require them to practice in collaboration with a physician, and seven mandate physician supervision. All states permit APRNs to prescribe medications, but many impose limits on this authority.

These are significant barriers to care, especially in rural areas where often little to no primary care is available. The Center is beginning to examine these barriers and consider strategies to overcome them. We are a consumer voice for nursing, and that means looking for solutions that increase consumer access to high quality care. 

Editor's note: An example of nurses as partners in primary care and how a community benefits can be seen at the 11th Street Family Health Services in Philadelhis, PA.