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Florida Turf War Over Nurse Practitioner Independence

Today I attended a hearing at the Florida House on a proposed committee bill that seeks to broaden the things that Advanced Registered Nurse Practitioners (ARNP’s) can do independently.

The House Select Committee on Health Care Workforce Innovation conducted a three hour hearing on Proposed Committee Bill 14-01 and both committee members and interested parties provided varying viewpoints.

The proposed bill would allow ARNP’s to prescribe controlled substances if their protocols with their supervising physician permit it.   The bill would also allow ARNPs to seek the designation of  “Independent Advanced Practice Registered Nurse” (IAPRN) from the Florida Board of Nursing if they meet certain criteria such as ARNP certification, full time practice for three years and the completion of a graduate level pharmacology course.  Once the nurse received this designation, that nurse could practice independently without supervision or protocol with a physician, could prescribe controlled substances and could sign, certify or verify any endorsement that a physician may currently provide.

Rather predictably, there were representatives of Nurse Practitioner groups advocating for increased autonomy and physician groups voicing opposition.

Proponents of the bill argued that giving ARNP’s more independence increases patient access to healthcare, especially in rural and traditionally under served areas and that patient safety would not be compromised.  Conversely, the bill’s opponents pointed out that there was no guarantee the independent ARNPs would practice in geographically under served regions and that patient safety is maximized with continued physician supervision.

The bill does not expand services that the ARNP provides, it simply removes the supervisory requirement for those ARNP’s designated as IAPRN’s.  The bill also provides for administrative discipline for IAPRN’s.

As in the past, the strength of special interests may well determine the outcome of this proposed legislation.

Julie Meadows-Keefe

Julie Meadows-Keefe




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