The Senate Public Health and Welfare Committee heard Wednesday from nursing experts on how it could help alleviate a nursing shortage and possibly expand the scope of practice for nurse practitioners.
According to the American Association of Nurse Practitioners, 25 states allow full practice authority for nurse practitioners. This means that all nurse practitioners can evaluate patients, order and interpret diagnostic tests and initiate and monitor treatments, including prescription of drugs.
There are about 6,142 nurse practitioners in Mississippi and there are about 500 new nurse practitioner license holders added per year.
Dr. Beverly Ann Glasgow is a nursing practitioner and the president of the Mississippi Association of Nurse Practitioners. She told the committee that nurse practitioners want to be able to practice to the scope of their education. She also said that nurse practitioners came about in the 1950s and 1960s due to the specialization of many physicians.
“We support access to care,” Glasgow said. “We’re not trying to be the doctor. We’re trying to be the nurse practitioner that we were trained to be.”
Increasing the scope of practice for nurse practitioners could help the state deal with an acute shortage of physicians. According to the most recent workforce report from the American Association of Medical Colleges on Mississippi, the number of primary care physicians per 100,000 population was 65.9, far below the national average of 90.8.
Mississippi is one of 15 reduced practice states, which means independently practicing nurse practitioners in Mississippi are required to engage in a regulated collaborative agreement with a physician. Until recently, they were required to be located within 15 miles of their collaborating physician.
Now the so-called tether has been extended out to 75 miles and a regulatory change that could be enacted by the Mississippi Board of Medical Licensure at its next meeting could allow nurse practitioners to collaborate with their supervising physician virtually rather than face to face each quarter.
A bill that would’ve given nurse practitioners independent practice authority in Mississippi died last year in the Legislature without a floor vote. Any change to the scope of practice authority has drawn considerable criticism and lobbying from the state’s physicians.
Robert Ware, a nurse practitioner and the treasurer for the MANP, told the committee that the collaborative requirement limits the care that nurse practitioners can provide in emergency situations such as a pandemic or natural disaster. He also said that eliminating the collaborative agreement requirement wouldn’t stop nurse practitioners from engaging in one, either voluntarily or as an employer requirement.
“With the current law, physicians control whether a nurse practitioner can or can not work,” Ware said. “A nurse practitioner can’t volunteer at emergency shelters, clinics or other locations without a collaborative physician at that practice site.”
Ware also said that Louisiana Gov. John Bel Edwards lifted the collaborative agreement requirement for the COVID-19 pandemic, which allowed the state to better relieve the burden on primary care physicians.
Eleven states, including Tennessee, Texas, Georgia, Florida, South Carolina and North Carolina, are even more restrictive than Mississippi and severely limit scope of practice in at least one area.
There are 23 registered nursing education programs statewide in community colleges, universities and private colleges that are all regulated by the Institutes for Higher Learning. There are 17 associate degree programs, eight bachelors, six masters, five doctor of nursing practice and three doctor of philosophy programs in Mississippi.
According to the latest report from the IHL, the number of nursing program admissions to RN programs increased by 4.3 percent from 2016 to 2020. The only decrease was in the master’s programs, which had a 38.7 percent decrease. A master’s degree or greater is required for a nurse to become a practitioner.
Many of those students aren’t completing the programs, as the number of graduates decreased by 5.1 percent during the same time frame.
Dr. Melissa Temple, the IHL’s director of Nursing Education told the committee that there is a shortage of nursing faculty, which is limiting the number of students that can be admitted to those programs.
“We need to address, number one, the faculty shortage to try to increase enrollment so that we can get those graduates out there,” Temple told the committee. “Many of our nurses are leaving because they’re tired and they want to make more money.”
Temple said that nursing faculty salaries could be an issue with the shortage. She also suggested that a scholarship program for certified nurses to continue their education would help as well.