Statehouse Update: Practice Expansion for APNs Rejected

Massachusetts legislators have rejected proposed legislation that would have allowed nurse practitioners and nurse anesthetists to practice independently.

The move last month on Beacon Hill by a joint conference committee scuttled the proposal that would have allowed advanced practice nurses to order and interpret tests, order treatment and therapeutics, and prescribe medications independently, in any setting, with any patient population, after completing two years of clinical practice under a supervising physician or supervising nurse practitioner with independent practice authority.

The MMS had strongly opposed the practice expansion measure, arguing it was contrary to an optimal physician-led, team-based health care delivery model and was a possible threat to patient safety.

Staffing Ratios Signed into Law

In late June, Gov. Deval Patrick signed into law legislation to establish nurse staffing levels inside intensive care units of Massachusetts hospitals. The legislation was a compromise between the Massachusetts Hospital Association and the Massachusetts Nurses Association, which agreed to drop its push for two ballot questions on staffing ratios and hospital financial transparency.

The law mandates patient-nurse ratios of one nurse to one patient, or one nurse to two patients, “depending on the stability of the patient as assessed by the acuity tool and by the staff nurses in the unit, including the nurse manager or the nurse manager’s designee when needed to resolve a disagreement.”

— Ronna Wallace
MMS Legislative Consultant

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