Examining the Role of the Clinical Nurse Specialist in Diagnosing and Prescribing

Examining the Role of the Clinical Nurse Specialist in Diagnosing and Prescribing

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Historically, the American Medical Association (AMA) has continuously contended the progression of nursing practice, in particular advanced nursing practice (Keeling & Bigbee, 2005). They have done so by opposing the advances of nursing practice claiming the broader and more specialized roles of advanced practice nurses (APNs), which includes diagnosing and prescribing, encroaches on physician practice and claim nurses are not educationally sufficiently prepared to take on these roles (Summers & Summers, 2007). The medical profession posits APNs should be supervised by physicians in their advance practice roles. Examples of such opposition are evident in for example AMA’s posting of a recent speech given by Nancy Nielsen (2009) stating that the AMA will oppose a proposed bill to allow APNs to classify themselves as primary care providers; or as presented and discussed at the recent 34th AMA Annual Meeting (AMA, 2010), in which a strong opposition to autonomous practice of APNs was discussed and the position of physician supervision of APNs practice was advocated.
This opposition not only hinders the advancement of cost efficient healthcare, it also stands in direct opposition to the newly proposed Patient Protection and Affordable Care Act (U.S. Congress, 2010), which recognizes APNs practice and working relationship with physicians to be one of collaboration, not submission, and recognizes the need for the expansion and recognition of APNs’ role in order to increase the availability of healthcare to all Americans.
In order to allow for APNs to be efficient in providing care to their patients, those APNs diagnosing and treating patients, need to be able to have the authority to prescribe treatments, inclusive of medications, f...


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...Summers, H. J. (2007). Changing poor portrayals of nurses in the media: The center for nursing advocacy. In D. J. Mason, J. K. Leavitt, & M. W. Chaffee (Eds.), Policy & politics in nursing and health care (5th ed., pp. 184-194). St. Louis, MO: Elsevier Saunders.
Tucker, S. (2003). Preparing CNSs for prescriptive authority. Clinical Nurse Specialist, 17(4), 194-199. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/12869866
United States of America Congress. (January 5, 2010). In U.S. Government Information (Ed.), An Act (One Hundred Eleventh Congress of the United States of America). Retrieved from http://democrats.senate.gov/reform/patient-protection-affordable-care-act-as-passed.pdf
Weinkam, K., Bailey, L., & Goodman, H. J. (Eds.). (2003). What is the RN scope of practice? (The BRN report, pp. 7-9). Retrieved from http://www.rn.ca.gov/pdfs/forms/brnfall2003.pdf

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