The U.S. Department of Veterans Affairs (VA) is facing criticism for a controversial proposal that would allow highly trained advanced practice nurses to treat veterans without a physician’s oversight. The agency said the plan is part of an overall effort to improve veterans’ access to VA health care by reducing long wait times. Patients have been known to wait from several weeks to months for even the most basic VA health care services.
According to officials, around 6,500 of the VA’s 93,000 nurses have advanced training. These nurses would see their responsibilities broadened under the proposal. They would have the authority to prescribe medications, perform diagnostic tests, treat acute and chronic illnesses and administer anesthesia without a doctor’s supervision.
The VA would follow in the footsteps of the military, 21 states and the District of Columbia that have increased the authority of advanced nurse practitioners by allowing them to practice independently. Nurse practitioners are trained to provide many of the same primary care functions as doctors. However, many state laws have prohibited them from performing certain health care services without a physician’s oversight.
Both the American Society of Anesthesiologists and the American Medical Association (AMA) have opposed the VA’s proposed policy. “… We believe that providing physician-led, patient-centered, team-based patient care is the best approach to improving quality care for our country’s veterans,” AMA Board Chair Dr. Stephen Permut said in a statement. “We feel this proposal will significantly undermine the delivery of care within the VA.”
On the other hand, nurses welcome the VA’s proposal as a way to improve care for veterans. The American Nurses Association released a statement saying that longstanding limits on the scope of practice for highly trained nurses has harmed veterans. They noted staff shortages cause backlogs for health care to grow longer.