Making the case for more APRN autonomy

CHARLESTON, W.Va. — Advanced practice registered nurses in West Virginia would be allowed to do more with a bill that’s pending in the Senate Health and Human Resources Committee.

Currently, APRNs enter into collaborative agreements with doctors who provide clinical supervision.  APRNs can diagnose and treat patients, but must have that written agreement with a doctor to prescribe medication from a limited drug formulary.

The bill that would change that, SB 212, would eliminate the oversight mandate and expand the prescriptive authority of APRNs and certified nurse-midwives.  It’s a step that’s already been taken in 20 states.

“More and more states are jumping on board, realizing that this is a solution,” said Aila Accad, president of the West Virginia Nurses Association.  She said giving APRNs more autonomy would expand health care choices for West Virginians, help contain costs and improve health care access.

Accad, a guest on Friday’s MetroNews “Talkline,” estimated the costs of seeing an APRN are anywhere from one third to 50 percent lower than seeing a physician.  She said empowering APRNs to provide more primary care would also help address the doctor shortage in the Mountain State.

“Here in West Virginia, we’ve got a rural population that needs more access and it’s not the primary care physicians who are going out to the rural communities, it’s the nurses who stay in their communities,” she said.

A recent legislative audit recommended that, if nurses are allowed to practice at the same level as family doctors, they should be regulated the same way — through the state Board of Medicine.  APRNs have pushed back against that.

“We don’t have exactly the same training as a physician because we are two separate professions.  We operate under different parameters and the different ways we view the patients and their needs,” Accad said.

Concerns were also raised in the audit about expanding prescriptive authority to more people at a time when prescription drug abuse is rampant.

Those with the  American Medical Association and the Association of Osteopaths oppose allowing APRNs to practice independently.

The 2014 Regular Legislative Session will continue through Saturday, March 9 in Charleston.





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