Coupling Increased Responsibilities and New regulations for Nurses
H.3508 is somewhat similar to H.3078 in that it would authorize nurse practitioners, clinical nurse specialists, and certified nurse midwives (referred to in the bill as APRNs) to perform certain functions prohibited under state law(ordering hospice services, certifying an individual is handicapped, providing prescription drugs including schedule 2 drugs under some circumstances). Unlike H.3078, H.3508 would also create a new bureaucratic board and impose more onerous regulations on nurses and midwives.
Under the proposed law APRN would operate under written practice agreements that stipulate just what services they can perform and are approved by the newly created Joint APRN Committee. In current law nurses must develop along with a physician written protocols that outline their responsibilities, but these protocols don’t require the same pre-approval that the new written practice agreements would. Written protocols for nurses are only reviewed upon request of the State Board of Nursing. In addition to approving the new practice agreements the Joint APRN Committee would have among other powers the ability to: recommend regulations to carry out this new bill, make recommendations for continuing professional education and training for APRNs, and approve APRN/physician ratios.
This bill would grant nurses and midwives a little more power in exchange for a large increase in regulation. Reforming our healthcare system requires letting individuals in the private sector devise their own means of providing services more efficiently, not increasing government regulation. For nurses and patients this would be one step forward two steps back.