Nurse practitioners praise executive order amid COVID-19 outbreak

Posted at 6:17 PM, Apr 07, 2020
and last updated 2020-04-07 19:45:26-04

NASHVILLE, Tenn. (WTVF) — Nurse practitioners are praising Governor Bill Lee for his issuing of an executive order that suspends physician oversight for the purpose of treating patients during the COVID-19 pandemic.

The statewide order suspends physician oversight of nurse practitioners, allowing them to work without having to submit charts or have visits from doctors as they practice.

The temporary order was signed on March 24, and lasts until May 18.

Some nurse practitioners are glad to have the order in place, saying it frees up health care staff to work in other areas as everyone's job becomes more difficult and also frees up money to spend in other other areas, including paying for personal protective equipment.

“It was a relief because, typically, we are required to have a certain amount of chart review every month,"said April Kapu, an Associate Chief Nursing Officer for Advanced Practice at VUMC. "In the course of our regular day, that’s somewhat manageable, but when you’re in a pandemic and you’re seeing high, high volumes of patients that becomes an incredible burden.”

Kapu said the hospital is currently staffing up in anticipation of a COVID-19 surge that could happen, though she's not sure when or if it will. She says they have been able to save time on what would've been a spike in paperwork that doctors would have to approve.

In rural areas, some nurse practitioners run their own medical practices. The executive order will keep them from having to pay a doctor to drive to their locations or from having to go over patient charts.

“Right now we’re very busy because we’re getting more and more patients that are understanding, their families and they, are understanding that they can’t go out and seek medical care. It’s too scary for the common problems that they have," said Renee Collins, an APRN and owner of At Home Primary Care out of Cleveland, TN.

Collins hires nurses who visit with patients who are 65-years-old or older and have chronic conditions. They're part of the at-risk population and are quarantining during the COVID-19 outbreak.

She said her work has increased because people are sheltering at home.

“It’s allowed us to free up those funds that we were spending on a supervisory physician. It gave us that money to use for the PPE for our staff because we do primary care. So, we don’t normally have to have N5 masks and them. We had to purchase those and we had to buy them in bulk. That’s expensive and it’s hard to find," she said.

There was already a push to remove physician oversight of nurse practitioners going on in the state legislature. However, the Tennessee Medical Association, a group that represents doctors, was opposed to the measure. They said they wanted to maintain the relationship between nurses and doctors.


See all our coronavirus coverage here


What is COVID-19 (a.k.a. the new coronavirus?)

According to the World Health Organization, coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases. Examples include the Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV). A novel coronavirus (nCoV) is a new strain that has not been previously identified in humans. COVID-19 stands for "Coronavirus disease 2019," which is when this strain of the coronavirus was discovered.

What are the symptoms?

The CDC says patients confirmed to have the 2019-nCoV reportedly had mild to severe respiratory illness with:

  • Cough
  • Shortness of breath or difficulty breathing

Or at least two of the following symptoms:

  • Fever
  • Chills
  • Repeated shaking with chills
  • Muscle pain
  • Headache
  • Sore throat
  • New loss of taste or smell

At this time, the CDC believes symptoms could appear as soon as two days after exposure, or as long as 14 days.


The CDC is recommending "common sense" measures such as:

  • Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer.
  • Avoid touching your eyes, nose, and mouth with unwashed hands.
  • Avoid close contact with people who are sick.
  • Stay home when you are sick.
  • Cover your mouth and nose with a cloth face cover when around others.
  • Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
  • Clean and disinfect frequently touched objects and surfaces.