IT'S LAWMAKERS' TURN TO HELP NURSES HELP PATIENTS

Every day, patients needlessly suffer because long waits prevent them
from getting the pain relief they so desperately need.

Patients in nursing homes and under hospice care often require
frequent adjustments to the levels of pain medication they receive.
Pain is all they're feeling, and relief is all they want. If they're
waiting for an hour for comfort to come, that's an hour too long.

This year, lawmakers can finally end the wait if they can summon the
political courage to do what is in the best interest of patients.

Lawmakers face a bill that would give Advanced Registered Nurse
Practitioners the authority to prescribe pain medication - something
ARNPs in 44 other states and the District of Columbia already have,
providing a valuable, cost-effective service to both physicians and
patients.

The bill - HB 811/SB 2072 - has the support of Gov. Jeb Bush, the
AARP, the Florida Pain Initiative, the Florida Association of Homes
for the Aging, the Coalition to Protect America's Elders and the
Florida Health Care Association, among others.

But it is opposed by the powerful and resourceful medical
establishment, which fears that nurses are vying for independent
practice. This bill makes no attempt to remove the long-standing
requirement that a nurse practitioner practice under general
supervision of a Florida licensed physician. It actually empowers
physicians, who maintain the ability to restrict an individual nurse
practitioner's authority to prescribe controlled substances or other
medications if he or she sees fit.

This bill is a call for ARNPs in Florida to be able to practice to
their full education and ability, under the supervision of a
physician, for the benefit of the health care system and, more
importantly, patients. This bill would improve pain management for
those who are poor, elderly or terminally ill or who live in rural
areas, populations that are traditionally underserved.

We know Floridians suffer in pain. A recent study by the Florida Pain
Initiative declared Florida has a "pain epidemic," with three in four
Floridians saying they suffer pain at least monthly, compared with 57
percent of all other Americans.

At a certain point, when people are elderly or suffering from chronic
conditions, relief from pain is all that can be done. That relief
frees patients' minds, improves their mental health and attitude and
allows them to focus on things other than the pain. This is especially
true when life is coming to an end. Unfortunately, doctors are rarely
able to make repeated visits to nursing homes or other off-site
locations, and Medicare and HMOs rarely pay for multiple visits.

There's no need for people in our state to wait for relief from pain
when allowing advanced practice nurses to prescribe pain medication is
something we can do right now to help solve this problem.

Nurse practitioners are qualified to do the job. They have the
background and education it takes, including an advanced education in
pathophysiology and pharmacology, which prepares them to diagnose and
prescribe medications and treatments within their specialty areas.

If it's simply a matter of trust - trust that ARNPs won't abuse the
privilege by over-prescribing pain medication - it must be said that
nurse practitioners already prescribe uncontrolled and no less potent
substances such as antipsychotics and cardiac medication, drugs that
also require proper use and have the potential for multiple side
effects. And year after year, nurses top the Gallup Poll ranking
professions for honesty and ethics.

Florida remains mired in the health-care dark ages as one of only six
states in the country that does not extend this authority to nurse
practitioners. Until Florida catches up with the rest of the nation,
people in nursing homes and hospice care will continue to suffer while
they wait for adjustments to pain medication that a qualified nurse
practitioner could easily make - but by law cannot. It's well past
time to end the wait.

Mary Tittle, Ph.D., ARNP, is the president of the Florida Nurses
Association. She can be reached at ltittle@tampabay.rr.com.