California NP's

Specialties NP

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Join the California Association for Nurse Practitioners in garnering support for SB 491 (Hernandez), if passed, this is a substantial piece of legislation that would make our state part of the progressive group of states that allow for full practice rights to NP's without physician involvement.

http://www.leginfo.ca.gov/pub/13-14/bill/sen/sb_0451-0500/sb_491_bill_20130401_amended_sen_v98.htm

It will make it even harder for new grad NPs to get hired in California, since no one will want to put up with the physician supervision requirements if they can just hire someone with 2-3 years of experience and not have to deal with any supervisory paperwork or headaches.

Specializes in Family Practice, Urgent Care, Cardiac Ca.

My thought is that it is the same level of "supervision" as exists now: contingent on standardized procedure documents... So would these be void after 2-3 years of experience?

Specializes in ACNP-BC, Adult Critical Care, Cardiology.

That would be the case in theory. The bill hasn't been signed into law but if it does, NP's who haven't met the required years of supervised practice would work under standardized procedures for the duration of 2-3 years.

Those who have evidence of having completed the required years of supervision will be exempt from the standardized procedure requirements and will be autonomous. NY's bill is similar in that it requires a period of physician supervision prior to achieving autonomous practice.

That's how I interpret this amendment.

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Specializes in Neurosurgery, Neurology.
That would be the case in theory. The bill hasn't been signed into law but if it does, NP's who haven't met the required years of supervised practice would work under standardized procedures for the duration of 2-3 years.

Those who have evidence of having completed the required years of supervision will be exempt from the standardized procedure requirements and will be autonomous. NY's bill is similar in that it requires a period of physician supervision prior to achieving autonomous practice.

That's how I interpret this amendment.

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And by autonomous you mean independent (i.e. no supervising/collaborating MD/DO requirement), right?

Specializes in ACNP-BC, Adult Critical Care, Cardiology.
And by autonomous you mean independent (i.e. no supervising/collaborating MD/DO requirement), right?

yes, that's what I meant.

So NPs will basically have to practice under the current model for two or three years, then can become independent? That's actually seems pretty reasonable. Or will MD "supervision" have other implications? And will the MD have to "sign off" on the NP's having met the requirements of the law? I think that new NPs should have the option of practicing under an MD OR an experienced NP before becoming independent.

That said, this compromise does seem to have the public's best interests in mind instead of solely reflecting the interests of the medical community. I personally would not feel comfortable practicing independently right out of school.

Specializes in Family Practice, Urgent Care, Cardiac Ca.

I agree...honestly, this isn't an awful situation, IF it doesn't change what is required for "Physician Supervision..."

If they DID change those requirements after all of the physician opposition to this bill and NP support, we would be in a bit of a tricky mess...

I wonder what sectors might be harmed by this requirement...Currently, California doesn't have NPs who are practicing TOTALLY autonomously, though standardized procedure documents can be tailored to allow something close to this... perhaps the NPs in REALLY isolated places who are the sole providers, but otherwise, this seems like a step forward, no?

I don't dislike the idea, but I do think it's going to make it much harder for new grad NPs to find work, since the new grads come with all kinds of red tape. It reminds me of PAs who always have a supervisory requirement - I've heard some state that they get passed over for jobs because the NPs don't have any requirements, or paperwork headaches to deal with. Once a person has the required 2-3 years they're good to go, obviously, and that's great. My concern is for the employment opportunities for new NPs who don't have those requirements fulfilled.

Specializes in ACNP-BC, Adult Critical Care, Cardiology.
I don't dislike the idea, but I do think it's going to make it much harder for new grad NPs to find work, since the new grads come with all kinds of red tape. It reminds me of PAs who always have a supervisory requirement - I've heard some state that they get passed over for jobs because the NPs don't have any requirements, or paperwork headaches to deal with. Once a person has the required 2-3 years they're good to go, obviously, and that's great. My concern is for the employment opportunities for new NPs who don't have those requirements fulfilled.

I see your point. One of the biggest gripes from new RN grads in California is that there are very limited jobs available to them because experienced RN's from out of state flock to California due to the mandatory nurse-patient staffing ratio in hospitals. I can see a similar situation unfolding in the NP realm resulting in a similar scenario, only this time it could be out of state NP's responding to the appeal of independent practice. The proposed law did not specify that the supervised practice be obtained in California from what I've read so far.

Bill died a few minutes ago. very sad.

http://www.sanluisobispo.com/2013/08/06/2618758/capitol-alert-nurse-practitioner.html

Specializes in Family Practice, Urgent Care, Cardiac Ca.

So very sad. I shall reserve my anger, spare allnurses.com another tirade against territorial physicians, hold my head high and keep moving forward with embodying professional and competent practice. If we can't tell em, we gotta keep showing em!

Specializes in ACNP-BC, Adult Critical Care, Cardiology.

CANP's message:

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SB 491 Held in Committee, Two Votes Short of Passage

Senate Bill 491, which would remove practice barriers for nurse practitioners in California, today failed to garner the necessary votes for approval by the Assembly Committee on Business, Professions and Consumer Protection. The bill’s author, Sen. Ed Hernandez (D-West Covina), requested and was granted reconsideration, meaning the committee will take up the matter again at its next scheduled hearing.

The measure required eight votes for approval. Today’s vote was 6 in favor and 3 opposed, with 5 committee members opting to not cast a vote. Despite extensive amendments that were filed prior to the hearing, the bill continues to meet with staunch opposition from the physicians community, whose representatives raised concerns about patient safety, the ability of nurse practitioners to provide adequate care in an autonomous setting, and other matters. Many committee members expressed that further amendments to the bill would be necessary to earn their support, and Sen. Hernandez pledged to work to allay their concerns.

CANP wishes to thank (removed for privacy), Senior Director of NP/PA Clinical Education and Practice for the Betty Irene Moore School of Nursing at UC Davis, whose testimony at today’s hearing helped to make a compelling case for the bill. Many thanks as well to those CANP members and other allies who have contributed to the campaign on behalf of the bill. While the effort has been impeded, it is not yet over. Stay tuned for updates on the bill’s prognosis.

...hope we're not seeing the end, yet.[/TD]

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