Peter I Buerhaus1, Yuchiao Chang2, Catherine DesRoches3, Sophia Guzikowski4, Linda Norman5, Karen Donelan6. 1. Center for Interdisciplinary Health Workforce Studies, College of Nursing, 206 Anna Pearl Sherrick Hall, Montana State University, Bozeman, MT. 2. Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA. Electronic address: yuchiao.chang@mgh.harvard.edu. 3. Harvard Medical School, OpenNotes, Beth Israel Deaconess Medical Center, Boston, MA. 4. Health Policy Research Center, The Mongan Institute, Massachusetts General Hospital, Boston, MA. 5. Vanderbilt University School of Nursing, Vanderbilt University, Nashville, TN. 6. Harvard Medical School, Health Policy Research Center, The Mongan Institute, Massachusetts General Hospital, Boston, MA.
Abstract
BACKGROUND: Population aging and physician shortages have motivated recommendations of increased use of registered nurses in care provision; little is known about RN and NP employment in primary care and geriatric practices or service types each provide. PURPOSE: Determine current RN and NP employment frequency in practices in the U.S., identify services provided by RNs, and whether NP presence in practice is associated with the types and frequency of services provided by RNs. METHODS: National survey of 410 primary care and geriatric clinicians. FINDINGS: Only half of practices employed RNs. RNs most frequently provide teaching or education for chronic disease management. RNs provide significantly more primary care and geriatric services when practices employed a NP. DISCUSSION: Reasons for RN underuse in practices should be identified, clinical placements in such practices should increase, and NP education programs should include care models using RNs to their full scope of practice.
BACKGROUND: Population aging and physician shortages have motivated recommendations of increased use of registered nurses in care provision; little is known about RN and NP employment in primary care and geriatric practices or service types each provide. PURPOSE: Determine current RN and NP employment frequency in practices in the U.S., identify services provided by RNs, and whether NP presence in practice is associated with the types and frequency of services provided by RNs. METHODS: National survey of 410 primary care and geriatric clinicians. FINDINGS: Only half of practices employed RNs. RNs most frequently provide teaching or education for chronic disease management. RNs provide significantly more primary care and geriatric services when practices employed a NP. DISCUSSION: Reasons for RN underuse in practices should be identified, clinical placements in such practices should increase, and NP education programs should include care models using RNs to their full scope of practice.