Ohio Nursing Organizations opposing PA legislation-- Voting 4/2

[ventana]

PAFT

 

 

Has likely done more for the advancement of the PAs in the trenches in the past 12 months, then AAPA has done in the last 12 years.

 

AAPA is starting to come around - mostly because of the excellent people we have in PAFT - who are leading them down the correct road with solid logical thoughts and data

[HLReed]

um, the new direction the aapa is taking, who do you think pushed them in that direction? we have been meeting with aapa folks constantly since before we existed as a formal group telling them in no uncertain terms that this is the way the profession needs to go or it will die. We are the conscience of the profession and the only ones saying what needs to be said, what everyone knows is true, but can't say for fear of upsetting those in power(docs, medical boards, etc)

why do you think we were specifically invited to the recent aapa policy summit? we are doing a lot of stuff behind the scenes that no one knows about....have you even read the guidelines that PAFT came out with LAST YEAR that the aapa are now mirroring?

http://www.pasfortomorrow.org/highest_practice_level

If you want our help an olive branch would probably work better than insults........

 

 

I don't know what insults you are referring to. That was an invitation regarding the current issue of this thread. If I unintentionally struck a nerve, I apologize.

 

Thank you for your efforts.

[EMEDPA]

I don't know what insults you are referring to. That was an invitation regarding the current issue of this thread. If I unintentionally struck a nerve, I apologize.

 

Thank you for your efforts.

I'm sorry if I over-reacted. I read your initial comment as saying we were chasing after issues of no importance.

We will certainly write a letter and send it off (electronically even...:) ) on behalf of the OH PAs.

[HLReed]

I'm sorry if I over-reacted. I read your initial comment as saying we were chasing after issues of no importance.

We will certainly write a letter and send it off (electronically even...:) ) on behalf of the OH PAs.

No, I want to clarify that I was simply saying that this issue very directly affects the practice of PAs in Ohio and your help would send a big message to those of us practicing here. Thank you for giving this your attention. It may make life a lot easier for OH PAs and our patients.

 

H

[HLReed]

Here is my JAAPA editorial blog detailing the issue a little more in the bigger picture. If you don't mind sharing this through your blogs and social media outlets, it may help elevate the issue and put pressure on the parties at the table. Thanks!

 

http://journals.lww.com/jaapa/blog/musings/pages/post.aspx?PostID=47

[Guest JMPA]

PAFT is awesome

[jdtpac]

I am very pleased to inform all of you that HB 412 was reported out of the health and aging committee this morning. The representatives of the Ohio Association work very closely over the last few days with the representatives from all of the physician organizations and nursing to come to some compromise over these issues. SubHB 412 was presented to the committee and because of the efforts mentioned above, the hearing lasted a total of 8 min. and the sub-bill was voted out unanimously. We have been informed and are confident that the bill will be sent to the full House next week for a vote. We do not anticipate any difficult in that process. I want to thank those of you who have made comments of support for the Ohio Association and the PA profession in Ohio.

 

John D Trimbath, PA-C, MPAS

OAPA President, 2013-14

[rcdavis]

This saga further substantiates my long standing opposition to any collaboration with nurse practitioners. Ever. They are not our friend. Never will be.

[True Anomaly]

This sage further substantiates my long standing opposition to any coloration with nurse practitioners. Ever. They are not our friend. Never will be.

 

I'm sad to say that I'm really feeling this as well over the past few years

[Guest Paula]

@jdt:  What actually was the NP and  nursing opposition?  rumors are flying and no one seems to clarify what the problem was?  What was the compromise?

[UGoLong]

I wasn't there, but from the OAPA...

 

Substitute HB412 - the PA Bill - was reported out of the House Health and Aging Committee this morning.

It is our hope that it will be on the House floor next Wednesday.

[HLReed]

@jdt:  What actually was the NP and  nursing opposition?  rumors are flying and no one seems to clarify what the problem was?  What was the compromise?

 

 

Yes and I'm curious if they still oppose.

 

Still, great news. Thanks for everyone who contributed. More work to be done for next week.

[Guest Paula]

Yes and I'm curious if they still oppose.

 

Still, great news. Thanks for everyone who contributed. More work to be done for next week.

Huh?  No one knows what the NP opposition was based on?  Something is fishy in the state of Denmark.  What is the compromise?

[jdtpac]

Paula et al,

 

It's a very complicated situation in Ohio,we have had problems with nursing opposing our existence ever since 1975 when the first PA practice that was passed. We are probably one of the only states that as language in our law that prohibits us from ordering or directing an RN/LPN in performing patient care services. We've been able to get around this for quite some time but as of late season got little more tense. In this new bill was language to allow PAs to delegate medical tasks to a medical assistant or other unlicensed person. The APRNs were also asking the Legislature for the same thing however our language was must more liberal than their. As you know, RNs rule the hospital as far as it goes with determining who manages patients on the floors. Basically they wanted us not to be able to delegate or supervise MAs in inpatient setting. So, without going into a lot of detail, in a nutshell, we had to compromise and put language into our bill that would address their concerns.It was little more confiscated and that was it would take me forever to explain. the easiest way I can tell you would be to say was nothing more than another "turf protection" issue. I hope this helps to give you a brief understanding of what we had to do to get the other more important issues addressed.

