Nurses' prescription power boosted in House bill

ATLANTA - Advanced practice registered nurses in Georgia would be able to write prescriptions under legislation approved overwhelmingly by the House on Thursday.

The bill, which passed 146-6 and now moves to the Senate, is the culmination of years of effort by APRNs to win a right they argue is crucial to improving access to health care in many parts of the state.

"Whole counties are without medical coverage,'' said Rep. Sue Burmeister, R-Augusta, who brought with her to the House floor a map showing vast stretches of medically underserved rural regions. "These APRNs are physician extenders into areas that badly need (them).''

APRNs already are allowed under Georgia law to phone in prescriptions to pharmacies.

But the Medical Association of Georgia, which represents the state's doctors, has lobbied for years against extending that prescriptive authority to writing.

With that opposition in mind, Burmeister agreed to a number of changes in the original version of her bill aimed at giving doctors more oversight of APRNs.

Among the key provisions is that a single "delegating'' doctor may not work with more than four APRNs except in certain settings, including hospitals, county health offices, free health clinics and birthing centers.

"If this bill passes, (APRNs) will have to be supervised by a licensed Georgia physician,'' said Rep. Debbie Buckner, D-Junction City.

But some opponents expressed concerns that the bill would encourage retail chains such as CVS and Wal-Mart to open more in-store clinics where APRNs would be able to dispense drugs unsupervised by on-site doctors. The measure would allow doctors with their main offices out of state to supervise APRNs up to 50 miles from where the nurses are practicing.

"There's not sufficient safeguards built into there,'' said Rep. Tom Bordeaux, D-Savannah, who also questioned whether APRNs have enough training to prescribe drugs.

But Burmeister said APRNs must have a master's degree.

As for the fear of APRNs operating out of in-store clinics, she said retail chains employing a large staff of APRNs still would be subject to the bill's one-to-four requirement for delegating doctors working with advanced practice nurses.

"Wal-Mart will have to contract with multiple doctors willing to put their licenses on the line,'' Burmeister said.