[MMA News Now, May 15, 2014]
On May 13, Gov. Mark Dayton signed legislation expanding the scope of practice for advanced practice registered nurses (APRNs). The bill passed the House 119-13 and the Senate 64-0.
The bill’s passage comes after many months of discussions and negotiations between nurse advocates, the MMA and other specialty societies. All sides have passionately debated the issue of how to remove administrative burdens related to APRN practice while at the same time ensuring patient safety and promoting continued collaboration on patient care.
The new law allows nurse practitioners and clinical nurse specialists to practice without the need for a collaborative management agreement or a written delegated prescribing agreement. But it creates a new requirement for newly graduated NPs and CNSs for 2,080 hours of on-the-job training in an integrated clinical setting before they can practice independently. In addition, APRNs will not be able to identify themselves as doctors when treating patients.
The most contentious issue related to the role of certified registered nurse anesthetists (CRNAs) in the treatment of chronic pain. Compromise language to try to maintain the status quo for CRNAs was reached on April 30. Under this language CRNAs are required to practice with a collaboration plan with a physician for treating acute and chronic pain and CRNAs treating chronic pain will continue to need to have a written prescribing agreement with a physician who works at the same licensed facility. A provision in a separate bill also directs the department of health to gather data on the types of chronic pain treatments are being provided by which type of practitioner.
The final bill also creates an advisory committee comprised of APRNs and physicians to advise the Board of Nursing on overlapping scope of practice issues and practice trends.
“This bill is not what physician groups wanted but the final version did include a number of changes that the MMA requested,” said Dave Renner, MMA’s director of state and federal legislation.