Nurse Practitioner bill approved in Senate committee

Published: May. 19, 2021 at 6:50 PM CDT
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NEW ORLEANS (WVUE) - The Louisiana Senate considers a bill that has divided medical professionals over nurse practitioners. It would allow them to practice without a doctor’s supervision. Both sides say the change could impact your access to health care in different ways.

After hours long testimony on Wednesday, the Louisiana State Senate Health and Welfare committee voted 4 to 3 for house bill 495 to be considered by the full senate.

Nurse practitioners and some other organizations including the AARP support the bill that removes the requirement for advanced practicing nurses to have a collaboration agreement with a licensed physician.

Kathy Baldridge is the president of the Louisiana Association of Nurse Practitioners. She said, “It’s time to modernize healthcare in Louisiana. We rank 50th and more than 95 percent of the state is a health professional shortage area so in other states it has been proven that when barriers to nurse practitioner practice are removed there is an increase in access to care and there is improvement in health outcomes of the population that’s being served.”

Some physicians believe the arrangement provides important support for patient safety. Dr. Roland Waguespack III is concerned removing the requirement would reduce quality of care. He said, “Independent practice of medicine by non-physicians is dangerous and puts patients at risk.”

Baldridge says the responsibility lies with the nurse practitioner regardless of the agreement. She said, “It’s just a misuse of the term oversight and misuse of the term supervision. We are seeing patients obviously within our scope of practice and again impetus is on us to call the physician if needed which we do anyway.”

Wageuspack thinks the agreement should actually be strengthened, rather than done away with. He said the drastic difference in training between physicians and nurse practitioners makes a difference in care, “That amount of training is the central for the safety of patients and our patients need to be aware of what safe medicine is and that they contain they continue to have access to such quality medical care.”

Proponents say passing the bill helps create more access to health care in underserved communities, but opponents argue the bill has no provision to attract nurse practitioners to rural and other areas with high patient to doctor ratios.

Waguespack said the positions are valuable in healthcare, but operate best in tandem with a doctor. “Nurse practitioners, etc., physicians’ assistants have become very integral essential members of the medical and health care team and physicians work closely with them and supervising and working collaboratively but part of that is a lot of decision flavored saying even nurse practitioners say that oftentimes they get an understanding of the limits of their own training,” said Waguespack.

Baldrige believes the nurse training allows them to make sound referral decisions without the regulation. She said, “I don’t have to have a regulatory contract that’s tied to my license that tells me that I need to collaborate. That’s inherent to what we do.”

The bill will move forward to the full state senate. If it is approved, it will go back to the state house to deal with any changes or amendments.

The nurse practitioner’s organization said usually the agreement is monetary and can pose a financial burden.

Nurse practitioners have been able to practice this past year without a collaborative agreement. The provision was waved in an emergency order by Governor Edwards to increase access to a health care provider during the pandemic.

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