Nurse Practitioners could soon operate independently in Indiana

Current Indiana law states ARPNs, AKA Nurse Practitioners, have to have a practice agreement with a supervising physician.

Posted: Apr 1, 2019 2:18 PM
Updated: Apr 3, 2019 1:20 PM

FORT WAYNE, Ind. (WFFT) - Currently in Indiana, Advanced Practice Registered Nurses, AKA Nurse Practitioners, are mandated by law to have a collaborative agreement to operate under the supervision of a physician in order to practice medicine. The agreement? 5% of their charts in which they perscribed drugs be retrospectively reviewed by the physician.

Indiana Senate Bill 394 is currently going through the Indiana House of Representatives right now is looking to change that.

Caitlin Krouse is a Doctor of Nursing Practice and Assistant Professor of Nursing at St. Francis. She’s been working collaboratively with state legislators to get this bill passed.

Krouse said, "this bill is really only getting rid of this mandated contract that APRN’s, Advanced Practice Registered Nurses, have with physicians and what the contract states is that we have to have to have 5 percent of our charts reviewed retrospectively in which prescriptions were prescribed."

Currently, there are 22 states where this type of law exists.

Tyler Johnson, a Doctor of Osteopathic Medicine and board member of the Indiana chapter of the American College of Emergency Physicians, says in those states, you’re seeing NPs doing what they aren’t trained to do.

"There’s concern that with independence, they start to fill roles they aren’t necessarily trained to be in, specifically the emergency department or urgent cares. There’s family nurse practitioners that are moving into those roles in other states where this has been passed where they don’t have a lot of training in those specialty areas," Johnson said.

Section 8 parts D and E of the bill states, in part, what it would take for an NPs to not need to have a practice agreement.

One of those requirements is "The Advanced Practice Registered Nurse establishes a referral plan to other appropriate practitioners for complex medical cases, emergencies,and cases that are beyond the Advanced Practice Registered Nurse's scope of practice."

"There’s laws that prohibit Advanced Practice Registered Nurses from working outside their scope. If an Advanced Practice Registered Nurse is working in a specialty area, for example, they’re not claiming they’re a specialist," Krouse said.

One of the major goals of this bill is to open up healthcare access to those in rural areas and underserved populations, and 2017 study done by the RAND corporation showed that it could allow more that 379,000 Hoosiers to see a primary care provider. In many instances throughout Indiana, NP's are primary care providers.

Johnson and other opposing Doctors argue though that in a speciality like emergency care, there isn’t the same type of rigorous training for nps to provide the same type of care.

Johnson said, "you have moments to rely on your skill and your training to help save somebody’s life and that training is just not present, currently, for nurse practitioners."

Both sides agree that everyone in the medical field has their place, it’s just a matter of who should be leading your care.

A vote could happen as early as April 2nd, so you’re encouraged to call your state representatives to voice your opinion. A link to contact them can be found here.

Indiana Coronavirus Cases

Data is updated nightly.

Cases: 1000163

Reported Deaths: 16309
CountyCasesDeaths
Marion1347632106
Lake660041156
Allen57441793
Hamilton46100461
St. Joseph44109607
Elkhart35696507
Vanderburgh32087477
Tippecanoe27796257
Johnson24902443
Hendricks23738354
Porter22802362
Madison18614404
Clark18424250
Vigo17347301
Monroe15180197
LaPorte15046250
Delaware14984259
Howard14626287
Kosciusko12217147
Hancock11630175
Bartholomew11505179
Warrick11255189
Floyd11013214
Wayne10897250
Grant9964218
Morgan9404176
Boone8863116
Dubois8227130
Dearborn817093
Henry8139151
Noble7984106
Marshall7838134
Cass7499119
Lawrence7403170
Shelby7138114
Jackson694088
Gibson6533113
Harrison644491
Huntington633999
Knox6273106
DeKalb626397
Montgomery6208109
Miami589797
Putnam575377
Clinton570271
Whitley560455
Steuben554675
Wabash5279101
Jasper524475
Jefferson506996
Ripley495685
Adams476073
Daviess4616113
Scott435869
Greene422096
Wells420987
Clay420260
White415962
Decatur4133101
Fayette404286
Jennings385160
Posey375343
LaGrange353978
Washington353249
Randolph341999
Spencer337342
Fountain332558
Sullivan326752
Starke313369
Owen312070
Fulton306567
Orange291762
Jay280445
Perry264752
Franklin264042
Carroll259132
Rush258832
Vermillion255454
Parke230026
Pike227943
Tipton226659
Blackford190540
Pulaski181855
Crawford158623
Newton156048
Benton150217
Brown144547
Martin137419
Switzerland134211
Warren120516
Union106815
Ohio84112
Unassigned0538

Ohio Coronavirus Cases

Data is updated nightly.

Cases: 1499485

Reported Deaths: 23327
CountyCasesDeaths
Franklin1626291662
Cuyahoga1447662412
Hamilton1044761409
Montgomery731681240
Summit610421094
Lucas55643904
Butler51076707
Stark459431053
Lorain35141568
Warren32476369
Mahoning30315672
Clermont27930321
Lake26669434
Delaware23960162
Licking23547283
Trumbull22550552
Fairfield22179241
Greene22098311
Medina21763305
Clark19630349
Richland18342280
Portage17696247
Wood17244220
Allen15730269
Miami15355296
Muskingum14551174
Columbiana13756263
Wayne13585263
Tuscarawas12479298
Marion11797175
Scioto11388154
Pickaway11286141
Erie10676180
Ross10462196
Lawrence9663137
Hancock9546149
Ashtabula9479197
Belmont9133197
Geauga8829157
Jefferson8481191
Huron8229139
Union810756
Washington8031137
Sandusky7724145
Athens769572
Knox7606138
Darke7553151
Seneca7208144
Ashland6817125
Auglaize667896
Shelby6410111
Brown628582
Crawford6184130
Defiance6087102
Mercer608293
Fulton592996
Highland590099
Madison587576
Clinton576190
Logan574692
Guernsey572467
Preble5660121
Putnam5250108
Williams520184
Perry512561
Champaign505071
Jackson498770
Ottawa479086
Coshocton471582
Morrow451256
Pike430762
Fayette422160
Adams411587
Gallia411265
Hardin411076
Van Wert364078
Henry357871
Holmes3567122
Hocking352578
Wyandot317961
Carroll297059
Paulding275945
Meigs259249
Monroe212953
Noble196546
Morgan190832
Harrison178242
Vinton162624
Unassigned05
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