Health Care

Is an Advanced Degree Nurse in the House

Every few years, there's a profession heard to be in short supply, and another in a glut. Teachers, lawyers, engineers and construction workers have all seen the rise and fall of their jobs over the years. There only always seems to be a shortage of doctors, especially in poor and rural areas. Is the solution to let up the reins on medical school admissions?

There may be another way: Let the nursing profession pick up the work.

Nurse Practitioners Open Their Doors

Patients in many clinics have already become comfortable being seen by nurse practitioners instead of doctors. In many places where appointments with doctors are difficult to schedule, patients are fine seeing nurses with advanced degrees: Nurse practitioners, doctor's assistants and nurse midwives.

Some people may initially be hesitant about seeing someone without a "Dr." in their name. But others are glad for the chance to have a less rushed visit, and possibly less time to wait. Most nurses schedule their patient appointments for longer periods. And many patients report they feel the nurses are better listeners.

States vary in their regulations, and many (such as Florida and Alabama) don't allow any nurses to prescribe controlled substances, even nurses with advanced degrees. Other states allow advanced degree nurses to do just about anything a doctor does, as long as there is a signed agreement between the doctor and nurse that they'll work together in patient care.

Nurse Midwives Get Nod from Medicare

Over the past decade more and more women have decided to return to the ways of an earlier era for childbirth. Instead of going to the hospital, many women are giving birth at home, under the care of a nurse midwife.

Recently, Medicare officials have recognized the value of these services. They've decided that a certified nurse midwife should be paid the same as a doctor for delivering a baby.

Women considering this option should talk frankly with the midwife about her ability to handle unforeseen events during the delivery, especially if there are special risks with the pregnancy. Knowing whether the midwife can administer certain medications and can get the patient admitted to the hospital if needed is important.

Legal Standards for Nurses

Each state has its own laws and court decisions about holding medical providers legally responsible for injuries or death. For doctors, these cases are called medical malpractice. Other cases can include nursing malpractice, dental malpractice and chiropractor malpractice.

Proving a medical professional legally responsible for malpractice can be difficult. Most states require you to show that the doctor or nurse didn't practice the "standard of care" owed to you as a patient.

You need an expert in the same professional area to give an expert opinion that the mistakes made were "unreasonable" and "negligent." You may also have to prove conduct wasn't what a reasonably well-qualified person in the same profession would have done.

What this means in practical terms is that if a doctor is sued for malpractice, only another doctor can give an expert opinion that it was the doctor's conduct that was unreasonable and caused the patient's harm. Only a nurse can give expert opinions about a nurse who is sued for nursing malpractice.

As the lines between the professions become blurred, so might the legal standards for care. In the meantime, if an advanced degree nurse is working under the supervision of a doctor, both of them could be held accountable for injuries occurring under their watch.

Questions for Your Attorney

  • Does it matter if my negligence or malpractice lawsuit involves a private or state-owned hospital?
  • My relative died due to nursing malpractice, is it too late to file a lawsuit?
  • Do our state and local government officials have to conduct a review or investigation of area nurses or doctors?
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