94-02-03 Professional Nurses change the face of Health Care RELEASE ON RECEIPT Contact: Katherine Jackson PROFESSIONAL NURSES CHANGE THE FACE OF HEALTH CARE CHARLOTTESVILLE, VA., Feb. 4--Next to curbing violence, controlling health care costs and ensuring adequate access to care are major concerns to Americans. Advanced-practice nurses can help meet that challenge by providing much of the health care that is needed in a primary care setting, says B. Jeanette Lancaster, dean of the School of Nursing at the University of Virginia. Advanced-practice nurses or nurse practitioners (NPs) are registered nurses with specialty training, usually at the master's degree level, in primary care or acute care of inpatients. Although NPs receive less training than physicians, they are adequately trained to provide care for 60 to 80 percent of primary care patients. At Virginia, Lancaster supports the collaborative practice of primary care delivery. In this model physicians and NPs share authority for managing patient care. "Nurse practitioners can establish independent practices that parallel those of primary care physicians, or they can establish collaborative practices in which doctors and nurses care for patients together," notes an article in The New England Journal of Medicine. The article further states that "collaborative practice is more comprehensive, more cost effective, and therefore more competitive than independent practice ... ." According to a nursing task force report to the Joint Commission on Health, the national annual income of NPs is about $43,600. In contrast, the national average annual income for family practice physicians is reported at $105,098. Professional nurse mid-wives and NPs complete training between 12 and 24 months after an undergraduate degree. Physicians, on the other hand, must continue their education seven years past the bachelor's degree. NPs, originally implemented during the doctors' shortage of the 1960s, perform many of the same tasks that doctors historically perform. NPs complete physical examinations, suture wounds, diagnose and treat common acute illnesses, and in 1991 received prescriptive authority in Virginia. At U.Va., the nurse practitioner program is offered as both a post-masters-degree and as a dual major within the master's program combined with adult health, community health, home health or psychiatric-mental health nursing, says Lancaster. Enrollment has increased from seven during the 1992-93 academic year to 23 presently. Increasing the number of nurse practitioners throughout the state could greatly reduce health care costs and increase access to care, Lancaster adds. Plans to more effectively use nurses in meeting the primary care needs of the State were mandated by Senate Joint Resolution 343. The resolution specifically requested Virginia schools of nursing, the State Council of Higher Education, the Virginia Department of Health and the Medical Society of Virginia to "identify strategies to increase the supply of nurse practitioners and develop cooperative relationships with schools of medicine to educate nurses and physicians for collaborative practice partnerships." In the nursing task force report a shortage of NPs and other professional was noted. The shortage, like the shortage in bedside nurses during the mid-80s, resulted from increased demand, alternative career possibilities for traditional female students and reduced faculty to train professionals, says Lancaster. The report further recommended: 0 development of innovative recruitment programs for minority and other disadvantaged students from underserved and rural areas in collaboration with local communities . 0 increased collaborative, multidisciplinary efforts in schools of nursing and medicine. 0 establishment of salary and/or reimbursement differentials for nurse practitioners practicing in underserved areas. The report states that "the urgency to reduce costs, improve access, guarantee quality by increasing accountability for practice outcome, and simplify the system for delivery cannot be ignored." It concludes that "schools of nursing are positioned to increase the number of primary care providers through strategic expansion of existing nurse practitioner programs..." ### Charlotte A. Buttner, Program Support Technician, Health Sciences Center News Office, McKim Hall Room 3116, # 429, Charlottesville, Va. 22908, 804-924-5679, cab2j@virginia.edu [Submitted by: unknown (cab2j@dmt03.mcc.virginia.edu) 03 Feb 94 09:16:53 EST]