Illinois legislators are being asked to support a bill that would give nurse practitioners and other non-physician health-care providers more freedom to practice.
House Bill 421 amends the Nurse Practice Act, allowing advanced practical nurses to practice without formal oversight by a physician.
Nurses designated APNs are nurse practitioners, clinical nurse specialists, nurse-anesthetists, or nurse-midwives, and are often primary-care providers.
Under current law, APNs work under a collaborative agreement with a licensed physician. The APN performs the services they are trained and nationally certified to perform, but only under the oversight of a licensed physician. The bill would allow APNs to practice without that oversight.
Debra Lowrance, a fully accredited APN specializing in women's health, lactation and midwifery, supports the bill.
"HB 421 takes away the requirement for a collaborating physician in agreements with advanced practical nurses. It allows advanced practical nurses to work in their full scope of practice," she said.
Crawford County has seen how having APNs leads to improved access to health care, and Lowrance believes HB 421 will continue to improve that access across the state.
"It will improve access to care for patients and allow more nurse-led clinics to be established, which would be very helpful in rural and underserved areas," Lowrance said.
"It has been demonstrated that APNs can provide quality health care, usually at a significant cost savings. In a state that is struggling with its financials it only makes sense to look for ways cost savings can occur," she added.
Under current law, APNs are required to have all of their work double-checked and approved by an M.D., which limits their ability to diagnose and treat patients, in addition to increasing costs.
"In my situation, the agreement creates a burden on the physicians I work with in that it doubles their paperwork because they have to sign off on orders, admission, discharges, etc. that they should not have to," Lowrance said. "It also would open up opportunities for CNM's to provide care in areas that currently do not have women's health services or midwifery services, allowing for more choices for women."
The Association of Medical Colleges projects the U.S. will be short 63,000 primary-care physicians this year. It is believed that passage a bill like HB 421 would help to fill that shortage with master's-level trained professionals who are nationally certified in their respective fields.
Using the services of an APN when and where appropriate can also reduce the cost average cost of medical care.
State Sen. Dale Righter (R-Mattoon) is interested in the bill.
"I would like to hear informed discussion and debate on the issue,' Righter said.
Righter believes that opposition will come from the Illinois Society of Physicians, and the main argument will be patient safety with regard to the difference between physician and APN care.
"It was originally about patient safety, and if it still is, then that is all right," Righter said. "However, I don't believe it is as critical to patient safety as it once was."
He is also aware of the difference in cost of services between an APN and physician if the bill is approved.
Lowrance said the bill would remove outdated barriers that prevent APNs from providing care to consumers.
"These barriers often delay care to consumers, especially in rural and urban underserved areas where few physicians are available to enter into these agreements with APNs," she said. "These restrictions also add unnecessary costs by requiring payments to doctors for collaboration and take precious time away from patient care."
The Illinois Society for Advance Practical Nursing says HB 421 would provide access to qualified practitioners for many patients and their families. They are often providing health care to under-served populations. Advanced practice nurses must be grounded in theory and research as guides to their clinical practice. While they work in collegial capacities with physicians, they must be prepared to diagnose and treat patients with acute and chronic illnesses and to prescribe medications. These responsibilities require nursing professionals who are as smart and savvy as they are caring and compassionate.
"I urge all of you to call, write and email your representatives and senators in Illinois this week and next asking for support for HB 421 regarding full scope of practice for Advanced Practice Nurses," Lowrance said.
Posted: Monday, March 09, 2015
Article comment by:
Bill, I appreciate you being interested in the APNs during this time. Healthcare is a big part of many of our lives and this can change things--for the better. APNs have a great reputation amongst the community and also in research. Evidence shows they provide safe, competent, patient satisfactory care. What more can you ask for? To let them do it more freely.