Lomotil

Legislative Editorial Encourages NPs

I read the January Editor's Memo with interest. You make some wonderful observations, and have high hopes for the NP profession in the coming year. I hope more of us will jump on board with you.

I am a Family Nurse Practitioner who works primarily in an Emergency Room setting, in unfortunately, Missouri (one of the five more backward states for NPs). I find that having a collaborative agreement and not being able to write prescriptions for controlled drugs is a severe barrier to my personal practice and that of my colleagues.

As you mentioned, it's a slap in our collective faces that "collaboration" and "supervision" is thought to be a necessary part of so much legislation across the country. Bravo for the forward thinking states that allow NPs to do unfettered what they were trained to do without feeling the need for mandatory physician or pharmacy involvement.

In Missouri, if a patient presented to the ER and my collaborative physician is more than 50 miles from me, I can't legally treat the person. And heaven forbid a patient should need cough syrup with codeine for severe cough, lomotil for diarrhea, or valium to stop a seizure. Even with the same level of education, I cannot do what my colleagues across the state line do on a routine basis.

What if this were the case for physicians? They have the same basic education, but enjoy carte blanche in every state. Not so with the nursing profession. It's truly absurd.

And I am also in favor of eliminating the "alphabet soup" from our titles. In Missouri, I am Toby Miller, RN, MSN, CS, FNP How redundant. I think NP would do nicely, just as MD or DO. It might eliminate some of the confusion.

With health care being what it is and the demand on our nation's health care providers and hospitals at meltdown level, it seems like we should be making things easier. We should give those willing to work in the health care profession the tools they need to provide care, and not hand out more rope to restrict our movement.

Your thoughts are indeed refreshing. Count me in to help wherever I can. I agree, it is time to turn up the legislative heat and walk away from the table empowered, not more encumbered.

Toby Miller

Family Nurse Practitioner

Kansas City, M.O.

As a practicing ANP/CNS and subscriber to The Nurse Practiboner, I just wanted to commend you on taking a clear stand in your January Editor's Memo.

I share your concerns for the need to continue resisting the pressure to reduce the NP role to "midlevel medicine", and the need to remove the words 'collaboration' and 'supervision' from every state practice act. I too, feel the historical physician hierarchy over NP's is a travesty against the nursing profession, and continues to undermine the dignity and respect the nursing profession deserves.

In the long run, the erosion of professional autonomy discourages highly talented people from joining the profession. I wholeheartedly support your stand on this issue, and hope other nursing leaders will have the courage to explicitly state this publicly. Maybe once we can get down to "brass tacks" we can move forward for the good of the profession, and ultimately transfer the benefits to health care consumers.

Lee Porter, MSN, ANP-C,CNS, Wilmington, N.C.

Copyright Springhouse Corporation Mar 2003
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