Will Kentucky Lawmakers Let You Trust Your Nurse?

Lawmakers are arguing about what nurses can legally do

Did you realize that state lawmakers are digging in for a battle over whether you can get drugs from a licensed nurse practitioner? The controversy, detailed in Steve Shaw’s LEO cover story this week, sounds more like a bunch of physicians protecting their turf than anything involving the safety of patients and their access to quality health services.

There’s a shortage of family practitioners, especially out in the state, where the void for basic needs could be filled by licensed nurses. But the law provides a catch — the nurses have to sign a collaborative agreement with a physician — and some physicians are charging the nurses fees for that.

Here’s a synopsis of what the story’s about.

It highlights one of the nastiest battles of last year’s legislature — reportedly set to restart this week.

The issue:  whether highly trained nurses should be able to independently prescribe non-narcotics (substances not regulated by U.S. Drug Enforcement Administration) such as antiobiotics and insulin.

A 1996 state law gave nurse practitioners the authority to prescribe non-controlled substances — but not without a “collaborative agreement” with a physician.

Doctors argue that nurse practitioners — even with their master’s degrees and continuing education in pharmacology — lack the education and training to prescribe safely by themselves.

But nurse practitioners, who are treating patients at new clinics nationwide, say the conflict is a “turf battle” about competition and money.

As health-care providers increasingly rely on technology to check for drug interactions and updates, the story questions the need for collaborative agreements.  The law doesn’t require the nurses to collaborate with the doctors who co-sign them, and some doctors allegedly are charging outrageous fees for them.

Nurse practitioners routinely consult with pharmacists and physicians for free.  Thus, some view the collaborative agreement as a competition fee.

Everyone agrees that the escalating demand for health services coupled with a dwindling supply of primary-care physicians is a crisis.

Last year’s twin Senate and House bills were “killed amid lavish lobbying, greed and smears.”

Stakeholders failed to compromise.

Even if the full House had voted on and approved the measure, sources believe it would have died in the Senate.

The prognosis remains pessimistic.  Two of the Senate’s chief proponents — Republican Gary Tapp of Shelbyville and Democrat David Boswell of Owensboro — are no longer there.