Bill to let advanced nurses prescribe drugs without 'collaborative agreement' with doctor rejected

Republican Sen. David Wallace of Leachville is shown in this file photo.
Republican Sen. David Wallace of Leachville is shown in this file photo.

The Senate public health committee on Wednesday rejected a bill that would allow advanced practice registered nurses to prescribe drugs without entering an agreement with a physician.

Nurses and other supporters of Senate Bill 189, sponsored by Republican Sen. David Wallace of Leachville, said it would extend primary care to more rural areas of the state.

Physicians and their advocates disputed that, saying nurses are no more likely than physicians to practice in rural areas. They argued that SB189 would hurt the quality of patients' care.

"Everyone's mother deserves the care given from a physician," said Amanda Deel, assistant dean for clinical education at the New York Institute of Technology College of Osteopathic Medicine campus in Jonesboro.

She said her own mother went into septic shock in September and was saved by the care provided by a family practice physician in rural Arkansas. She also noted that the Jonesboro school and another osteopathic medical school, in Fort Smith, opened within the past three years and will soon be helping to supply the state with more physicians.

[RELATED: Complete Democrat-Gazette coverage of the Arkansas Legislature]

"Give us time to fulfill our mission," she said.

The bill needed five votes to clear the all-Republican eight-member committee, but received only three.

Wallace, the committee's vice chairman, voted to advance the bill, as did Sens. Kim Hammer of Benton and Bart Hester of Cave Springs.

Chairman Missy Irvin, Bill Sample of Hot Springs, Ron Caldwell of Wynne, Jimmy Hickey of Texarkana and Scott Flippo of Bull Shoals voted against it.

Advanced practice registered nurses must complete a master's degree in nursing and obtain certification from a national organization.

Arkansas Code 17-87-310 allows them to prescribe drugs if they have a "collaborative practice agreement" with a physician and are granted a certificate of prescriptive authority by the Arkansas State Board of Nursing.

The nurses have long sought to remove the requirement to enter an agreement with a physician.

The Senate committee did recommend approval of a bill that would loosen a restriction on certified registered nurse anesthetists.

Senate Bill 184, sponsored by Sen. Gary Stubblefield, R-Branch, would amend Arkansas Code 17-18-102 to require the nurses to work "in coordination with" rather than "under the supervision of" a physician, dentist or other practitioner authorized to order anesthesia.

Lance Ogle, a certified registered nurse anesthetist in Forrest City, said the change would more accurately reflect what often happens when anesthesia is administered.

In hospitals that don't employ anesthesiologists, a surgeon gives the order for the anesthesia but doesn't supervise how it's administered, he said.

The committee advanced the bill in a voice vote, with no members dissenting. It next goes to the full Senate.

A Section on 02/21/2019

CORRECTION: Senate Bill 189 would allow advanced practice nurses to prescribe drugs without having to have a “collaborative agreement” with a physician. Such nurses already can prescribe drugs as long as they have an agreement with a doctor. An earlier version of a headline on this story inaccurately described the bill’s effect.

Upcoming Events