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Content by MikeFNPC

  1. TMB Proposes Harmful Radiology Rule Monday, February 4, 2019 (3 Comments) Posted by: Erin Cusack Share| The Texas Medical Board (TMB) recently proposed a new rule that could dramatically impact the practice of APRNs in Texas across all settings – from hospitals in urban areas to the most remote rural clinics. The rule proposal says: §193.21.Delegation Related to Radiological Services... (d) The following acts have been determined to be the practice of medicine under the authority of the Act, §157.001(b)(1), and cannot be delegated to a midlevel provider, certified radiological technologist (MRT and LMRT), or non-certified radiological technologist (NCT): (1) the reading and interpretation of the radiological studies; and (2) rendering a diagnosis based on the radiological studies. Nurse Practitioners and Clinical Nurse Specialists regularly use x-ray and other imaging for everything from mammograms to broken bones. Certified Registered Nurse Anesthetists use fluoroscopy for central line placement and other procedures. Certified Nurse Midwives use ultrasound to ensure the health of mother and baby during pregnancy. By adopting this rule, physicians on the TMB are prohibiting an essential part of APRN practice and forcing their competition to practice blindfolded. While almost all APRNs would be affected, APRNs who own or work in small and micro businesses will no longer be able to provide certain treatments. Rural communities that do not have a physician to read and interpret these studies will have to seek care elsewhere. TNP Members received a call to action on Friday. If you are a TNP member, be sure to check your email. If you didn’t receive it, feel free to email admin@texasnp.org. If you are not a TNP member and are interested in receiving these important updates that impact your profession, join TNP today. Comments on Rule §193.21 can be emailed to rules.development@tmb.state.tx.us or mailed to Ms. Rita Chapin to P.O. Box 2018, Austin,Texas, 78768-2018. Comments are effectively due on February 22. Earliest date of adoption of this rule is February 24. https://www.texasnp.org/news/news.asp?id=436888 It's coming because we aren't paying attention. Please make comments on the site, and send an email to the TMB, the link is on the site. (Admin comment - I added the contents of the link as well as the contact info)
  2. MikeFNPC

    Passed AANP on Monday...I Have Questions!

    Congratulations! I would only add to above comments with, join your local APRN professional organization, there you would be able to meet others who could turn you on to community opportunities that may fit your schedule/life. Good luck, and welcome to an amazing profession.
  3. MikeFNPC

    Texas Medical Board Attempting to Limit Scope of Practice

    I hope doing what's safe for the patient is what we all strive for. This has nothing to do with the patient. It has everything to do with control. If we stand by and allow the door to open for medical boards to control NP's that door will be impossible to close. I find it hard to believe that this topic has only attracted the attention of a few of us. I've sent messages to the Texas Board of Nursing, and several elected officials expressing my opposition to this rule with logical and practical examples of how this rule is part of the problem with access to care, not part of the solution. My question to NP's of every state is, should we do something, or nothing?
  4. MikeFNPC

    Texas Medical Board Attempting to Limit Scope of Practice

    Another interesting item. In the report from the Texas Register, it also says, "Any physician authorizing standing delegation orders or standing medical orders which authorize the exercise of independent medical judgment or treatment shall be subject to having his or her license to practice medicine in the State of Texas revoked or suspended under §§164.001, 164.052, and 164.053 of the Act." So, the TMB isn't just attacking NP's they're attacking other MD/DO's who are willing to sign delegation agreements with NP's. Thanks to the OP for bringing this to light, Texas, take notice of the kind of care that the TMB is proposing for the general public.
  5. MikeFNPC

    AANP Cert. Exam

    Hahah, 10 years. This is rich. I was going to wait till next Wed and see how she did, lol.
  6. MikeFNPC

    Commute to your job?

    I work 20 miles away and it takes 20-25 min. I'm like DJmattee, I get up at 5, workout, go to work, and get home about 5:30 ish.
  7. MikeFNPC

    Texas Medical Board Attempting to Limit Scope of Practice

    I think that the TMB may be shooting themselves in the foot with this one. I just don't see how this rule can pass. There are too many independent NP clinics doing xrays. How many patients would suffer and even die waiting for an MD/DO to read an xray? I agree with the TMB when it works to get along with APRN's, not when they aggressively attack. The rural clinic I work at has two providers, myself and an MD, each of us have a panel. We have xray and use it frequently. Sometimes the MD is off for 2 weeks at a time or more. We don't have anywhere close by for patients to go for imaging. I wonder how many lives it would take for the TMB to wake up, or do they even care. Hey Texas Docs, it really isn't about the money, it's about the patient.
  8. MikeFNPC

    Texas Medical Board Attempting to Limit Scope of Practice

    The problem we have here in Texas is with the occupation code. https://statutes.capitol.texas.gov/Docs/SDocs/OCCUPATIONSCODE.pdf In chapter 151, it says that to practice medicine in Texas you have to have gone to medical school. Therefore, NP's cannot practice medicine in Texas. And now, it would seem, that the TMB is saying in the same section that you quoted, that reading xrays and making a diagnosis is practicing medicine. https://www.sos.texas.gov/texreg/pdf/backview/0125/0125is.pdf What I think should happen is we need to change the occupation code to include APRN's in being able to practice medicine.
  9. MikeFNPC

    What did you wish you knew as a new grad NP?

    UpToDate, a must have.