Pushing for Better Patient Care

August 09, 2015

Lifting Nursing Restrictions Will Improve Patient Care, Save Billions, Says Doctor of Nursing Practice Graduate

Ahmed at State House

Stephanie Ahmed (right) confers with bill sponsor Rep. Kay Cahn, D-Newton (center) and strategist Gloria Craven at the Massachusetts State House's Hall of Nurses.

To 2008 MGH Institute of Health Professions Doctor of Nursing Practice graduate Stephanie Ahmed, there’s a way to improve overall patient care, greatly reduce the length of time it takes someone to see a medical professional, and potentially save billions of dollars in health care costs in Massachusetts over the next decade.

For the past several years, she's proposed a bill in the Massachusetts Legislature that would allow advanced practice nurses to work more independently: “An Act to Remove Restrictions on the Licenses of Nurse Practitioners and Certified Registered Nurse Anesthetists as Recommended by the Institute of Medicine and the Federal Trade Commission.” Ahmed, president of Massachusetts Coalition of Nurse Practitioners, has joined with the Massachusetts Association of Nurse Anesthetists to file the legislation. 

“Competency does not change with state boundaries. Either you are competent or you are not,” says Dr. Ahmed, who is director of ambulatory nursing at Brigham and Women’s Hospital. “This model of oversight doesn’t exist in other disciplines in the state—you don’t see psychiatry overseeing the psychologists, or optometry being overseen by ophthalmologists. These are unnecessary and antiquated restrictions that only occur in nursing.”

The bill is sponsored in the House of Representatives by Rep. Kay Khan, D-Newton, who is also an advanced practice nurse, and Sen. Marc Pacheco, D-Taunton.

It would remove the requirement for a physician to retrospectively review prescriptions written by a Nurse Practitioner (NP) or a Certified Registered Nurse Anesthetist (CRNA). It also would eliminate requirements for written prescriptive practice agreements and time limitations on CRNA prescriptive practice, further update the Nurse Practice Act to reflect that NPs and CRNAs can not only order tests and therapeutics but interpret them in order to best treat the patient, and remove the state Board of Registration in Medicine’s authority over the state Board of Registration in Nursing’s adoption of regulations.

Ahmed contends a new law would greatly benefit patients. According to a 2013 survey of medical offices by the Merritt Hawkins & Associates physician search and consulting firm, new patients in the Boston area wait an average of 66 days—more than three times the national average of 19.5 days—despite the region having the highest per capita of physicians in the country.

Add a recent Rand Corporation study that suggests allowing advanced practice nurses to practice to the full extent of their education would cut health care costs between $4.8–$8.4 billion in Massachusetts over 10 years, and Ahmed believes it’s imperative for the bill to be approved.

“It will modernize the statutes for Massachusetts advanced practice nurses and allow NPs and CRNAs to practice to the full extent of their education and training,” she says. “It will improve patient care, and in the end that’s what everyone should be striving for.”