Fear of nursing?

January 20, 2004 -- Today's Orlando Sentinel carried a generally good article by Linda Kleindienst about an ongoing battle between physicians and nurses over whether Advanced Practice Nurses should be able to prescribe controlled substances to relieve pain in Florida--apparently one of only six states that does not yet allow the practice. However, the article included no rebuttal to the Florida Medical Association's implication that Nurse Practitioners are less qualified to prescribe these substances than physicians.

The article reports that Florida nurses are engaged in a major push for new legislation to gain the prescribing rights, even though physicians are "major campaign contributors" who "usually win the legislative battles." The legislation in question apparently would provide that a Nurse Practitioner (NP) would be able to write prescriptions for the substances if given the authority by, as the piece puts it, "the doctor he or she works for." The piece notes that nurses argue that the result of the current rules is that patients often go without pain medication because physicians are not available to prescribe it, quoting one veteran Gulf Coast NP as saying that she doesn't have the tools she needs to treat the injured workers she sees. According to the report, the Florida Medical Association argues that such prescription authority should be left to physicians who have the "specialized education and experience," and apparently has suggested that allowing NPs to prescribe in this way could lead to an increase in prescription drug abuse. Some nurses in the article suspect that physicians who oppose the piece are really acting out of a fear of competition. Unfortunately, the article did not include any response by a nurse to the FMA's inference that NPs are less competent, when many studies show that care provided by NPs and other Advanced Practice Nurses is equal to or better than that provided by physicians.

The article also notes that Florida nurses are fighting new proposed legislation that would require dermatologists to be in the same office suite when an NP or physician's assistant is seeing a new patient or existing patient with a new condition. Some argue that the effect of this measure would be to limit access to dermatologists, "a problem in a state that has such a high rate of skin cancer."

See Linda Kleindienst's article "Nurses push to prescribe painkillers" in the Orlando Sentinel.