Excessive nursing regs should be eased

OKLAHOMA nurses are once again seeking full practice authority, arguing the state’s regulations reduce citizen access to health care treatment and are much more excessive than those imposed in other states. Yet a proposed “compromise” would have made the situation worse.

Under Oklahoma law, nurse practitioners and advanced practice registered nurses are required to have a collaborative agreement with a physician to provide many health services. Nursing officials say those agreements cost nurses between $10,000 and $50,000 per year, but little actual oversight is provided. The head of the Association of Oklahoma Nurse Practitioners has said a physician may not even communicate with a nurse for two years.

Nurses have asked legislators to provide them “full practice authority,” which would remove the requirement for physician “supervision” that reportedly exists only on paper anyway. Twenty-one states grant nurses full practice authority, as does the federal Veterans Affairs system, so Oklahoma wouldn’t be breaking new ground in taking this step. States that allow full practice authority include nearby New Mexico and Colorado.

In contrast, Oklahoma is one of only 12 states that require a physician to supervise nurse practitioners, which makes Oklahoma a heavy-regulation outlier. Indeed, when analysts for the finance site WalletHub reviewed the 50 states to determine which are the most “conducive to both personal and professional success” for new nurses, Oklahoma ranked 48th in “work environment” due in part to the regulatory environment.

This appears an issue where Oklahoma has much room to improve. Yet when the Senate took up the issue recently, the proposed response would have likely made things worse. Senate Bill 1127, by Sen. Ervin Yen, R-Oklahoma City, would have made it illegal for a physician to accept monetary payment in exchange for supervision. But the requirement for supervision would have remained on the books.

As Toni Pratt-Reid with the Association of Oklahoma Nurse Practitioners noted, “If we’re mandated to have a collaborative agreement, no one is going to do it pro bono.” Had SB 1127 passed, it would have almost certainly created an even greater shortage of nurse practitioners in Oklahoma. Thankfully, the Senate rejected the bill.

Yen, an anesthesiologist, opposes full practice authority, as do several organizations representing doctors. One measure that would provide nurses full practice authority, House Bill 1013, passed the House 72-20 last year and could receive a vote in the Senate this year. Yen says he won’t hear the bill in his committee, citing concern about nurse practitioners prescribing opioids, among other things.

While we don’t doubt opponents raise some legitimate concerns, it’s hard to believe full practice authority is a threat to public safety if more than 20 states allow it. There aren’t exactly a ton of horror stories coming from those states.

Oklahoma’s health statistics are poor, so anything that increases access to care deserves support. At the national level, the Trump administration’s rollback of burdensome regulation is credited with fueling greater economic growth. If Oklahoma lawmakers take the same approach to state regulations, similar results can occur here, and the nurse practitioners’ issue is a good place to start.