Pubdate: Fri, 12 Mar 2004 Source: Bradenton Herald (FL) Copyright: 2004 Bradenton Herald Contact: http://www.bradenton.com/mld/bradentonherald/ Details: http://www.mapinc.org/media/58 Author: Mary Tittle, President of the Florida Nurses Association Bookmark: http://www.mapinc.org/find?232 (Chronic Pain) 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 --- MAP posted-by: Larry Seguin