The fight to eliminate the anachronistic farce of a collaborative agreement in Kentucky has been underway since before I became a nurse practitioner. Though gaining more support every year it has come up in the legislative session, the opposition has found ways to keep nurse practitioners beholden to the dispensation of physicians in a manner that reeks of FTC violation and hinders healthcare delivery to a woefully underserved rural population across the commonwealth. This time, there were no stall-tactics, no tacking on of offensive amendments, no removal of mutually beneficial components, or other means of killing the bill.
Senate Bill 7, the first bill to be passed by the General Assembly this year, eliminates the mandated non-controlled substance collaborative agreement for nurse practitioners provided they have been in a prescriptive practice for 4 years. There are also key language amendments in this new section of KRS Chapter 314 that further clarifies that nurses oversee nursing practice - something that has been a huge area of misunderstanding by our physician colleagues. The bill passed on January 14th 2014 with only one "nay" (see voting record), and will go into effect this summer. The official signing ceremony is set for February 28th and I expect with Governor Steve Beshear, there will be bourbon to celebrate.
The Kentucky Collation of Nurse Practitioners and Nurse Midwives has worked tirelessly to move us another step closer to achieving the ideals of the Institute of Medicine's vision for the future of nursing. While the ideal is to get to full independent practice to the full scope of our education and training, Kentucky is not a state that embraces change without a lot of time to mull it over. To the bone. Even when the preponderance of evidence recommends action. My only question is whether the next step will focus on the controlled-substance collaborative agreement, or the 4-year mandate.
Patience is a nuisance.
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