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Nurses association to file legislation for nurse practitioners to cut ties with physicians

Posted at 6:24 PM, Jan 31, 2020
and last updated 2020-01-31 20:27:43-05

NASHVILLE, Tenn. (WTVF) — An organization representing nurses promises to bring legislation that will allow nurse practitioners to cut off physician oversight from their practices.

Tennessee Nurses Association (TNA) Executive Director Tina Gerardi said the bill is meant to allow nurses to be more financially successful, but also serve patients better.

Advance Practice Registered Nurses (APRN) are currently required to have a physician look over charts and be available if the nurses have questions.

"Those nurses that don't work in a facility have to pay for the physician to do that for them. Many of them are paying between $1,000 and $5,000 a month. Which is an economic burden to them, but also, over time, the cost is being passed on to either the taxpayer through having to pay additional money for their services that they're providing," said Gerardi.

Nurse Practitioners across the state are also having trouble finding physicians to partner with to provide the service that's required by law. In rural areas, there aren't many qualified physicians, or some are near retirement age and attracting young doctors to the area is difficult.

"If that physician, for whatever reason, retires or is sick or can't continue that contract, there are no services because the APRN can't practice without that collaborative agreement," she said.

The legislation would allow APRNs to practice fully with authority to hand out prescriptions without the supervision of a physician. The Tennessee Medical Association, the group that represents physicians in the state, is opposed to the measure.

TMA president-elect Dr. Kevin Smith said his organization has been trying to reach an agreement with TNA to allow them more freedom without losing physician oversight altogether.

"We would be in favor of more communication between the doctor and the nurse practitioner. More real-time and as the issues come up. We think that that's what the essence of a team is," said Smith.

The state legislature placed a multi-year moratorium on legislation about the issue after the two groups couldn't reach an agreement in a previous attempt from nurses to separate from doctors.

The two organizations were supposed to meet and reach a middle ground. Right now, they both admit it hasn't happened, despite meetings over the past year.

"Access to care and the health of Tennesseans is really at stake here. It's not a self serving piece of legislation," said Gerardi. Tennessee is currently ranked 44th in the country in terms of health. Gerardi says more freedom for nurse practitioners could help.

Plus, she says many nurse practitioners don't need the oversight of physicians in the first place.

"The patient's already been seen," she said. "They've already gotten their medications, they've already gotten their prescriptions. They've already taken them. And then there's a chart review. It's just not effective. It's a waste of time for the physician as well as for the APRN because it's not really affecting the care the patient receives."

Smith said he believes the safety of patients is TMA's prime concern.

"We just can't convince the other party that independent practice is a bad idea," he said.