CT APRN Advocacy support legislation NP to work independent of doctors

Trauma Columnist · Mar 9, 2014

What we wanted to do was to see how much advocacy related topics we could glean from posters. Please start a new thread with this info.

This is great news by the way.

futureeastcoastNP · Mar 9, 2014

Wonderful news! Yes, I requested the new section be made, but as trauma said they want to see if people would use it. Post the new thread with a title like "APRN Advocacy: title" that way they know it's meant for the hopefully soon to be created new section.

Thanks for keeping up with the news!

Home Health Columnist / Guide · Mar 9, 2014

CT Nurses Assoc.: APRNs 2014 Legislation

Governor Malloy introduces Governor’s Bill

GB #36 AN ACT CONCERNING THE GOVERNOR'S RECOMMENDATIONS TO IMPROVE ACCESS TO HEALTH CARE.

Section 1. Subsection (b) of section 20-87a of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2014):
(b)(1) Advanced nursing practice is defined as the performance of advanced level nursing practice activities that, by virtue of [postbasic] post-basic specialized education and experience, are appropriate to and may be performed by an advanced practice registered nurse. The advanced practice registered nurse performs acts of diagnosis and treatment of alterations in health status, as described in subsection (a) of this section. [, and shall]

(2) An advanced practice registered nurse having been issued a license pursuant to section 20-94a shall, for the first three years after having been issued such license, collaborate with a physician licensed to practice medicine in this state. In all settings, [the] such advanced practice registered nurse may, in collaboration with a physician licensed to practice medicine in this state, prescribe, dispense and administer medical therapeutics and corrective measures and may request, sign for, receive and dispense drugs in the form of professional samples in accordance with sections 20-14c to 20-14e, inclusive, except [that an] such advanced practice registered nurse licensed pursuant to section 20-94a and maintaining current certification from the American Association of Nurse Anesthetists who is prescribing and administrating medical therapeutics during surgery may only do so if the physician who is medically directing the prescriptive activity is physically present in the institution, clinic or other setting where the surgery is being performed. For purposes of this [subsection] subdivision, "collaboration" means a mutually agreed upon relationship between [an] such advanced practice registered nurse and a physician who is educated, trained or has relevant experience that is related to the work of such advanced practice registered nurse. The collaboration shall address a reasonable and appropriate level of consultation and referral, coverage for the patient in the absence of [the] such advanced practice registered nurse, a method to review patient outcomes and a method of disclosure of the relationship to the patient. Relative to the exercise of prescriptive authority, the collaboration between [an] such advanced practice registered nurse and a physician shall be in writing and shall address the level of schedule II and III controlled substances that [the] such advanced practice registered nurse may prescribe and provide a method to review patient outcomes, including, but not limited to, the review of medical therapeutics, corrective measures, laboratory tests and other diagnostic procedures that [the] such advanced practice registered nurse may prescribe, dispense and administer.

(3) An advanced practice registered nurse having been issued a license pursuant to section 20-94a and having maintained such license for a period of not less than three years in accordance with the provisions of subdivision (2) of this subsection may thereafter, alone or in collaboration with a physician or another health care provider licensed to practice in this state: (A) Perform the acts of diagnosis and treatment of alterations in health status, as described in subsection (a) of this section; and (B) prescribe, dispense and administer medical therapeutics and corrective measures and dispense drugs in the form of professional samples as described in subdivision (2) of this subsection in all settings.

Legislation has been referred to committee on Public Health. DPH review completed-- no public safety issue. Need to write legislators to move out of committee and support.

From the CT Mirror:

By: Arielle Levin Becker | February 11, 2014

Let nurse practitioners in CT work independent of doctors

...After receiving a request from the APRN society, the state health department launched a review of the scope of practice requirements for nurse practitioners. The review committee included representatives from 23 groups.

Public Health Commissioner Dr. Jewel Mullen said the process “did not uncover any documentation to suggest that the elimination of the collaborative practice agreement impaired safety.”...

PatMac10,RN, RN · Mar 9, 2014

Sounds awesome! At least some progress is being made. Now I'd only NC would hurry up and jump on the bandwagon.

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Psychcns · Mar 9, 2014

I heard that in NC the supervising physician has to sign charts!! (And they don't recognize CNS!)

MN has some APRN modernization activity going on now too. I will repost thread later or maybe someone else will..

futureeastcoastNP · Mar 9, 2014

1. I noticed it said they must have a license "in this state" for three years. Does that mean, as the law is written now, that experienced NPs from other states will still have to collaborate until they have been in Connecticut for three years, even with 3+ years in another state?

2. Regarding NC, don't hold your breath. NC will likely be one the last states to move forward with NP independence as PAs and Physicians hold a very close relationship there. PAs can serve on the board of medicine in NC and Duke University invented PAs, so NC is very pro PA. I doubt they would do anything that would hurt PAs (such as giving NPs independence) so it would take a lot of effort to change things there.

PatMac10,RN, RN · Mar 9, 2014

I heard that in NC the supervising physician has to sign charts!! (And they don't recognize CNS!) MN has some APRN modernization activity going on now too. I will repost thread later or maybe someone else will..

We do recognize CNS, but it's not mandatory for a CNS to have recognition and a license number on the NC BON website. If one does decide to voluntarily be recognized then they can apply for that and CNS will be indicated in an extra section APRN below their RN license just like NPs, NMs, and CRNAs.

@future Your probably right. It baffles me that NC is the first state to introduce legislation to have nurses listed in a registry and have a defined practice act. Yet, we are so behind when it comes to legislation for APRNs. Oh well. We can always work towards change.

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Psychcns · Mar 9, 2014

@PatMac10-- if North Carolina recognizes CNS as APRN, do you know if they allow CNS to prescribe. I do locum tenens and NC often has jobs.

Psychcns · Mar 9, 2014

@PatMac. Does North Carolina allow CNS to have prescriptive authority. (I do locum tenens and NC has had jobs I might be interested in)

PatMac10,RN, RN · Mar 9, 2014

@PatMac10-- if North Carolina recognizes CNS as APRN do you know if they allow CNS to prescribe. I do locum tenens and NC often has jobs.[/quote'] No. CNS do not prescribe here. I'm not sure if they can even make a diagnosis. From what the NPA says they work solely in a role of a educator/expert clinician in their particular population focus. You can look up the role description on the NCBON website. The way they have their role described in the nurse practice act isn't particularly well explained in my opinion. Feel free to PM with any other questions. I don't want to hijack this thread. Lol.
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