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The Department of Veterans Affairs would dramatically expand the authority of nurses to treat patients without a doctor’s supervision in a controversial proposal by the country’s largest health-care system. The plan, which would allow nurses with advanced training to broaden their responsibilities for patients, is drawing attention to a bitter debate over the relative roles of doctors and nurses. Because of VA’s high visibility, it is likely to be closely watched. The agency, through amended regulations, wants to give vast new authority to its most trained nurses to order and read diagnostic tests, administer anesthesia, prescribe medications and manage acute and chronic diseases — without a doctor’s oversight. (Rein, 5/27)

A Senate investigation of poor health care at a Veterans Affairs Medical Center in Tomah, Wis., found systemic failures in a VA inspector general’s review of the facility that raise questions about the internal watchdog’s ability to ensure adequate health care for veterans nationwide. The probe by the Senate Homeland Security and Governmental Affairs Committee found the inspector general’s office, which is charged with independently investigating VA complaints, discounted key evidence and witness testimony, needlessly narrowed its inquiry and has no standard for determining wrongdoing. (Slack, 5/31)

The study found that the VA is up to 30 percent better at providing medication to veteran patients than the private sector is for its patients. That was largely due to the VA's ability to provide a one-stop shop for timely medication to patients with appropriate followup care, such as therapy and blood-level checks, to ensure proper medication dosages. Patients in the private sector also have other hurdles like insurance programs that don't cover certain mental health care costs, such as medication associated with mental health disorders. (Neuhaus, 5/30)

This is Pain School — a five-week, 15-hour course that covers more than a dozen parts of daily life that can make pain better or worse. The classes cover nutrition, sleep, exercise, breathing, visualizations, relaxation and, yes, stress. (Bebinger, 5/31)