When Your Doc Is Not a Doc: Should Nurse Practitioners Be Autonomous?
Standing in the neurologist’s office alongside her mother’s wheelchair, Ann Livy goes over the symptoms once again in her head. Livy (not her real name) is a doctor herself — she works as a pathologist in a hospital near their home in Central Texas and asked that she remain anonymous. She knows the neurologist will have a finite amount of time. So she thinks through the problems that her 70-year-old mother has been experiencing since her medication was changed in November 2015. The shaking and the hallucinations are simply a part of living with Parkinson’s disease, but Livy is concerned about intense hallucinations and the weakening limbs that have confined Frances Johnson (also a pseudonym) to a wheelchair.
A women in a white coat sweeps into the room, announcing that she is a doctor. She begins examining Johnson, using deft hands to check her motor skills and asking informed questions. It is only when Livy catches sight of the name tag pinned to the white coat and sees the letters APRN, short for Advanced Practice Registered Nurse, that she realizes her mother is being treated by a nurse practitioner — a highly qualified nurse who is trained to treat certain medical conditions and holds a doctorate but who is not a physician.
Livy explains how Johnson has been losing feeling in her legs and has become more mercurial and emotional. But the nurse practitioner dismisses these concerns, saying this is the reality of Parkinson’s. Gently, trying to avoid being offensive, Livy asks if they can be seen by the neurologist instead. The nurse practitioner tells her there is no point in doing that since the doctor will only repeat what she has just said. (Nurse practitioners, unlike physician’s assistants, are allowed to treat patients without a doctor’s on-site supervision.)
“It was exasperating,” Livy says now. “I know the difference in the training and I was very aware she was not a doctor. We’d come to see the guy who had gone to school for years studying neurology, and we weren’t getting to see him.”
Read more: http://www.houstonpress.com/news/nurse-practitioners-in-texas-want-to-work-without-doctor-supervision-9569688
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