The U.S. Department of Veterans Affairs (VA) recently announced its
final rule to allow most advanced practice registered nurses (APRNs) within the VA system to provide services without the clinical oversight of a physician – regardless of state laws to the contrary.
Many veterans suffer from serious medical challenges, including traumatic brain injuries, which require highly complex medical care. Nurse practitioners remain an integral part of the overall health care team; however, they are not a substitute for physicians.
ISMS is troubled by this decision. We strongly opposed the policy established
through the VA’s final rule.
The categories of APRNs affected include Certified Nurse Practitioner (CNP); Clinical Nurse Specialist (CNS); and Certified Nurse-Midwife (CNM).
There are exceptions – the final rule does not include Certified Registered Nurse Anesthetists (CRNAs), and radiology studies must only be performed and read by individuals who are credentialed in radiology.
All APRNs working outside of VA facilities would still remain subject to state or local laws pertaining to APRN scope of practice. Illinois requires physician collaboration
for advanced practice nurses to diagnose, treat and prescribe outside of a
hospital, hospital affiliate, or ambulatory surgical treatment center.
Previously, ISMS urged the
Congress to maintain all APRN supervision requirements.
ISMS also joined other national specialty and state medical societies to advocate that nurse practitioners not be allowed to practice independently. Scores of concerned Illinois doctors also communicated concern directly to the VA in response to an ISMS call to action. Thank you to all of the doctors who spoke
out in the interest of patients.
Every veteran deserves the highest standard of care. Team-based health care must be physician-led!
For more on the role of APRNs, access ISMS' medical legal guideline
Advanced Practice Nurses' Authority to Diagnose and Prescribe.