NEW YORK NURSE: June 2007
by Nancy Webber
As the legislative session wound down in June, NYSNA lobbyists noted that, unlike in other years, there had been few attacks on the state Nurse Practice Act.
“There were times when we had to fight for the scope of nursing practice on several fronts,” said Shaun Flynn, director of the NYSNA Governmental Affairs Department. “This year has been relatively quiet.”
In some cases, efforts to erode portions of the act were blunted by NYSNA’s insistence that bills be amended in the interest of patient safety.
For example, a law that allows radiologic technologists (RTs) to inject contrast media, was enacted last year, but only after the addition of two new provisions. After conferring with NYSNA, bill sponsors agreed to ensure that a physician would be immediately available to treat patients for allergic reactions or other emergencies; and that a physician, physician assistant, or RN would evaluate patients on the day of the procedure to determine their medical fitness for the test.
Another law, enacted three years ago, permits daycare workers who complete a training course to administer medications under the direction of children’s parents. NYSNA has been critical of the regulations created to implement this law, and is working with state agencies to get them amended.
While challenges to nursing practice have been absent in New York, they have been front and center in other states. Most are proposals that would authorize assistive personnel to administer medications.
“We can see problems developing in states where nurses do not have as strong a lobbying presence as they do in New York,” said Flynn. “Sooner or later, similar legislation will be introduced here.”
According to the American Nurses Association (ANA), 12 states now permit unlicensed personnel to administer medications in select settings. In Oklahoma, for example, certified medication technicians are authorized to administer insulin by injection.
Legislation to allow medication administration by assistive personnel has been introduced in nine additional states this year, according to the ANA. In many cases, the laws would create new types of “medication aides” or “medication technicians” to perform this task in specific settings.
Nurses know that giving a patient a drug or medication is actually a small part of the process. The first-quarter 2007 issue of the Journal of Nursing Scholarship defined ten categories of thinking nurses use when administering medications: communication, dose/time, checking, assessment, evaluation, teaching, side effects, work around, anticipatory problem solving, and drug administration.
“If future attempts are made to hand off medication administration to assistants, RNs must be ready to educate lawmakers and the public about the complexity of this process,” said Flynn. “At a time when concern about medication errors is increasing, it’s critical to keep this activity in the hands of licensed nursing and medical personnel.”