More States Expand Nurse Practitioner Autonomy

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More States Expand Nurse Practitioner Autonomy

Is California next?

By Working Nurse
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For as long as most can remember, advanced practice nurses have struggled against regulatory requirements that place much, if not all, of their practice under the supervision of physicians. Here in California that fight continues, but in other parts of the country it appears that the tide is turning.

A Mixed Record

Readers will probably recall the legal clash between nurse anesthetists and anesthesiologists in California, which the courts finally resolved in nurse anesthetists’ favor back in 2012. However, the latest effort to secure autonomy for California’s nurse practitioners, S.B. 323, passed the State Senate last October only to fail in the Assembly.

Widespread Support

In West Virginia and Florida, recent legislative victories will allow nurse practitioners in those states to administer a broader range of care and prescribe most drugs without physician supervision.

Both those bills found strong bipartisan support. The West Virginia bill, which is the broader of the two, was a top priority for AARP and was endorsed by both the progressive West Virginia Citizen Action Group and the arch-conservative Americans for Prosperity, which is funded by the Koch brothers.

These legislative moves have been prompted in part by the shortage of primary care providers. The Affordable Care Act may have given more Americans access to health insurance, but providers in underserved and rural areas are few and far between. A 2012 report by National Governors Association recommended expanding the role of NPs for exactly that reason.

The Tipping Point?

Since the U.S. doesn’t have national licensing for RNs, these battles must be fought on a state-to-state basis against vehement opposition from physician groups, including the AMA. However, with the passage of the West Virginia law, 22 states and the District of Columbia now extend full practice authority to nurse practitioners.

Before long, states that still restrict NP practice may find themselves in a shrinking minority.

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