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Wednesday, August 12, 2026

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This is a repost from Primary Care Progress and the first of our celebrating Nurses Week 2013.

photocredit: Primary Care Progress

photocredit: Primary Care Progress

The future of nursing in primary care
An interview with Virginia P. Tilden, Ph.D., R.N., F.A.A.N.

By Sonya Collins

Thank you for giving us an interview for National Nurses Week.

I’m very pleased to know that PCP is honoring National Nurses Week.  And I hope in the future that it’s joined by a Team-Based Care Week that is all about doing the right thing for patients.

I love that idea.  And how do you see the role of nurses in primary care evolving in the coming years? How do you see this role in ten years?

I see nurses in both staff and provider positions having a vital and expanding role and a responsibility for reinventing primary care now and in the years ahead.

In the staff role in traditional primary care practices, the RN typically does patient triage, telephone advice, and prescription management, sometimes including case management and chronic care management. Overall job satisfaction in this role typically is low, and burnout and turnover are high, such that medical assistants have tended to step into this staff role.

However, important reinvention of the RN staff role is happening now with exciting results. A recent ABIM Foundation study of innovative primary care practices found many RNs playing a different role. Care in these practices is typically team-based with RNs working at the top of their licenses as care coordinators, case managers, and systems specialists, resulting in much better patient care and higher morale for everyone, including physicians.

April 16th is Health Care Decision Day. It’s an opportunity to jump start those conversations about end of life preferences–or advance directives–that you’ve postponed. At Hunter College, the Hunter Student Nurses Association, the Hunter-Bellevue School of Nursing, and the Center for Health, Media & Policy at Hunter College are sponsoring an information table at the Brookdale Campus on 25th Street and 1st Avenue on April 16th from 1:00 to 8:00, and on the Main Campus at 68th and Lexington on April 17th from noon to 6:00. The undergraduate nursing students, in addition to helping to plan the two days, will staff the tables and help people to make sense of the various forms that will be available. (The photo above was taken at a similar event that the students did earlier in the academic season at the Main Campus.)

Of course, people will be encouraged to first talk with their loved ones about their preferences for end-of-life care and what’s important to them. The forms can be completed when having these conversations and then mailed into the New York Legal Assistance Group for registering them on a secure online storage service to enable health care providers anywhere to respect and honor your health care wishes. This service is available thanks to Tina Janssen-Spinosa, JD, of the NYLAG. Or people can simply make copies and give them to their health care providers, though the online repository ensures that new providers also know your wishes.

I wrote a commentary in the American Journal of Nursing about the need for health care professionals–nurses, in particular–to lead the public conversations about the importance of these “advance directives” and received an email from Jerry Soucy, RN, BSN, CSS, CHPN, Staff Educator at the VNA Care Network and Hospice in Southborough, MA. He shared a blog post from the local chapter of the Hospice and Palliative Nurses Association about MOLST–Medical Orders for Life-Sustaining Treatment–another opportunity to have patients wishes be visible to health care providers no matter where they are moved in a hospital. The post emphasizes that Susan Block’s four questions to guide end-of-life conversations are probably more important than any form: