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Rethinking The Nursing Paradigm: The Ethics Of Gatekeeping In American And British Nursing, David C. Grandy

Honors Theses

In the British National Health Service (NHS), the general practice physician (GP) serves as gatekeeper to resources.1 In the United States, managed care physicians, who attempt to contain health care expenditures by establishing priorities and strictly regulating treatment accessibility, necessarily employ gatekeeping responsibilities in practice.2 However, both systems of health care generally overlook the potential contribution of nurses in identifying and implementing effective methods of resource allocation. The central focus of this thesis includes two primary assertions. First, I will argue that nurses currently function as gatekeepers both in England and the United States, and that the traditional nursing paradigm …