Louisiana nurse practitioners pushing bill to allow practice without physician oversight

    Louisiana nurse practitioners are once again trying to rid themselves of a state mandate that requires them to have formal written agreements with physicians or dentists in order to operate practices and care for patients.

    With the assistance from Sen. Regina Barrow, D-Baton Rouge, SB 187 was filed to in essence do away with what’s called collaborative practice agreements.

    The bill would amends current state law to pave the way for nurse practitioners—and other advanced practice registered nurses such as certified midwives, clinical nurse specialists and certified registered nurse anesthetists—to be exempted from the having to enter into the agreements.

    “It outdated and it’s a hinderance to every practice that we have,” says Buzz Jeansonne, Louisiana Association of Nurse Practitioners health policy chair, of the agreements.

    The bill was introduced to the Louisiana Senate on March 14 and has been referred to the Committee on Health and Welfare. It has yet to move. Still, it’s already been met with opposition.

    The Louisiana State Medical Society is publicly opposing the bill. Jennifer Marusak, the society’s vice president of governmental affairs, says collaborative practice agreements are important because nurse practitioners should have access to a physician if one is needed. While nurse practitioners are integral to the healthcare process, she says, they don’t have same knowledge and experience of a physician.

    “The physician is the one who has done the additional training,” she says. “They have done their residencies. They have gone the extra mile and they are equipped to diagnose, treat and work on patients without supervision.”

    Jeansonne, who owns five clinics, says the bill doesn’t change the scope of a nurse practitioner’s work.

    “I don’t ever claim that I have the knowledge that a physician has,” he says, adding that nurse practitioners practice advance practice nursing and not medicine.

    Jeansonne says that based on his experience and his knowledge of others nurse practitioners, physicians typically have little or no contact with patients, their information or their care in the nurse practitioner-physician relationship.

    Nurse practitioners often function as the primary care providers with limited prescriptive authority, he says. The agreements can be financially cumbersome for nurse practitioners who have to find and pay willing physicians to enter into them, he adds.

    This isn’t the first time that a bill has been filed to allow advanced practice registered nurses to practice without being affiliated with a physician or dentist. Similar bills have been filed in past years without much success for nurse practitioners.

    Jeansonne says he believes people have a better understanding of the role of nurse practitioners now than they did several years ago. Jeansonne says the passage of the bill would allow nurse practitioners to open clinics and urgent care centers in healthcare deprived areas.

    “There’s no doubt the nurse practitioners can fill those voids,” he says.

    —Alexandria Burris

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