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美国最后一个州也给了护士处方权,中国呢?

2016-04-19 田雨思 编译 "HealthBang"微信号

在经历了长期抵抗之后,佛罗里达州政府于4月15日正式签署立法,允许护理医师和医师助理开具涉及控制性药物的处方。这意味病人获取药品的渠道将被大大拓宽,包括从避孕药到特定镇痛药等各种药物。美国的护士分为四个等级,分别为助理护士(Nursing Assistant)、职业护士(Licensed Practical Nurse)、注册护士(Registered Nurse)和护理医师(Nurse Prac

在经历了长期抵抗之后,佛罗里达州政府于4月15日正式签署立法,允许护理医师和医师助理开具涉及控制性药物的处方。这意味病人获取药品的渠道将被大大拓宽,包括从避孕药到特定镇痛药等各种药物。

美国的护士分为四个等级,分别为助理护士(Nursing Assistant)、职业护士(Licensed Practical Nurse)、注册护士(Registered Nurse)和护理医师(Nurse Practitioner)。其中,护理医师为最高等级的护士,可以承担一部分医生的工作,通常有医学硕士以上学历,在某一个领域有专门的学习和研究。

佛罗里达州是美国最后一个放开对护理医师处方权的州。

在赋予医师助理处方权方面,佛罗里达也落后于其他州,所幸还有其他州垫底——全美仅剩下肯塔基州对医师助理的处方权进行限制。

美国的医师助理(Physician Assistants),可以在医生的监管下行医,包括给病人诊断、处理伤痛、开化验单等。在一些缺医生的边远地区,医生只要一周去诊所一两天就行,医师助理几乎处理所有的事情。

美国医师助理学会主席杰夫瑞·卡茨在声明中说道:“允许医师助理开具药方这一具有里程碑意义的立法,可以更好地满足病人的需求,使他们获取高质量的医疗护理。”

虽然这次的法案将于2016年7月1日正式生效,但可能直到2017年,病人才能正式从中获益,因为法令仍然需要通过美国禁毒署的一系列程序审查。

在美国护理医师协会副主席泰宁·克帕诺看来,护理群体十多年在改善佛罗里达州居民医疗状况方面做出积极努力,新法令表现出对这种努力的肯定。

在整个佛罗里达州,大约有超过5000名护理医师和医师助理,他们的工作对该州迅速增长的老年群体至关重要,尤其是在乡村地区。

在该法案的立法辩论期间,立法者表示,他们非常认同护理医师和医师助理的从业能力和资质,根据美国医师助理学会的信息,美国大部分医师助理都拥有两年制的硕士学位。

医师助理和护理医师通常在医生个人诊所、连锁药店等机构工作,他们的工作包括问诊、开处方以及提供保健护理方面的咨询服务。

近些年来,美国国内涌现了一批新的价值导向的医疗模式,如“可信赖医疗组织”(accountable care organizations),以及以病人为中心的“医疗之家”。在这些模式中,保险公司、医疗保险、医疗补助三方签订合约,共同操作,而医师助理和护理医师,则是这些新型模式中的基本组成部分。美国主要的保险公司,如Aetna AET, Anthem, UnitedHealth Group and Blue Cross and BlueShield plans都在逐渐抛弃传统的付费医疗模式,增加与“可信赖医疗组织”的合作。

除了美国,英国、荷兰等一些发达国家的护士也都拥有一定范围的处方权。英国在1992年即制订了《处方法》,赋予护士一定范围的处方权。自从2003年起,英国护士已拥有180种药物的处方权。通过增加护士可开具处方的药品数,医生们可以拥有更多的时间来诊断其他严重疾病,患者则可以缩短治疗时间,同时,民众获得药品的途径更多了,也更方便了。

荷兰赫罗纳大学的著名护理学者皮特里·露布的一项调查显示:68个国家的637名高级护理从业者代表中,有67.3%的人表示拥有处方权。这表明,高级护理从业者拥有一定范围的处方权在国际上已经较为普遍。

如今,护士的工作已不仅仅局限于医院,逐步渗入到临终关怀、康复保健、家庭护理及社区护理等领域。护士拥有处方权具有多重意义,比如,可以提升护士的职业价值,保证从业人员的队伍稳定,增强他们的责权意识,还能激发他们不断地学习。

然而,中国目前的脚步远落后于其他国家,即便是获得博士学位的护士也无法获得处方权,这已经严重限制了护理理论与实践的发展。

你们觉得呢?

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    2016-04-20 明崖

    希望中国也能开放这个制度

    0

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    2016-04-19 I come

    这种事情呵呵就行了

    0

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    2016-04-19 王新春

    不好弄啊!不然被打!

