THE NURSE PARADIGM

Abstract

Because one of the most revolutionary parts of health care reform in America is bound to be the burgeoning role that nurses will play, including providing many of the services that were once confined to physicians. Their new prominence will benefit patients—and raise some new questions about the importance of tender loving care and the economic value of medical services. Exhibit A in what the president of Columbia-Presbyterian Medical Center in New York City calls "a major paradigm shift" is that hospital's decision to give its nurse practitioners admitting privileges, further blurring the line between what doctors do and what nurses can. Dr. William T. Speck, the president of Columbia-Presbyterian, says that, in his hospital, which is both a prominent teaching and research center and the health care nucleus of a sprawling urban area, giving nurse practitioners more authority simply made good sense.