Gains in Iowa and Nevada for Patients, Nurses

Jun 6, 2013, 1:00 PM

The Iowa Supreme Court ruled last week that advanced registered nurse practitioners (ARNPs) can supervise fluoroscopy, a high-tech X-ray and imaging procedure. The high court ruling was in response to a challenge by three nursing organizations to an earlier decision from a district court.

“We believe the district court erred in second-guessing the department of public health and nursing board on the adequacy of ARNP training to supervise fluoroscopy,” the Iowa Supreme Court wrote. “The record affirmatively shows ARNPs have been safely supervising fluoroscopy and are adequately trained to do so… Allowing ARNP supervision of fluoroscopy improves access to healthcare for rural Iowans and helps lower costs.”

Experts say the ruling has implications for patients, especially those living in rural areas with limited access to doctors, who will be able to get test results more quickly. That can alleviate fears if the fluoroscopy shows that a patient does not have a serious health problem or, conversely, it can facilitate quicker treatment if a patient needs it.

The American Nurses Association (ANA) hailed the ruling as a “scope of practice win” and a victory for Iowa residents. “In today’s high-demand health care environment, we need nurses and all other health care professionals working to the top level of their capabilities and licenses,” ANA President Karen A. Daley, PhD, RN, FAAN, said in a statement. “The court’s decision will help Iowans get the health care services they need in a timely, efficient, and effective way.”

The case originated when the board of medicine and physicians’ organizations argued that the department of public health and nursing board had exceeded their regulatory authority by allowing nurses to supervise fluoroscopy.

New Nevada Law

Nevada enacted a law this week that affects advanced practice registered nurses (APRNs). Governor Brian Sandoval signed Assembly Bill 170 into law on Monday; it allows APRNs to practice independently and expands their prescriptive authority. This means, for instance, that nurse practitioners can order specific pain medications, providing patients with more immediate relief than if the patients had to wait while nurse practitioners tracked down physicians to approve the prescriptions.

The bill will streamline and improve health care delivery, Angela Golden, president of the American Association of Nurse Practitioners (AANP), said in a statement. “Nevada now keeps pace with 16 other states and the District of Columbia, which offer patients full and direct access to nurse practitioner services and moves into alignment with national recommendations. We urge lawmakers in other states that are considering similar legislation to follow suit and take steps toward closing the gap between the care that nurse practitioners are educated to provide and the care that dated regulations allow them to deliver.”

Read the Iowa Supreme Court decision.
Read more about the Nevada law.
Read the ANA statement.
Read the AANP statement.

This commentary originally appeared on the RWJF Human Capital Blog. The views and opinions expressed here are those of the authors.