Mississippi RN - March 2021

March, April, May 2021 Mississippi RN • Page 5
Looking to the Future, Recognizing the Past:
The Advancement of Mississippi APRNs
Gayle Harrell, MSN, FNP, NP-C, CWCN
Along with my fellow APRNs, I recently witnessed
the milestone achievement of the Mississippi House of
Representatives’ passage of HB 1303. This bill, authored
by Representative Donnie Scoggin, FNP, would greatly
facilitate an APRN’s ability to provide healthcare in
Mississippi. As of the date this MS RN went to print,
HB 1303 was still awaiting action by the Mississippi
Senate subcommittee. Regardless of the final outcome
of this legislation, we are pleased with the progress this
year and certainly owe an immense debt of gratitude
to Representative Scoggin, and the many APRNs and
RNs who devoted untold hours to educate legislators,
patients, and communities on the need for healthcare
services provided by APRNs. This progress and our successes thus far are the
direct result of years of passionate, yet professional efforts by the hundreds of
dedicated and honorable nurses advocating for our patients and representing our
profession in a positive manner.
MNA’s successful history of representing nurses began in 1911 with the
purpose of elevating our profession by advocating for legislative policy to advance
the nursing profession and the implementation of educational standards. In
fact, MNA’s Bylaws delineate the purposes of MNA, which shall be to work for
improvement of health standards, and the availability of health care services for all
people; foster high standards of nursing; stimulate and promote the professional
development of nurses; and promote and protect the professional environment of
nurses.
I will always remember when as a junior nursing student, I attended my first
Nursing Summit in 1994. I distinctly remember our presenter, Dr. Judy Levitt, who
inspired me to support my chosen profession by joining the Mississippi Association
of Student Nurses and, upon becoming a nurse, to become a proud member of
MNA. I also remember the theme of that Summit was Advanced Practice Nurses,
although at that time, I had no idea that I would ultimately become an APRN.
As I look back and think about that experience, I am reminded how MNA’s
staunch support through the years has always been leading the way for us. While
I recognize that Summit years ago may not have been MNA’s first activity focused
on APRNs, it certainly heralded the beginning of many such events to come.
MNA’s efforts have been instrumental in obtaining legislative authorization
for Nurse Practitioners (NPs) to receive direct reimbursement. In 1990,
MNA was successful in having a bill introduced allowing NPs to receive
Medicaid reimbursement. In 1994, NPs were authorized the right to sign
third-party reimbursement claim forms, eliminating the need for a physician’s
countersignature. MNA was always on the alert and vigilant, working to secure
legislation to strengthen language to ensure proper payment.
MNA also formed an Advanced Practice Task Force to collect and analyze
information that would provide relevant data on NP patient healthcare outcomes.
Research and education have always been vital to NP legislative growth of
practice. In 2000, two bills were proposed to provide NPs the authority to write
for controlled substances. It would take two more attempts, but ultimately in 2004,
this became a reality. All these changes were difficult, due to the obstacle of joint
promulgation between the Mississippi Board of Nursing and the Mississippi Board
of Medical Licensure. Removal of joint promulgation and the term “supervision”
replaced with “collaboration” would not happen until 2009.
Unfortunately, current statutes still require a “collaboration” between a
physician and the APRN. This collaboration is in reality a “contract.” For some
APRN’s across the state, physicians require a fee to “collaborate” and complete
the required quality assurance for the APRN. In fact, an APRN cannot practice
unless there is a “collaboration contract.” There are 28 states that have removed
this restriction. Twenty-two states require a set number of hours of collaboration
be completed before the contract is not required. On January 11, 2021, Medscape
presented an article by Christina Bennett that shares data on states that do not
require “contracts” to practice. While there are individuals who declare that the
restriction of a “collaboration contract” is safer and has better outcomes, this
and other research data indicate that where there is no required “collaboration
contract,” the quality of outcomes is better. APRNs collaborate with physicians,
other APRNs and other healthcare providers on a routine basis, depending on
the needs of their patients. APRNs will continue to collaborate even when the
“collaboration contract” is no longer a requirement.
MNA has been consistent in representing all nurses. We have always taken
pride in providing reliable information to legislators, patients, and the community,
in a respectful and honest manner while providing quality continuing education
opportunities to nurses. While it may be frustrating when what we need and
seems reasonable takes longer than we like to achieve, MNA has always and will
always strive to represent nursing in an honorable, respectful and trustworthy
manner. I encourage you to be a member of this outstanding organization. Support
MNA and the MNA Political Action Committee to help us continue to make our
profession #1.
MNA has supported and advocated for all nurses throughout Mississippi. MNA
has been, is, and will remain THE PROUD VOICE of all Registered Nurses and
Advanced Practice Registered Nurses across all nursing roles!
References:
Bennett, Christina. “Independent NPs: What’s the Evidence?” 11 Jan. 2021. medscape.com/
viewarticle/943940.
Srinivasan, Seetha. “A Way to Serve: The Mississippi Nurses’ Association, 1911-2011.”
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