Nurses take on larger role in expanded health care

Published: Thursday, Dec. 26, 2013 11:04 p.m. CDT • Updated: Thursday, Dec. 26, 2013 11:21 p.m. CDT

CRYSTAL LAKE – Carol Radovich can write a prescription, diagnose a patient and provide routine checkup services like most primary care physicians.

But she is no doctor.

Radovich, as part of a booming profession, is one of the more than 8,000 nurse practitioners in Illinois charged with many of the same responsibilities as traditional doctor. For Radovich, it was a 17-year journey to earn the master’s degree, certifications and experience needed to gain the status.

While it was a long road, it is that nursing experience and education that make nurse practitioners more appealing than traditional physicians for some patients, Radovich said.

It has become a popular alternative across the country, with more than 450,000 patients receiving treatment from about 106,000 nurse practitioners last year.

“I think some patients prefer it because they feel the nurse practitioner spends more time with them, whether that is just a perception or not,” Radovich said. “Because of how nurses are brought up through [the] ranks, they spend a bit more time with patients and have a more personalized interaction. It’s just a difference in schooling.”

Jeannine Nosko, director of patient care services for Centegra, said the role of nurse practitioners has grown significantly in the past decade, and Centegra is committed to continuing the expansion with a program for nurse practitioners in acute care.

She said because nurse practitioners have the luxury of being centrally located, they are able to help physicians that must divide time between hospitals, clinics and practices.

“Nurse practitioners are going to have an ever-expanding role in the future with thinly stretched physicians,” Nosko said. “There is a higher volume of people needing medical care.”

The number of nurse practitioners and patients seeking their services are expected to grow as implementation of the Affordable Care Act continues to roll out.

Sue Clark, a spokeswoman and lobbyist for the Illinois Society for Advanced Practice Nursing, said as more people become insured, the demand for primary care will increase, with physicians already handling full schedules.

To handle that demand, Clark said, it is imperative the state grants nurse practitioners the same scope of responsibilities other states allow. In Illinois, nurse practitioners are required to have a collaborating physician that speaks with the nurse practitioner at least once a month.

The collaborating physician also can review charts and discuss cases, but it is not required by law. Clark said the essentially supervisory role is onerous and not required in many other states. Nurse practitioners in some other states are allowed to open their own practice, admit patients to hospitals and take on greater responsibilities.

“Countless studies have shown there is no difference in outcomes between the two,” Clark said of patients visiting doctors as opposed to nursing practitioners. “I think it will be harder for the state Legislature to ignore removing the collaborative agreement as the demand for primary care goes up. It’s a burden on (doctors and nurses).”

Clark is confident nurse practitioners will receive some more authority in the next legislative session. She said there is a bill with early support that would allow nurse practitioners to sign Physician Orders for Life-Sustaining Treatment forms – a form that details a patient’s end-of-life care plan.

Despite some limits on the position, Radovich said it was well worth the work to become a nurse practitioner and she is happy to see the role expand across the country. Radovich, who was the lone nurse practitioner in Centegra when she started in 1998, said there are now 25 in Centegra and it will not be long before it grows.

“It’s a great job,” she said. “It’s already a popular option for patients, and it is going to continue to become more popular as it is more accessible.”

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