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Sailorman

Puzzled and would like others opinions

Question

What are your thoughts on if you discovered a VA Registered Nurse practicing at at the VA as Certified Nurse Practitioner? I checked with the States licensing officials and this nurse doesn’t have the proper license as a CNP. 

This lady is treating veterans and signing off on veterans C&P’s for years. No telling how much damage she has done. 

 

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Did you comment against this 2016 proposal during the Fed Reg comment period?

https://www.federalregister.gov/documents/2016/05/25/2016-12338/advanced-practice-registered-nurses

I knew when I read this ( and comented against it) that tis would create problems.

VA went ahead regardless of any negative comments to do this:

https://www.va.gov/opa/pressrel/pressrelease.cfm?id=2847

In part:

"VA Grants Full Practice Authority to Advanced Practice Registered Nurses

Decision Follows Federal Register Notice That Netted More Than 200,000 Comments

WASHINGTON - The Department of Veterans Affairs (VA) today announced that it is amending provider regulations to permit full practice authority to three roles of VA advanced practice registered nurses (APRN) to practice to the full extent of their education, training, and certification, regardless of State restrictions that limit such full practice authority, except for applicable State restrictions on the authority to prescribe and administer controlled substances, when such APRNs are acting within the scope of their VA employment.

“Advanced practice registered nurses are valuable members of VA’s health care system,” said VA Under Secretary for Health Dr. David J. Shulkin. “Amending this regulation increases our capacity to provide timely, efficient, effective and safe primary care, aids VA in making the most efficient use of APRN staff capabilities, and provides a degree of much needed experience to alleviate the current access challenges that are affecting VA.”   

It is BS plain and simple but the only way to get around this is to get an IMO/IME from a Real doctor, that fully follows the IMO/IME criteria here at hadit.

This is why I hope VA really starts implementing the Choice program for all VA Patients, or that VA pts start using their Medicare if they can. And maybe better yet VA could transfer VHA into private  care, for all veterans, who can go to any private doctor or facility for care.Privitization.

Just think if that happened--I bet a slew of FTCAs or 1151 claims would be filed, when real non VA doctors find out  veteran's actual medical situations.

I have stated many times here and I believe this- that VA saves lives every day-

that's great and they should ,but what about those vets who get piss poor care and often do not even know it.

 

 

 

 

 

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Thank you very much, Bertha. No I never commented because I never knew about the policy change. 

Its sure is shameful that the VA allows this to happen. I really appreciate you providing me with this reference. 

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Posted (edited)

It may not be so bad.  I have a daughter in law who is an MD in the military.  She says she trusts her "PA's" (Physician Assistants).  My wife is also a retired nurse, and, beleive me the doctors very often do as the nurse suggests anyway.  

I personally worked in a nursing home years ago.  While the doctors "signed off" on the orders, we went, sometimes weeks and never saw a doctor.  And the patient didnt either.  

Its not unusual in private or VA care for the doc to delagate much stuff to a nurse.  The doc's license is "on the line" so he does not do that unless he trusts the nurses competence. 

Very often, you make a doctors appointment and you dont see the doc..often a nurse, PA, etc.  This is true in both VA and private practice.  

If the nurse is very competent, you dont have much to worry about.  They call it "triage", where the nurse assesses the situation to determine if the doctor is needed.  Sometimes yes, sometimes no.  Its just the way it works.  There is a shortage of doctors, and nurses are utilized to fill the void.  

Frankly, I would rather see a competent PA or nurse, than an incompetent doctor anyday.  Just go to work at a hospital (I actually did that many many years ago) and you will see that first hand.  

The nurse (or PA) is "under the supervision" of a doctor, even if the doc is not in the same room at the time.  At the nursing home, often the doctor is 20 miles away, and docs really dont go to nursing homes that often...and the sickest people in the world are there, often.  

Edited by broncovet

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Thanks Broncovet I see and appreciate your input. 

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While I agree with your premise, its not all black and white.  Some are great, some are terrible.

I know a neurologist I would not take one of my chickens too.

Eat poop drink cluck egg eat poop drink cluck egg poop etc etc.,

How hard is that,

Hamslice

 

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