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TN Bill Seeks to Remove Physician Oversight for APRNs

According to state data, there are more than 16,000 advanced-practice registered nurses in Tennessee. (Adobe Stock)
According to state data, there are more than 16,000 advanced-practice registered nurses in Tennessee. (Adobe Stock)
March 17, 2020

NASHVILLE, Tenn. -- State lawmakers are considering a bill that would remove physician oversight requirements for the state's advanced-practice registered nurses, or APRNs. Senate Bill 2110 is co-sponsored by two Republicans, Sen. Jon Lundberg of Bristol and Rep. Bob Ramsey of Maryville.

Currently, APRNs cannot open an independent practice in the state unless they have an agreement with a physician. Tina Gerardi, executive director of the Tennessee Nurses Association, said the bill would remove what she called red tape.

"In Tennessee, we are ranked 44th in the country in health outcomes," Gerardi said. "We have to do something different in order to get access to patients who need it. And this is one way to do that."

The Tennessee Medical Association opposes the legislation and argues existing laws provide a, "necessary framework for physicians, nurses and other health-care providers to work together in delivering patient care."

The bill now is with the Senate Health and Welfare Committee.

Gerardi said the current review requirements for APRNs have little impact on patient care.

"How it works currently, the patient's seen already by the APRN, diagnosed, treatment plan, given prescriptions, and then 30 days later, 20% of the charts are reviewed, 100% of the charts for scheduled drugs are reviewed," she said. "But it's all after the fact, it has no impact on the quality of the care."

She said she believes money is primarily driving doctors' opposition to the legislation.

"Physicians are charging APRNs anywhere between $1,000 and $5,000 a month to do that review," Gerardi said.

So far, more than 20 states have lifted collaborative practice agreements between APRNs and physicians.

Nadia Ramlagan, Public News Service - TN