Nurse practitioners juggle scope-of-practice issues with providing care

A study published last week, for instance, notes that although scope-of-practice laws might not restrict nurse pratitioners' ability to provide primary care, it does impact how they are paid.

The Associated Press: Nurses Spar With Doctors As 30 Million Insured Seek Care
Christy Blanco's health clinic in El Paso, Texas, is sitting empty. Blanco, a nurse practitioner, says she has a waiting list of patients, all the necessary equipment, and a Ph.D. in nursing that gives her the training to start treating patients. About 50 miles (80 kilometers) away in Las Cruces, New Mexico, dozens of nurse practitioners at clinics like Blanco's are busy caring for patients with a range of diseases from diabetes to asthma to depression (Pettypiece, 3/4).

Kaiser Health News: Nurse Practitioners Say How They're Paid Affects Care They Can Provide
In the study, published Thursday by the National Institute for Health Care Reform, researchers found that while so-called "scope of practice" laws did not appear to restrict the primary care services nurse practitioners can provide to patients, they do affect how the advanced nurses are paid (Tran, 3/1).

In related news, proposed legislation in Maryland would lead to the licensing of midwives without nursing degrees --

Baltimore Sun: Proposed Legislation Would Allow Midwives To Conduct Home Births
Supporters of home births are trying to convince legislators to create a pilot program that could eventually lead to the licensing of midwives without nursing degrees. The three-year pilot would allow certified professional midwives to deliver babies in a home setting without worry of arrest or prosecution. Certified professional midwives are trained in midwifery and meet standards set by the North American Registry of Midwives. Under the pilot program, midwives would share their birth outcomes with the state Department of Health and Mental Hygiene. The pilot would allow time for the state to figure out the best way to structure a legal midwifery licensing or certification program and look at what other states do, said Del. Ariana Kelly, a Montgomery County Democrat who sponsored the legislation to create the pilot (Walker, 3/1).