Regulations for nurses prescribing controlled substances in Louisiana are strict. Nurse practitioners are not authorized to prescribe controlled substances for the treatment of chronic pain or obesity. They are also prohibited from writing recipes for controlled substances for themselves or for family members. Before the PI can request the privilege of prescribing controlled substances, he or she must have completed at least 500 hours of practice with a cooperating physician immediately prior to the request. An application for prescription of controlled substances must be submitted to the Louisiana Board of Nursing before the privilege is granted. Louisiana is one of the most restrictive states when it comes to laws that govern nursing practice. Although more than half of the state`s population lives in areas designated as areas of scarcity for health professionals at the federal level, attempts to change the scope of laws in the pelican state have been rejected by lawmakers. In 2012, the Louisiana House of Representatives committee voted strongly against House Bill 951, which proposed to allow nurses to practice without medical supervision. What are the current laws governing nurses` ability to practice in Louisiana? Mark deClouet, a psychiatric nurse in Louisiana, said there had been misinformation in the legislature about the bill and agreements on collaborative practices. Panelists said lawmakers viewed the agreements as a level of oversight and were concerned that nurses did not have the same level of training as primary care physicians. BATON ROUGE, La.
Louisiana lawmakers in the House of Representatives have passed a bill that would allow nurses to practice medicine independently of doctors, a decision that 14 other states have already approved. Louisiana nurses are pushing to eliminate collaborative practice agreements that they believe will improve access to health care across the state. Louisiana nurses have the authority to prescribe medications, including controlled substances, as long as this is specified in the parameters of the Cooperative Practice Agreement. For each meeting at which the NP prescribes medication, a history and physical examination should be performed and documented, along with an established diagnosis. The treatment plan should be discussed with the patient, as well as a follow-up plan. Prescriptions written by nurses in Louisiana must include not only the name of the NP, but also the name, address, and phone number of the cooperating physician. Another panelist, Edward Timmons, professor of economics at St. Francis University in Pennsylvania said states that have eliminated collaborative practice agreements tend to see more favorable health outcomes for patients. Eight of the top 10 states and Washington, D.C., for patient outcomes do not have collaborative practice agreements, while all of the last ten have the requirement.
Louisiana ranks 50th. Under current law, nurses in Louisiana must have a collaboration agreement with a physician, where the nurse practitioner often pays a monthly fee to the physician. Without the agreement, a nurse will not be able to see patients legally, although the rule has been suspended since March 2020 as part of Governor John Bel Edwards` COVID-19 orders. Kourtni Atkins-Luster runs a clinic in Grosse Tete. In all respects, she practices independently, but she still has to pay to have a doctor on staff. In Louisiana, the cooperating physician is not required to practice on-site or at a specific distance from the nurse. However, the cooperating physician must be reachable by telephone or other means of communication in order to be able to consult the NP at any time if necessary. The Concerted Practice Agreement is required to describe this Agreement. A “substitute” secondary physician may also be appointed if the primary cooperating physician is unreachable.
In the event that the NP is unable to reach a cooperating physician, the Louisiana Nurse Practice Act prohibits the nurse from prescribing for this period. “For over a year, we`ve essentially had what we call `full practice authority,` the power to exercise within our means,” said Kathy Baldridge, president of the Louisiana Association of Nurse Practitioners. “We have seen an improvement in access to care.” Lawmakers are close friends of doctors in Louisiana and there will never be laws favoring nurses in Louisiana until we unite as a force and make enough noise to be heard in the legislature. The problem in Louisiana is not enough to stand up and speak out. We should be in the legislature when tons of research shows the benefit of giving nurses the autonomy they deserve and allowing them to practice fully. Hello, have you seen the Governor of Tennessee issue an executive order in response to the national COVID emergency that gives all APRNs full power of practice? In addition, the order includes the need for insurance providers to cover medically necessary telemedical visits, which is the prescription: “The provisions of the Tennessee Code Annotated, Section 63-7-123, Tenn. Comp. R. & Regs. 1000-04-.04, Tenn. Comp. R.
& Regs. 0880-06-.01 in Tenn. Comp. R. & Regs. 0880-06-.03 and Tenn. Comp. R.
& Regs. 1050-02-.15 are suspended to the extent necessary to exempt nurses who have received a certificate of fitness to write and sign prescriptions or dispense medications from the following requirements: (1) Submission to the nursing committee indicating the name of the nurse, the name of the licensed physician working with the nurse, contains; and a copy of the form describing the categories of legendary and non-legendary drugs to be prescribed or dispensed by the nurse;(2) review the diagrams; and (3) have cooperating physicians visit remote sites every thirty (30) days. Nurses practicing in Louisiana must work under a collaborative practice agreement with a physician. The collaborative practice agreement between the NP and the physician must describe the nurse`s prescribing authority, a patient intake plan, provisions for diagnostic tests, and a plan to document patient visits and interactions. A copy of the collaborative practice agreement must be kept on site and reviewed and signed by the nurse and physician at least once a year. “What they do, once they`re independent, they practice medicine,” she said. MP Jeremy LaCombe (D-Livonia). “The group in this state that treats and oversees the independent practice of medicine is the Louisiana State Board of Medical Examiners (LSMBE). They do it for all the other groups, why should it be different. If the nurse prescribes controlled substances, an addendum to the collaborative practice agreement is required that specifically addresses that prescription.