Success for Nurse Practitioners in Nevada: The Story of Assembly Bill 170

by Susan S. VanBeuge, DNP, APRN, FNP-BC, Legislative Liaison, Nevada Advanced Practice Nurses Association and Tomas Walker, DNP, APRN, CDE, Vice-President, Nevada Advanced Practice Nurses Association

Legislative changes adopted by Nevada’s 77th legislature will increase the health and well-being of its citizens. Of notable significance to the APRN community, Assembly Bill 170 was passed by a constitutional majority in both houses and signed into law on June 3, 2013 by Nevada Governor Brian Sandoval.

Assembly Bill 170 was years in the making and represents a sustained effort of planning and team development, driven by the perseverance of a few dedicated APRNs and other concerned individuals. As finally amended and passed, Assembly Bill 170 (AB170) changes three key pieces of legislation affecting nurse practitioners in Nevada:

1. Our professional titles are changed from Advanced Practice Nurse (APN) to Advanced Practice Registered Nurse (APRN).

2. Nurse practitioners will now have a license to practice rather than a "certificate of recognition" allowing us to practice.

3. The third change relates to collaborative practice. There are two parts to this section. First, upon graduation, the new APRN will be required to complete 2 years, or 2,000 hours, of practice experience prior to prescribing Schedule II medications independently (without a collaborative agreement with a physician). Upon completion of 2 years or 2,000 hours, a collaborative agreement is no longer required. For newly graduated APRNs who do not wish to prescribe Schedule II medications, no collaborative agreement is required to practice in Nevada. Second, APRNs who have been practicing greater than 2 years or 2,000 hours, no collaborative agreement is required to practice in Nevada.

This process of change began with the recognition of Nevada’s chronic shortage of primary care providers. It gained momentum as more APRNs recognized that we could contribute to the health and welfare of Nevada’s citizens if we were allowed to practice to the full extent of our education. Many of our active members had faced barriers in providing care when collaborative agreements were ended, resulting in a disruption of patient care. Realizing a team approach was needed to achieve our goals, we developed statewide and local relationships with stakeholders—legislators, insurers, those involved with healthcare policy, community clinics—all working toward the common goal of passing this legislation.

Further assistance came from the national level, as interested parties such as AANP provided expertise and support, drawing upon the experience of other states, to move Nevada forward. Among those important external relationships was AARP, who supported our efforts by providing us literature on the Future of Nursing: Campaign for Action, attending work-group conference calls, and engaging directly with our local APRN professional association. The local AARP representative was involved throughout the process, and AARP members in red shirts attended hearings in both Las Vegas and Carson City, providing a visual reminder of their support to Nevada’s legislators. Nurse practitioners and other concerned members of the community appeared in large numbers to support Assembly Bill 170 at every opportunity. They shared their stories directly with the legislators and put a human face on health care in Nevada.

In the final analysis, one comment rang through all of the discussion: the legislators view APRNs as active members of the healthcare community in Nevada. We are not asking for money, grants or favoritism, but rather we are asking for the opportunity to provide care to all of Nevada’s citizens by removing unnecessary and restrictive legislation. The support of AARP, countless patients, and the concerned citizens of Nevada contributed to the successful passage of AB 170.

by Susan VanBeuge | July 16, 2013

Tags: practice, nevada


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