Nurse practitioners pushing for more autonomy [TN]
Posted over 9 years ago by Nicholas M Perrino
"If her patients are insured, [nurse practitioner Tami] Bland's name is on their card as their primary-care provider. She takes their mothers' calls at 2 a.m., helping decide whether they need to go to the emergency room. She meets families at the pharmacy.
Yet by Tennessee law, a medical doctor must sign off on Bland's patient charts and those of her fellow NPs.
Bland likes the doctor, Pediatric Consultants' Dr. Larry Rogers, who oversees the clinic, and appreciates his commitment as well as having his expertise when needed.
But she thinks the state's requirements for doctors to be involved in the day-to-day management of NPs' patients is inefficient, expensive — and unnecessary.
Many physicians, and the Tennessee Medical Association, say it's necessary.
Tennessee is one of just 13 states that restrict the practice of Advanced Practice Registered Nurses, which include nurse practitioners, certified registered nurse anesthetists, certified nurse midwives and clinical nurse specialists. Another 16 states reduce the ability of NPs in at least one element of their practices.
The remaining 21, and the District of Columbia, allow NPs to evaluate patients, diagnose, order/interpret diagnostic tests, initiate and manage treatment — including prescribing medications — under the sole authority of the state board of nursing."