Advanced Practice Nurses: Pushed Forward by Health Reform Advocates, Pushed Back by Physicians over Turf – Enough Already!

By Shawn Kennedy, MA, RN, AJN editor-in-chief

As we’ve noted in past posts on this blog and in AJN editorials in August 2006 and August 2008, organized medicine does not want to acknowledge that nurses can practice independently.  And now the turf war between advanced practice nurses (APRNs, which include nurse practitioners, nurse anesthetists, nurse midwives and clinical nurse specialists) and physicians is heating up.

In California, physicians are suing the state for allowing nurse anesthetists to practice without supervision, using patient safety as a reason. In Kentucky, physicians are opposing legislation to expand the scope of practice for NPs—at issue is whether NPs should need a signed collaborative arrangement with a physician (even though the physician does not supervise the NP). According to an article by a Louisville, Kentucky, newspaper, the Courier-Journal, the physicians charge high fees for their signature or demand a percentage of the practice.  The bill, though, passed the state House committee on March 4, with several members questioning the ethics of physicians’ requiring fees.

Nurses have been and continue to fight for the right to practice, and during this period where the government is seeking solutions to health reform, this is a battle that shouldn’t have to happen—a view shared by Stephen Ferrara, NP, at A Nurse Practitioner’s Place (“I have tried to refrain from taking the bait from some recent negative opinions regarding nurse practitioner delivered care”). […]

2016-11-21T13:18:48-05:00March 12th, 2010|health care policy, nursing perspective|2 Comments
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Comic Book Superheroes Meant to Raise AIDS Awareness Raise Some AJN Readers’ Ire

By Christine Moffa, MS, RN, AJN clinical editor

Back in January I posed the following question: “Is doing something as silly (and, to some, either sexist or demeaning) as this justified in the name of increasing awareness about a disease?” In that post, I was referring to the bra-focused tactics of a light-hearted campaign intended to raise breast cancer awareness. Along those lines, our March cover has received a lot of attention; unfortunately, not all of it has been positive.

Our goal was to draw attention to our two CE features of the month: “Every Nurse Is an HIV Nurse” and “Aging with HIV: Clinical Considerations for an Emerging Population.” As Shawn Kennedy, interim editor in chief and editorial director at AJN, points out in this month’s editorial, “AIDS awareness in this country seems to have diminished—in fact, for some, it hardly seems a concern at all. A recent CDC report on risk behavior in adolescents found that during 2007, 39% of sexually active high school students ‘had not used a condom during last sexual intercourse.’”

I asked Robert Walker to provide us with this month’s cover art after meeting him through a mutual friend. Through his comic book series O+Men, about nine HIV positive superheroes, he has been getting a lot of recognition for promoting HIV and AIDS awareness. For more information about Walker, read this month’s On the Cover in AJN, or listen to an interview with Walker on National Public Radio.

While […]

2016-11-21T13:18:50-05:00March 11th, 2010|Nursing|1 Comment
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There’s a Place for Speed in Online Publishing–But Peer Review Is More Important Than Ever

By Shawn Kennedy, MA, RN, AJN interim editor-in-chief

I read with interest, and also a little concern, a post on a newish blog called Nurse Story.com, which argued for faster Web-based publishing without peer review or much editing. 

Yes, the open access model of scientific publishing, with full transparency for all aspects of the review and revision process, is worth watching. Yes, more and more publishing companies are going the online only or online mostly route (and while it’s PC to say it’s in pursuit of being green, I’d bet the primary reason is because it’s cheaper). And yes, it’s much faster to publish on the Internet. You can throw up an article or blog post and change content online by the minute. But is fast and quick all we need? Technology is changing nursing practice, but is it changing our knowledge base so quickly that we shouldn’t take time to weigh and sift the good from the bad? […]

2016-11-21T13:18:53-05:00March 9th, 2010|nursing research|2 Comments
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Notes from the Healthweb and Nursosphere

This week Not Nurse Ratched has an amusing, meandering, and thoughtful post about the uses of Facebook by patients in the hospital. There’s a short excerpt below, but read the whole thing here.

They update Facebook constantly. CONSTANTLY. They have us take photos of injuries they can’t reach so they can post the photos to Facebook. I am not making this up. “I want a photo of my hideously dislocated ankle/knee/shoulder but I can’t move, so would you mind using my phone to take a picture for me?” And they keep updating and updating. I have actually said, “I’m about to give you a medicine that is going to render you unconscious immediately, so you should set your phone down.”

How could we have a weekly Web roundup that doesn’t at least mention health insurance reform? The spotlight has been slowly turning toward the insurers themselves, a crucial part of the equation (along with cost control and many other factors). This week Secretary of Health and Human Services Kathleen Sebelius met with the top executives of insurance companies to demand an explanation for the steep increases in rates seen in the last year.

If you’re looking for yet another reason why processed food isn’t good for you (besides the frequent presence of high fructose corn syrup and massive doses of salt, and the inaccurate packaging claims that the foods are “healthy” and “lean”), this week the NY Times reported news […]

2016-11-21T13:18:59-05:00March 5th, 2010|health care policy, nursing perspective|1 Comment
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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