Health Reform Likely to Expand Role of Nurses; Oregon, Washington Ahead of Most States

As the U.S. extends health coverage to 32 million people, so-called "advanced practice" nurses are likely to be key in areas of medicine with too few doctors, such as primary care, obstetrics, geriatrics and mental health. "Nursing is absolutely critical to help fill the void, " says Michael Bleich, dean of the School of Nursing at Oregon Health & Science University, which is celebrating its 100th anniversary this year.

The popular image is the hospital-based nurse carrying out the orders of a physician. But the field has expanded immensely since the 1950s, when that stereotype emerged along with the high-tech, physician-dominated hospital, Bleich says. The reality is nursing was never so dominated by doctors, and the field has evolved into a highly varied profession, including nurse practitioners with graduate training to provide much of the care traditionally offered by physicians.