Fighting the battle for prescribing rights.... HELP!

Well Ralph and I made it home without any drama. But what we did find when we got here is an attempt by the Tennessee legislature to remove the ability of NPs and PAs with prescribing authority to prescribe schedule drugs. Not just the opoids either, ALL schedule drugs. So I have been beating the drum and reinforcing my soap box as we prepare for the fight.

(Yes Ralph I will go ahead and tell them this is gonna be a "rant")

If this goes into law, NPs and PAs will not be able to prescribe opoids, ADD, ADHD, narcolepsy drugs and many others that the primary care provider writes for on a daily basis. We all know about healthcare shortages, and also know that NPs and PAs ar ethe ONLY helathcare Provider many rural residents see.

If this goes into law, the chronic patient's are not going to be the only ones who loose. What about your child that sits beside the child with ADD that can not get his medications because he lives in Podunk, TN and the closest "physician" is 100 miles away (remember, a "physician" would be the only one who could write a Rx for amphetamine salts)? What about the teacher attempting to teach the class with this child in it? If you live in, or are visiting, a rural area and yo break your leg? Sorry you will have to deal with excruating pain until you get some where with a "physician" so they can give you morphine.


If this passes, what will be next? Well they couldn't prescribe schedule drugs, so let's not let them prescribe anything? How big a step backward this would be for healthcare across the country. I don't want to be the "example" state that other states use to limit NP and PA scope of practice. This bill could ultimately affect every state to some degree.

I have written letters to my state legislators Represenative Barrett Rich and Senator Dolores Gresham( a copy is at the end of this blog, er rant). I will be in Nashville, TN on March 5th for NP Hill Day. PLEASE join me if you live in Tennessee. If you live elsewhere, bring this to the attention of your fellow NPs and PAs.

THERE IS POWER IN UNITY!

SB 0976 by *McNally ( HB 1211 by *Shepard)

Controlled Substances - As introduced, places certain conditions on nurse practitioners and physician assistants who are authorized to prescribe or issue Schedules II, III and IV drugs. - Amends TCA Title 63, Chapter 19 and Title 63, Chapter 7.

The bill in the Tennessee Senate is sponsored by Senator Randy McNally, a pharmacist:

Senator Randy McNally

R-Oak Ridge
District 5 — Anderson, Loudon, and part of Knox Counties — Map

district address

94 Royal Troon Circle
Oak Ridge, TN 37830
Phone (865) 483-5544

nashville address

301 6th Avenue North
Suite 307 War Memorial Building
Nashville, TN 37243
Phone (615) 741-6806
sen.randy.mcnally@capitol.tn.gov

Personal Information

• Married with two children
• 1962 Graduate of Oak Ridge High School
• B.S., Memphis State University, 1967
• U.T., College of Pharmacy, 1969
• Hospital Pharmacist, 1978 to present, at Methodist Medical Center, Oak Ridge, TN

My letter:

RE: SB 0976 by *McNally ( HB 1211 by *Shepard)

Controlled Substances - As introduced, places certain conditions on nurse practitioners and physician assistants who are authorized to prescribe or issue Schedules II, III and IV drugs. - Amends TCA Title 63, Chapter 19 and Title 63, Chapter 7.

I am currently board certified as both a Family Nurse Practitioner and an Acute Care Nurse Practitioner working as a provider in the emergency room of Saint Francis Memphis hospital. As such, the above bill will essentially eliminate my ability to treat patients in the emergency setting suffering from painful injuries. Additionally, it will severely limit the ability of my nurse practitioner colleagues to provide healthcare in the outpatient setting.  

As you know, there exists a Health Care Provider shortage currently - especially for physicians. In many rural communities Nurse Practitioners are the only source of quality healthcare available to the residents. Nurse Practitioners are educated on the pharmacological effects, abuse potential, and proper prescribing of all schedules of controlled substances, just as physicians are.

This bill will completely handicap the abilities of Nurse Practitioners to care for many of their patients. This legislation would not only prevent us from writing opioids, it will also prevent us from writing anti-anxiety medications, as well as medications for ADHD and ADD. This is a far reaching issue with many radiant effects on the entire healthcare system in the state of Tennessee, should this bill pass.

I will be the first to admit that there is a severe drug abuse problem throughout our country. However, if you will research the clinically based evidence, there is no indication that the problem is improper Nurse Practitioner prescribing practice. If you look at the states with “strict prescribing limitations” on Nurse Practitioners, you will find that the evidence shows their drug abuse rates are the same or greater that Tennessee’s.

I would appreciate the opportunity to meet with you and discuss this matter and some realistic alternatives to this bill at your convenience. I can make myself available as your schedule at home or in Nashville allows.  I will be in Nashville on the evening of March 4^th and on the hill all day on March 5^th if you have any available time then.

Thank you for your time and consideration,