Who Should Be Allowed to Sedate Patients?

Where should the medical profession draw the line between tasks that truly require the attention of a doctor and those that can be capably handled by a specialized nurse? New Jersey health officials are currently considering this question.

According to the Wall Street Journal, the New Jersey health department is reviewing a plan to allow nurse anesthetists to sedate patients without the direct supervision of an anesthesiologist. Presently, nurses are only allowed to do this type of work when an anesthesiologist is in the facility; with the proposed change, the nurses would only need to be able to reach a doctor should the situation escalate.

Many doctors have expressed concerns that nurses do not have the specialized training necessary to effectively handle these situations when something goes wrong. As a result, they argue, such a change would place patients at risk of harm.

In contrast, supporters of this change note that nurse anesthetists are registered nurses with graduate degrees who have at least one year of experience working in intensive care. In more than half of the states in the United States, nurses who have specialized anesthetics training are allowed to work without the supervision of doctors. According to a recent study published in Health Affairs, a medical journal, allowing nurses to work without a supervising physician does not result in a rise in complications or patient deaths.

Patient safety should always be at the forefront of any medical decision-making process. At the same time, the medical profession is constantly making choices about the level of specialized training necessary to handle particular tasks. Some steps simply do not require the expertise a doctor can offer, and demanding that doctors participate can increase costs and decrease efficiencies.

Currently, the New Jersey health department is accepting comments on the proposed change by members of the public. Anyone with concerns regarding this change should contact the department and make these concerns known.

Related Story:

Doctors Oppose a Nursing Push, The Wall Street Journal

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