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Nurses are seeking more authority to help patients by using all of their health care knowledge and training. It only makes sense as health care needs grow to allow nurses to use all of their skills.
Rules that limit a nurse’s authority to heal make little sense when we have a shortage of health care workers. That’s why AARP is advocating for law changes in two different ways:
- Increased scope of practice: allowing advanced practice registered nurses (APRNs) to serve as the primary or acute care provider of record. APRNs are nurses who have additional training in a specific area, like elder care. In many states, while they don’t have to work under a doctor, they must have an agreement with a doctor to collaborate, ensuring the APRN has a designated doctor to consult with. However, APRNs are trained and qualified, and they should be able to work independently, not reliant on a doctor.
- Nurse delegation: allowing nurses to delegate and transfer authority to trained home care professionals in regular direct contact with patients. Nurses are often not allowed to train or delegate tasks to a home care professional. Instead, the medical tasks fall to the family caregiver — like Pop, who was 91 years old at the time — to perform.
Related: A Call to Nurses: Family Caregivers Need You
These changes could mean:
- Less travel to a doctor’s office for a family caregiver to organize, instead allowing an APRN to prescribe certain prescriptions at a patient’s home.
- Medical/nursing tasks could be delegated to a trained home care worker, instead of falling on the family caregiver.
- More access to primary medical care, especially in an area with a shortage of health care workers.
- Removal of outdated barriers that prohibit APRNs from providing care to their patients to the full extent of their education and training.
Part of AARP’s fight for family caregivers and their loved ones has been working across the states to give nurses, like Sue, more authority to heal; and we’re making progress.
Increased Scope of Practice
Kentucky Gov. Steve Beshear signs Senate Bill 7 with APRNs, advocates and AARP volunteers.
Kentucky legislation, passed in early February, will give advanced practice registered nurses the ability to prescribe medications (except for controlled substances) after working under contract with a physician for four years.
In Connecticut, SB 36 passed both the State House and Senate overwhelmingly and was signed by Governor Dannel Malloy. The legislation deletes the collaborative agreement between a nurse practitioner and doctor.
In Minnesota, SF 511 passed the legislature last week and would allow APRNs to practice and prescribe prescriptions without a doctor. The bill awaits Gov. Mark Dayton’s signature.
Legislation is being considered in California and Pennsylvania to gives APRNs the authority to write prescriptions and in New Jersey to eliminate the requirement for a collaboration agreement with a doctor for APRNs to write prescriptions.
Although the Nebraska legislature also passed a bill (LB 916) this session to expand the scope of APRNs, Gov. Dave Heineman vetoed the bill. The support of the legislature was a major step forward, and advocates are hopeful that the bill will become law in 2015.
Nurse Delegation
In West Virginia, legislation passed this year allows delegation of medication administration and five additional health maintenance tasks to direct care workers and establishes an advisory committee to further consider policies around nursing delegation.
In Kentucky, SB 103 allows the caregiver of someone with diabetes to be trained by a health care practitioner and administer medication to their loved one. The legislation also protects these family caregivers and health care practitioners from liability unless an injury is the result of negligence or misconduct.
As I saw throughout my parents’ medical challenges, nurses are lifesavers. To all nurses past, present and future, THANK YOU.
Follow me on Twitter @RoamTheDomes for more news on caregiving and other AARP advocacy initiatives across the country.
If you are a family caregiver, you’re not alone.
- To stay up to date or get involved with our caregiving advocacy in the states, sign up for the AARP Advocates e-newsletter or visit your state Web page.
- To find the tools and support you need, as well as ways to connect with other caregivers, visit the AARP Caregiver Resource Center.
Also of Interest
- A Call to Nurses: Family Caregivers Need You
- You Won’t Believe What They Found on Colonoscopy Instruments
- Fight fraud and ID theft with the AARP Fraud Watch Network.
- Join AARP: Savings, resources and news for your well-being
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