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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.

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