Monday, September 29, 2014

Tennessee Nurses Get Positive Feedback on Bill to Expand Their Authority

Office-holders and candidates across party lines and jurisdictions endorse proposal for “full practice authority” at TNA forum.

Posted By on Mon, Sep 29, 2014 at 9:18 AM

click to enlarge State Reps. Camper and Fitzhugh listen to U.S. Rep. Cohen - JB
  • JB
  • State Reps. Camper and Fitzhugh listen to U.S. Rep. Cohen
Some hours beforehand, Connie McCarter, president of District 1 of the Tennessee Nurses Association, had predicted that some 70 people would be in attendance for her organization’s Legislative Forum last Tuesday night, and, when the 6:30 starting time at Jason’s Deli on Poplar came, sure enough, there were 70-odd attendees.

McCarter had also hoped that a generous cross-section of political candidates and office-holders would turn up, and, while for a time that prospect looked touch-and-go, there would ultimately materialize not only a good cross-section of the political world but a diverse and stimulating presentation of issues of interest to nurses and to the medical world at large.

Best of all from the TNA’s perspective, there was general agreement on the organization’s aims from the visiting politicians, across political and jurisdictional boundaries.

Things started off with George Flinn, a radiologist/businessman of some note and just now a Republican nominee for the Tennessee state Senate. Flinn was asked about aspects of the TNA’s wish list for the forthcoming 2014-15 session of the General Assembly — notably about a proposed bill to grant something called “full practice authority” to nurse practitioners, who belong to the most highly experienced arm of the nursing profession.

As of now, some 16 states allow nurses in this category the latitude, independent of supervising physicians, to issue prescriptions, assay medical diagnoses, call for diagnostic tests, and make referrals to specialists. These are all prerogatives which, in Tennessee, are reserved for M.D.’s, and the nurses — probably with good reason — fear professional resistance to such a bill from the Tennessee Medical Association.

Flinn’s response, then, had to be gratifying to the attendees: “Let’s be honest. You’re already doing the work, that kind of practice. So why not make it aboveboard? Let’s get in there and make it right. Let’s have Tennessee be a leader in this, rather than just a follower.”

Asked point blank by Wilhelmina Davis, the TNA’s governmental liaison in Nashville, if he would “stand with us” against potential opposition from the TMA, Flinn assured her he would.

Candidate Flinn concurred also on the need for a bill requiring suicide prevention training among medical professionals, and, in answer to a nurse’s question about the desirability of a “health care compact” to channel spending on federally authorized programs, Flinn said, “The states should have full discretionary input… How do we allocate it? We know better.”

Two members of the Shelby County Commission — Republican Heidi Shafer and Democrat Van Turner — followed Flinn, praising the 
click to enlarge Commissioners Turner and Shafer - JIM MCCARTER
  • Jim McCarter
  • Commissioners Turner and Shafer
TNA for its sponsorship of the forum and pledging support for those programs of the county Health Department that coincided with the Association’s goals.

The two commissioners also spoke at some length about methods for dealing with the kind of violence that had recently plagued the nearby Poplar Plaza shopping center, where three people were attacked by a youth mob three weeks ago. Turner stressed the inter-dependent nature of Shelby County communities. “”What happens in Hickory Hill affects High Point Terrance and Fox Meadows and Germantown,” he said.

Shafer laid stress on a dual response consisting of long-term programs aiming at “a 20-year fix” and short-term responses by law enforcement so as to provide “absolute security.” She said, “I don’t care whether we call it Blue Crash or Blue Crush.” She also spoke of her personal commitment to the concept of full-scale renovations for Poplar Avenue, which she referred to as the “spine” of Shelby County, connecting east and west, south and north.

“It’s like New York seeing to the needs of Times Square. Poplar Avenue is our big money producer,” said Shafer.

Next came talks to the TNA membership by McCarter and David regarding specific aims and activities of the Association. McCarter informed members of such coming attractions as a conference of advanced practice nurses on October 10 at Embassy Suites and a November 14 “legislative boot camp” to be held by the Tennessee Action Coalition.

Davis gave attendees a rundown on what to expect in the next session of the legislature and pointedly characterized the TNA as representing “the largest bloc of voting persons in the state.”

Late arrivals at the TNA event included state Representatives Karen Camper of Memphis and Craig Fitzhugh of Ripley, the Democrats’ leader in the House of Representatives. Both endorsed “full practice authority” and other key aspects of the TNA agenda, and Fitzhugh got a little extra applause when he pointed out that his daughter-in-law had gained the status of nurse practitioner in the previous week.

Fitzhugh also made an extended pitch for state government to accept Medicaid expansion funds under the Affordable Care Act (Obamacare) and said the state had already forfeited some $750 million of outlays that, by some estimates, would amount to $2 billion annually in funding — money that, among other things, could keep several of the state’s struggling hospitals afloat.

That was also a major concern of the evening’s last speaker, 9th District Congressman Steve Cohen, who was more skeptical of the bona fides of Republican Governor Bill Haslam than Fitzhugh, who had expressed an optimism that Haslam was still intent on finding a formula that would allow Tennessee to avail itself of Medicaid expansion funds.

“Craig’s got more confidence in the Governor than I do,” Cohen said. “I have very little confidence in him…..Other states have worked out arrangements. He can’t.”

Other differences of opinion surfaced among the political figures present at the TNA forum, but there was a striking unanimity on the issue of full practice authority for nurse practitioners, When Tom Emerson, an independent Tea  Party candidate for the U.S. Senate, also approved the TNA’s position on full practice authority (“I’m surprised you didn’t already have it”), that gave the Association a de facto consensus on the issue down the length of the political spectrum — at least on Tuesday night 
click to enlarge From left: Davis, Dr. Florence Jones, McCarter, Flinn - JIM MCCARTER
  • Jim McCarter
  • From left: Davis, Dr. Florence Jones, McCarter, Flinn


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