From the President
Marcia Flesner, PhD, RN
The Never Ending Journey
As we enter 2008, the Missouri legislative session has swung into high gear and MONA is busy working with legislators to seek passage of bills to improve access to care for Missouri residents.
For three years, MONA has worked to pass legislation authorizing advanced practice nurses (APRNs) to prescribe controlled substances. Since starting the effort in 2005, MONA members, staff and our lobbyist have met resistance from medical groups and their lobbyists, legislators and sometimes even nurses. The opponents have made dire claims about unsafe practice outcomes, increased diversion of drugs and the inability of APRNs to manage pain control. The testimony offered in opposition always had the undercurrent of the real fear of physicians - who is in control of helping Missouri residents manage their health care conditions.
MONA staff, board members and APRNs have spent immeasurable hours working to document that APRNs are capable of performing the task and educating our opponents to the following facts:
- APRNs in a collaborative practice agreement with a physician have been prescribing medications in Missouri since 1993 with no poor outcomes reported;
- APRNs possess the knowledge and skills to prescribe controlled substances for patients with acute self-limiting or chronic diseases.
- Over 20 years of research has shown APRNs provide equivalent or improved care as their physician collaborators, at lower costs;
- APRNs in 47 states prescribe controlled substances in with no poor outcomes reported;
- States that allow APRNs to prescribe controlled substances report low numbers of APRN discipline cases related to chemical impairment;
- APRNs improve access to affordable healthcare.
I recently attended a workforce group meeting to discuss efforts to create and fund a Database Center containing data on health professions in Missouri. One of the first reports I received at the meeting was a growing demand for primary care in America and the fact that there will not be enough primary care physicians to take care of the aging population within the next five to ten years.
APRNs are capable and ready to respond to the crisis that faces primary care medicine. Restricting APRN’s ability to practice to their full potential does not serve Missouri residents seeking care. There is no shortage of patients in Missouri seeking primary care. I hope in 2008 that legislators will see the wisdom of passing Senate Bill 724 and House Bill 1620 which would remove the barrier facing APRNs in Missouri. Please contact your elected officials in 2008 to assist MONA in our never ending journey to improve access to care for Missourians.