Should we delegate more to paramedics and increase their tasks?
A report from the General Inspectorate of Social Affairs (Igas) answers yes.
He proposes to go "further" in expanding the skills of paramedics, primarily nurses, in a report commissioned by the government and published on Wednesday.
Highlighting the growing difficulties of access to healthcare in France, as well as the desire for autonomy of paramedics, the Igas says it is "convinced that the status quo is no longer possible" and recommends "to support an overhaul of the articulation and sharing of knowledge between all the »health professions.
Expanded skills for midwives
Some changes have already been made in recent years: in 2021, midwives have seen their responsibilities extended and can now prescribe more drugs or work stoppages of more than 15 days.
Orthoptists can now prescribe glasses and lenses, without consulting an ophthalmologist.
And an experiment was launched for direct access, without a prescription, to physiotherapists and speech therapists working in a coordinated care structure.
In its report, the Igas details several recommendations making it possible to go “further, in line with the care needs of patients and the aspirations of professionals”.
Will RPNs be able to prescribe soon?
But to make this development sustainable, the experts consider it necessary to “ensure the recognition and portability of acquired skills”.
With a focus on Nurses in Advanced Practice (IPA), whose training should be “supported and made viable”, “in particular through appropriate upgrading and funding measures”.
The authors recommend broadening the scope of intervention of APIs by allowing patients to consult them on their own initiative or by letting these nurses prescribe certain medications or work stoppages.
The mission also proposes the creation of a status of IPA practitioners, allowing in particular "the recognition of IADE (State-certified nurse anesthetists) as specialized advanced practice nurses".
In a press release, the National Union of Nursing Anesthesiologists welcomes the proposal aimed at creating "an appropriate statutory space" and welcomes "that a large part of its argument has (it) been deemed relevant by the mission" , but notes that "many questions persist", especially concerning training.
The National Professional Council for Anesthesia-Resuscitation and Perioperative Medicine (CNP ARMPO) “welcomes” the proposal to define a specific statute for IADE but denounces an argument “written in a partisan, unprofessional manner and against doctors”.
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