VOA标准英语2010年-Nurse Practitioners Expand Role in US

The new health care reform law in the United States will require everyone to have health insurance.  People who avoided going to the doctor because they had no insurance will be more likely to visit primary care physicians for minor¹ illnesses.  But there's a shortage of primary care doctors, and nurse practitioners³, who have advanced nursing training, are hoping to fill the gap.

Leslie Henry and Maura Constance are nurse practitioners at the Arlington Free Clinic in Arlington, Virginia.  

Henry is examining a woman who has allergies⁴. "Well, you definitely look like you have allergies," she says.

A nurse practitioner² is a registered nurse who has completed advanced nursing education. "Nurse practitioners have a lot of the same functions as doctors.  We take classes that look at different systems in the body.  The same thing a doctor would take," says Constance.

They learn how to diagnose and manage common illnesses like colds, or chronic⁵ problems such as diabetes⁶ and heart disease.  "We assess their medical problems and we come up with a treatment plan. We write prescriptions," says Henry.

For years, nurse practitioners have been playing a larger role in the nation's health care, especially in regions with few doctors. 

Jan Towers is Director of Policy for the American Academy of Nurse Practitioners. "There are also shortages in terms of having providers who will work with the elderly.  Nurse practitioners are particularly prepared to work with those kinds of people and in those kinds of settings because of community health preparation that we get in our nursing programs," she says.

States regulate nurse practitioners and laws vary on what they are permitted to do. Most nurse practitioners are overseen⁷ by a physician.

With the shortage of primary care physicians, 28 states are considering expanding the authority of nurse practitioners.  This includes practicing without a doctor's supervision⁸ and prescribing narcotics⁹ such as morphine for pain. "Given that there is going to be a need for primary care providers, and nurse practitioners are highly qualified¹⁰ primary providers who have been underutilized to date.  And they will be able to be part of what we think is a solution to getting primary care providers to everybody," she says.

The American Medical Association (the largest association of U.S. physicians) argues that the shortage of doctors is no reason to put nurses in charge. The group says the quality of medical care will drop if nurse practitioners are given more authority.  Instead, it says, more primary care doctors should be trained. 

But that may be hard to do since primary care physicians earn much less than specialists. 

Dr. Winston Liew, is a primary care physician in Fairfax, Virginia. He says studies on the effectiveness of nurse practitioners have been too small to be conclusive¹¹.  "I think we still need to do more evaluation¹². It's obviously a very important skill, but I think it doesn't really encompass¹³ what primary care physicians do," he says.

Studies have shown nurse practitioners are better at listening to patients than doctors, and they make good decisions about when to refer patients for specialized¹⁴ care. 

Leslie Henry says she'd like to see nurse practitioners have more independence. "Nurse practitioners provide good care and certainly the studies have supported that.  Also, nurse practitioners get paid a lot less than a medical doctor and that means maybe we can provide affordable¹⁵ care," she says.

She says she enjoys helping¹⁶ people.  Her frustration¹⁷ is that -- like for doctors -- there are too many patients and not enough time to spend with them.

 

1 minor   

adj.较小(少)的，较次要的；n.辅修学科；vi.辅修

参考例句：

• The young actor was given a minor part in the new play.年轻的男演员在这出新戏里被分派担任一个小角色。
• I gave him a minor share of my wealth.我把小部分财产给了他。

2 practitioner   

n.实践者，从事者；(医生或律师等)开业者

参考例句：

• He is an unqualified practitioner of law.他是个无资格的律师。
• She was a medical practitioner before she entered politics.从政前她是个开业医生。

3 practitioners   

n.习艺者，实习者( practitioner的名词复数 )；从业者（尤指医师）

参考例句：

• one of the greatest practitioners of science fiction 最了不起的科幻小说家之一
• The technique is experimental, but the list of its practitioners is growing. 这种技术是试验性的，但是采用它的人正在增加。 来自辞典例句