    0

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    2016-04-19 李继凯

    中国不可能的

    0

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    2016-04-19 李继凯

    不能乱学

    0

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    2016-04-19 Lisa971

    国情不一样。患者对医护人员的信任都没达到很干。

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1757348, encodeId=cef01e57348c8, content=<a href='/topic/show?id=6e234242482' target=_blank style='color:#2F92EE;'>#处方权#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42424, encryptionId=6e234242482, topicName=处方权)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=72d137305274, createdName=12498623m105暂无昵称, createdTime=Mon Dec 26 06:17:00 CST 2016, time=2016-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79787, encodeId=a595e97875c, content=希望中国也能开放这个制度, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=73441710184, createdName=明崖, createdTime=Wed Apr 20 16:00:00 CST 2016, time=2016-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79724, encodeId=dbd0e972404, content=这种事情呵呵就行了, beContent=null, objectType=article, channel=null, level=null, likeNumber=151, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuK9CDibOwszLoEBg36ZXqzB5NDasNV9GTfFDmBicM1V8hUS4OtTicG3IiaFIKq4wqD23LUxORRJXqjVs/0, createdBy=00e81647535, createdName=I come, createdTime=Tue Apr 19 22:15:00 CST 2016, time=2016-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79717, encodeId=8922e9717ac, content=不好弄啊!不然被打!, beContent=null, objectType=article, channel=null, level=null, likeNumber=156, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xSHQO6hUsLfmSqiaQiceT0D77ib0rXiblAIwyTo0iciakSAGHE0nfEpNHl9icHMY6tKTW3kFdWSwKcWGvneZHicqoJsI5V/0, createdBy=2a221626427, createdName=王新春, createdTime=Tue Apr 19 21:36:00 CST 2016, time=2016-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79685, encodeId=dfcfe96859f, content=中国不可能的, beContent=null, objectType=article, channel=null, level=null, likeNumber=164, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=240a1683959, createdName=李继凯, createdTime=Tue Apr 19 19:06:00 CST 2016, time=2016-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79686, encodeId=b4aae96866e, content=不能乱学, beContent=null, objectType=article, channel=null, level=null, likeNumber=149, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=240a1683959, createdName=李继凯, createdTime=Tue Apr 19 19:06:00 CST 2016, time=2016-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79546, encodeId=93e3e9546d6, content=国情不一样。患者对医护人员的信任都没达到很干。, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160313/IMG56E50DEC424F44672.jpg, createdBy=ce5b1699635, createdName=Lisa971, createdTime=Tue Apr 19 13:30:00 CST 2016, time=2016-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79542, encodeId=b3b8e9542fa, content=基础教育不一样,体制不一样, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ab3f1711729, createdName=1dea5dd7m74(暂无匿称), createdTime=Tue Apr 19 12:48:00 CST 2016, time=2016-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79537, encodeId=67e3e95370e, content=放屁, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151018/IMG5623B9060FDC17867.jpg, createdBy=b87832484, createdName=nugent, createdTime=Tue Apr 19 11:46:00 CST 2016, time=2016-04-19, status=1, ipAttribution=)]
    2016-04-19 1dea5dd7m74(暂无匿称)

    基础教育不一样,体制不一样

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1757348, encodeId=cef01e57348c8, content=<a href='/topic/show?id=6e234242482' target=_blank style='color:#2F92EE;'>#处方权#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42424, encryptionId=6e234242482, topicName=处方权)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=72d137305274, createdName=12498623m105暂无昵称, createdTime=Mon Dec 26 06:17:00 CST 2016, time=2016-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79787, encodeId=a595e97875c, content=希望中国也能开放这个制度, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=73441710184, createdName=明崖, createdTime=Wed Apr 20 16:00:00 CST 2016, time=2016-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79724, encodeId=dbd0e972404, content=这种事情呵呵就行了, beContent=null, objectType=article, channel=null, level=null, likeNumber=151, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuK9CDibOwszLoEBg36ZXqzB5NDasNV9GTfFDmBicM1V8hUS4OtTicG3IiaFIKq4wqD23LUxORRJXqjVs/0, createdBy=00e81647535, createdName=I come, createdTime=Tue Apr 19 22:15:00 CST 2016, time=2016-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79717, encodeId=8922e9717ac, content=不好弄啊!不然被打!, beContent=null, objectType=article, channel=null, level=null, likeNumber=156, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xSHQO6hUsLfmSqiaQiceT0D77ib0rXiblAIwyTo0iciakSAGHE0nfEpNHl9icHMY6tKTW3kFdWSwKcWGvneZHicqoJsI5V/0, createdBy=2a221626427, createdName=王新春, createdTime=Tue Apr 19 21:36:00 CST 2016, time=2016-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79685, encodeId=dfcfe96859f, content=中国不可能的, beContent=null, objectType=article, channel=null, level=null, likeNumber=164, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=240a1683959, createdName=李继凯, createdTime=Tue Apr 19 19:06:00 CST 2016, time=2016-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79686, encodeId=b4aae96866e, content=不能乱学, beContent=null, objectType=article, channel=null, level=null, likeNumber=149, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=240a1683959, createdName=李继凯, createdTime=Tue Apr 19 19:06:00 CST 2016, time=2016-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79546, encodeId=93e3e9546d6, content=国情不一样。患者对医护人员的信任都没达到很干。, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160313/IMG56E50DEC424F44672.jpg, createdBy=ce5b1699635, createdName=Lisa971, createdTime=Tue Apr 19 13:30:00 CST 2016, time=2016-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79542, encodeId=b3b8e9542fa, content=基础教育不一样,体制不一样, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ab3f1711729, createdName=1dea5dd7m74(暂无匿称), createdTime=Tue Apr 19 12:48:00 CST 2016, time=2016-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79537, encodeId=67e3e95370e, content=放屁, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151018/IMG5623B9060FDC17867.jpg, createdBy=b87832484, createdName=nugent, createdTime=Tue Apr 19 11:46:00 CST 2016, time=2016-04-19, status=1, ipAttribution=)]
    2016-04-19 nugent

    放屁

    0

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