Is care from a nurse practitioner as safe as care from a doctor?
When something goes wrong, everyone wants a doctor in the room
Nursing groups are taking advantage of today’s climate of out-of-control health care costs to lobby for advanced practice registered nurses (APRNs or nurse practitioners) to be able to practice independently.
Under current Texas law, APRNs have to sign a delegation agreement with a collaborating physician in order to practice. Under such agreements, the doctor supervises the nurse practitioner, and delegates authority to diagnose, treat, write prescriptions, and even perform minor procedures in an office setting.
You probably have already experienced practice at a doctor’s office or clinic, where you show up for an appointment and a nurse practitioner sees you instead of a doctor. You may also have unwittingly been provided anesthesia services by a certified registered nurse anesthetist (CRNA), instead of an anesthesiologist physician. In both circumstances, though, there was to be a written agreement of delegation and a supervising physician.
That will come to an end, though, if nursing lobbyists have their way. In Texas, House Bill 1415/Senate Bill 681 is pending and, if passed, would remove the safety net of physician delegation agreements and supervision of nurse practitioners.
The Texas Nurse Practitioners lobbying group is excited about this pending legislation and its website claims that, “Granting APRNs full practice authority utilizes their extensive education and improves access to health care service . . . .”
Extensive education? Well, that is certainly true when comparing an advances practice registered nurse to a licensed vocational nurse (LVN), or even a regular registered nurse (RN). But nurse practitioners lack anywhere near the same training as doctors.
According to the Texas Medical Association, the typical doctor completed 12,000 to 16,000 hours of clinical training in medical school and residency. On the other hand, a typical APRN only completes 500 to 1,500 hours of training.
In my experience as a Houston medical malpractice lawyer, I have seen where nurse practitioners and nurse anesthetists were providing care in situations that went beyond their training and capabilities. Unfortunately, the patients ended up paying the price for that lack of training, in the form of severe injuries or even death.
After seeing this over and over in cases, I have formed the opinion that nurse practitioners and CRNAs are fine until something goes wrong. That is when they go running for an anesthesiologist or doctor, and when everyone else wishes a doctor was already in the room.
Exercise your choice in healthcare
Keep in mind that, as a patient, you do not have to consent to be seen or treated by a nurse practitioner. If you want to be treated by a doctor, speak up and embrace your right. Sometimes care by a nurse practitioner is fine, but other times it may compromise your care.
When you go to a doctor’s office or clinic to be seen for a common cold, ear infection, or a condition of similar acuity, then a nurse practitioner or physician’s assistant (PA) may be fine. If you find that the treatment does not take care of the problem, though, on the next visit you should consider asking to see a doctor.
If you are hospitalized after a surgery, many surgeons use nurse practitioners to round and see their patients for them. Quite often, that may be fine. But what about when your recovery is not exactly “in the box” or you have concerns that your condition is getting worse rather than better? It would be a good idea to tell the nurse practitioner and your regular nurse that you want to see your surgeon or doctor as soon as possible.
If you or someone you care for has been seriously injured as a result of nurse practitioner, CRNA, or other care, then call 281-580-8800 for a free consultation with an experienced medical malpractice lawyer at Painter Law Firm.
Robert Painter is a medical malpractice lawyer at Painter Law Firm PLLC.
On 4/1/2018, the new law will end the current practice where doctors can secretly enter a DNR order against patient and family wishes [...]read more
This article was originally published in the September/October 2017 edition of "The Houston Lawyer" magazine [...]read more
On 4/1/2018, the new law will end the current practice where doctors can secretly enter a DNR order against patient and family wishes
This article was originally published in the September/October 2017 edition of "The Houston Lawyer" magazine
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