4 allergies   

n.[医]过敏症；[口]厌恶，反感；（对食物、花粉、虫咬等的）过敏症( allergy的名词复数 )；变态反应，变应性

参考例句：

• Food allergies can result in an enormous variety of different symptoms. 食物过敏会引发很多不同的症状。 来自辞典例句
• Let us, however, examine one of the most common allergies; hayfever. 现在让我们来看看最常见的变态反应的一种--枯草热。 来自辞典例句

5 chronic   

adj.(疾病)长期未愈的，慢性的；极坏的

参考例句：

• Famine differs from chronic malnutrition.饥荒不同于慢性营养不良。
• Chronic poisoning may lead to death from inanition.慢性中毒也可能由虚弱导致死亡。

6 diabetes   

n.糖尿病

参考例句：

• In case of diabetes, physicians advise against the use of sugar.对于糖尿病患者，医生告诫他们不要吃糖。
• Diabetes is caused by a fault in the insulin production of the body.糖尿病是由体內胰岛素分泌失调引起的。

7 overseen   

v.监督，监视( oversee的过去分词 )

参考例句：

• He was overseen stealing the letters. 他被人撞见在偷信件。 来自辞典例句
• It will be overseen by ThomasLi, director of IBM China Research Laboratory. 该实验室由IBM中国研究院院长李实恭(ThomasLi)引导。 来自互联网

8 supervision   

n.监督，管理

参考例句：

• The work was done under my supervision.这项工作是在我的监督之下完成的。
• The old man's will was executed under the personal supervision of the lawyer.老人的遗嘱是在律师的亲自监督下执行的。

9 narcotics   

n.麻醉药( narcotic的名词复数 )；毒品；毒

参考例句：

• The use of narcotics by teenagers is a problem in many countries. 青少年服用麻醉药在许多国家中都是一个问题。 来自《现代汉英综合大词典》
• Police shook down the club, looking for narcotics. 警方彻底搜查了这个俱乐部，寻找麻醉品。 来自《简明英汉词典》

10 qualified   

adj.合格的，有资格的，胜任的，有限制的

参考例句：

• He is qualified as a complete man of letters.他有资格当真正的文学家。
• We must note that we still lack qualified specialists.我们必须看到我们还缺乏有资质的专家。

11 conclusive   

adj.最后的，结论的；确凿的，消除怀疑的

参考例句：

• They produced some fairly conclusive evidence.他们提供了一些相当确凿的证据。
• Franklin did not believe that the French tests were conclusive.富兰克林不相信这个法国人的实验是结论性的。

12 evaluation   

n.估价，评价；赋值

参考例句：

• I attempted an honest evaluation of my own life.我试图如实地评价我自己的一生。
• The new scheme is still under evaluation.新方案还在评估阶段。

13 encompass   

vt.围绕，包围；包含，包括；完成

参考例句：

• The course will encompass physics,chemistry and biology.课程将包括物理、化学和生物学。
• The project will encompass rural and underdeveloped areas in China.这项工程将覆盖中国的农村和不发达地区。

14 specialized   

adj.专门的，专业化的

参考例句：

• There are many specialized agencies in the United Nations.联合国有许多专门机构。
• These tools are very specialized.这些是专用工具。

15 affordable   

adj.支付得起的，不太昂贵的

参考例句：

• The rent for the four-roomed house is affordable.四居室房屋的房租付得起。
• There are few affordable apartments in big cities.在大城市中没有几所公寓是便宜的。

16 helping   

n.食物的一份&adj.帮助人的，辅助的

参考例句：

• The poor children regularly pony up for a second helping of my hamburger. 那些可怜的孩子们总是要求我把我的汉堡包再给他们一份。
• By doing this, they may at times be helping to restore competition. 这样一来, 他在某些时候,有助于竞争的加强。

17 frustration   

n.挫折，失败，失效，落空

参考例句：

• He had to fight back tears of frustration.他不得不强忍住失意的泪水。
• He beat his hands on the steering wheel in frustration.他沮丧地用手打了几下方向盘。