* Nurses can deliver quality care cheaper
* Expanded education needed
* Nurses can fill forecast shortage of physicians
By Maggie Fox, Health and Science Editor
WASHINGTON, Oct 5 Nurses can handle much of the
strain that healthcare reform will place on doctors and should
be given both the education and the authority to take on more
medical duties, the U.S. Institute of Medicine said on
A report from the institute calls for an overhaul in the
responsibility and training of nurses and says doing so is key
to improving the fragmented and expensive U.S. healthcare
system -- President Barack Obama's signature political
"We are re-creating nursing in America," Dr. Risa
Lavizzo-Mourey, president and CEO of the nonprofit Robert Wood
Johnson Foundation, said at a news conference.
"We believe that this report and the implementation of its
findings is vital to the strength of healthcare in this
nation," she said.
The foundation, which promotes healthcare reform and funds
research on the issue, worked with the Institute of Medicine on
Nurses already often deliver babies, counsel patients with
heart disease or diabetes and care for dying cancer patients --
and these roles should be expanded nationally and paid for by
both public and private insurers, the report says.
"Nurses have to be full partners with doctors," said Donna
Shalala, a former Health and Human Services secretary who
helped write the report. She said it should "usher in golden
age of nursing" by allowing nurses to practice "to the full
extent of their education and training."
DOCTOR SHORTAGE ANTICIPATED
The U.S. healthcare reform law passed in March is expected
to add 32 million Americans to health insurance company rolls.
Several groups, including the Institute of Medicine, have
forecast shortages of doctors to provide care.
Last month, the Association of American Medical Colleges
released new estimates that showed 63,000 more doctors would be
needed in 2015 than would be available. [ID:nN30276233]
"We evaluated the evidence which has been accumulating now
for decades as to the capability of nurses to bridge that gap,"
said Dr. John Rowe of the Columbia University Mailman School of
Public Health, one of the report's authors.
"There have been concerns in the past that nurses could
provide the quality and safety for some areas of primary care.
The committee concluded that it was very clear from the
evidence that nurses can very effectively and safely ...
deliver those primary care services."
The United States has more than 3 million nurses, making
them the single-largest segment of the healthcare workforce,
said the non-partisan institute, which advises the federal
government on medical matters.
It said states, federal agencies and healthcare
organizations should remove so-called "scope of practice"
barriers that limit what nurses may do.
The U.S. government and non-profit organizations should
fund grants and scholarships to allow nurses to further their
educations so they can take on bigger responsibilities.
"We really need to use nurses to their full potential,"
By 2020, 80 percent of nurses should have a bachelor's
degree at least and 10 percent of them should go on to get a
doctorate degree, the report recommends. Many nurses now
practice with a two-year certificate.
(Editing by Bill Trott)