[EMEDPA]

 

 

It's a very complicated situation in Ohio,we have had problems with nursing opposing our existence ever since 1975 when the first PA practice that was passed. We are probably one of the only states that as language in our law that prohibits us from ordering or directing an RN/LPN in performing patient care services.

how do em or hospitalist pas ever get any work done if they need all their orders cosigned? I can only speak for myself, but I would find that untenable and refuse to work in the state just because of this. I left a job a few years ago when the nurses all tried to pull this. we had zero backing from the docs so all of the PAs quit. they then hired NPs(many of whom were the same nurses who refused pa orders). within a few years they had fired all the nps and the nurses who refused to take pa orders and now staff the dept only with pas again.

[CoastalPalm]

Q: Can a Registered Nurse or Licensed Practical nurse Execute a PA orders?

 

A: Section 4730.03 states that a physician assistant may independently order or
direct the execution of procedures or techniques by a registered nurse or
licensed practical nurse to the extent that the physician assistant is
authorized to do so under their supervisory plan or the policies of the health
care facility in which they are practicing.

 

http://www.med.ohio.gov/pdf/FAQs/PA_FAQs.pdf

[EMEDPA]

Q: Can a Registered Nurse or Licensed Practical nurse Execute a PA orders?

 

A: Section 4730.03 states that a physician assistant may independently order or

direct the execution of procedures or techniques by a registered nurse or

licensed practical nurse to the extent that the physician assistant is

authorized to do so under their supervisory plan or the policies of the health

care facility in which they are practicing.

 

http://www.med.ohio.gov/pdf/FAQs/PA_FAQs.pdf

how is that different than any other state then? does the practice plan have to spell everything out or can it simply say " PA is authorized to direct hospital staff and ems crews as needed in the practice of emergency medicine" ?

[CoastalPalm]

how is that different than any other state then? does the practice plan have to spell everything out or can it simply say " PA is authorized to direct hospital staff and ems crews as needed in the practice of emergency medicine" ?

 

I think we'll have to wait for jdtpac to comment on that.  He stated that "We are probably one of the only states that as language in our law that prohibits us from ordering or directing an RN/LPN in performing patient care services."  This quote from the State Medical Board of Ohio seems to say otherwise, so perhaps he'll provide the relevant language in the law.

[jdtpac]

Ohio law 1975-2006:

Be construed as authorizing a physician assistant to order or direct the execution of procedures or techniques by a registered nurse or licensed practical nurse in the care and treatment of a person in any setting

 

Ohio law 2006-present:

Be construed as authorizing a physician assistant independently to order or direct the execution of procedures or techniques by a registered nurse or licensed practical nurse in the care and treatment of a person in any setting, except to the extent that the physician assistant is authorized to do so by the physician supervisory plan approved under section 4730.17 of the Revised Code for the physician who is responsible for supervising the physician assistant or the policies of the health care facility in which the physician assistant is practicing;

 

The language that is bolded was added because the problems the PA's were happy with nursing stating it was illegal for them to take our orders. Most larger institutions generally ignored this and the bigger problem was in private practice. Working with all the physician organizations and the Ohio hospital Association in 2006 we hope we are addressing that issue by adding the above language. Healthcare facilities create policies to grant the privileges to be able to write orders including giving orders to registered nurses at LPN's, and PAs that practice outside the health service will be have to have a similar statement on file in their supervisory plan. For the most part, we have had very little problems since this language was changed. However, the nursing board still feels that because their law does not specifically state that PA can give a nurse orders our languages mute. The nursing statute says that LPN takes orders and directions from a physician, dentist, podiatrist, chiropractor and registered nurse. There is not the same reference for RNs because they have an "independent license to practice nursing". 

 

I've been practicing in Ohio since 1979 and have been extensively involved in the Ohio Association working on legislative issues. In all this time, I don't know of a single nurse that has lost their license because if they get an order from the PA. Our problem is generally not at the practice level, it's on the political level with both the nurses and docs fighting us over "turf". what happened recently is just another battle we had to fight. We continue to push the boulder up the hill, I have faith that eventually we're going to get to the top and roll that sucker down the hill.

[HLReed]

Right.

 

My orders are followed just like any other licensed clinician in the hospital setting. Luckily, I work for a hospital that has its practice-level policies well laid-out and very strong PA leadership system-wide (some names you'd recognize ;-) ). I've never had any problems with this law, but state-wide it's another thing that someone could point to and say "Hey look, why deal with all this BS when you can just hire NPs instead of PAs?"

 

Selfish politics at the higher levels creating roadblocks to patient care.

[UGoLong]

Time for a positive update:

 

HB412 Passes the House

The PA bill, HB412, was passed 87-1 by the Ohio House of Representatives on May 14, 2014.  It will now go to the Ohio Senate.  OAPA is hopeful that it will get referred to the Senate Health Committee and get at least one hearing before the Ohio General Assembly recesses in June.  They won't be back until after the November elections.

- See more at: http://www.ohiopa.com/aws/OAPA/pt/sd/news_article/89340/_PARENT/layout_details/false#sthash.s0YhEooi.dpuf