Saturday, August 14, 2010

A Nurse Practitioner's Response To Incoming Senate President Mike Haridopolos's Medicaid Tour

I am a rural health care provider in Branford, Florida. I would like to know how many nurse practitioners have been involved in your round table discussions regarding health care reform? I noticed that on your website it states that you want to let "patients decide" but it only says " Patients Decide. First and foremost, it is vital that patients and doctors, not administrators, make all medical decisions." This seems exclusionary of other types of providers. Nurse practitioners and physician assistants are practicing primary health care out here in the trenches where most primary care doctors don't want to be.
President Obama is proposing that many more patients will be entering the Medicaid system and that there won't be enough medical providers out here to take the brunt. Florida's medical system is being overwhelmed with unnecessary costs due to patients showing up to the emergency rooms for treatments that could have easily been taken care of on an outpatient basis if they had access to appropriate care. How do we help control this?
Give me the ability to practice to the fullest of my capabilities with the allowance of prescriptive authority. Consider the following scenarios that happen often in primary care.
A mother brings her child to the office with a note from his teacher complaining that he is distracting others, misbehaving, being destructive and unable to complete assignments. Therefore, he will be held back if not evaluated for attention deficit disorder or attention deficit disorder with hyperactivity that may need medications to control. By the end of the visit, it's determined that a trial of meds are needed. Wait, I can't write for those medications. Now this parent needs to make a separate trip to see yet another medical doctor who can finish the job that I already started costing tax payers more money for an unneeded additional visit.
A man walks into the office with a machete laceration which I suture back together. He states that he is a fair amount of pain and asks what I can write for him to make the healing process more tolerable. Motrin or Tylenol may not be appropriate but it's all I can offer as a nurse practitioner if there happens to be any allergy to Tramadol.  This patient may still present to the emergency room even though the majority of the problem has been solved. Make sense to you? Me either.
A man presents to the office in severe distress because his wife has cancer and he is so worried about her situation that he can't sleep. All he wants is a light sleeping pill so that he can be rested. He really needs to help with her care but he is afraid to drive due to daytime sleepiness. I'm sorry. I can't help you with that either.
A man comes to the office complaining of fatigue, lack of interest in routine activities, no sex drive and is having marital problems due to these symptoms. I run labs and find that he is suffering from male menopause and would like to give him a prescription for testosterone replacement. Nope, it's not allowed to be written by nurse practitioners either.
I just returned from the National Health Service Corps conference in Washington, DC in which close to 600 participants from all walks of health care attended. I am proud to be one of it's members and to provide high quality, competent care for my patients and will continue to do so for many years to come.
 Help me to help you keep Floridians healthy. All I ask is that you keep me and the many nurse practitioners out here in mind when you vote on key issues that affect our practice.


  1. Your advocacy is pure. I hope we can help you in any way that we can.

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  3. Anonymous4:56 AM

    Become an M.D. or stay a nurse. Stop whining.

  4. Anonymous, get over the fact that NPs can take care of patients and we are not "just a nurse" anymore. Patient care advocacy isn't whining by the way.

  5. Anonymous8:58 PM

    Of course they can, an above average high schooler can take care of patients too. NP
    s are a great thing. But why do you want an unrestricted license to practice medicine and write prescriptions? GO TO MEDICAL SCHOOL. Or treat simple cases and do scut work.

  6. Anonymous, as a floor nurse, I didn't want the responsibility of practicing medicine and writing prescriptions. However, after I completed my Master's Degree as a Family Nurse Practitioner, I was prepared enough to take care of my patients who are happy that I can do more than simple cases and scut work.

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