Originally created 03/11/00

The wrong Rx for nurses



Given the choice, we all want the best doctors we can find to diagnose and treat us. We also we want the best health care we can afford.

Because Georgians have such a stake in their health, they'll want to pay attention to the merits of a bill moving through the General Assembly.

House Bill 784 would grant prescription writing rights to registered nurses if they have a signed collaborative agreement with a sponsoring doctor. Some other states allow nurses to prescribe drugs if they have such agreements, but the devil in these medical-legal arrangements is in the details. There are always limits to these authorities, and for good reason.

Nurses aren't the only ones wanting to prescribe medications. A number of special-interest groups would also like to have expanded rights, and they're beginning to lobby for these rights. Health care professionals such as optometrists and psychologists also had bills introduced this session to give them broad prescriptive authority.

Nurses have for years wanted their own prescription pads, and they have wanted those prescriptive rights without having to have the collaborative agreements.

But the General Assembly should proceed with caution in expanding authority in the dicey area of drug dispensing. A nursing degree, requiring four or five years of schooling, is not in the same league as a medical degree, which calls for four years of undergraduate, four years of medical school, one year of clinical internship and three to five years of clinical residency.

Prescribing medications is a complicated process, fundamentally based on accurate diagnoses, and is one of the critical aspects of a doctor's job. This isn't something that should be passed off to professionals with less training and little, if any, malpractice insurance.

Besides practicing medicine beyond their training level, having nurses writing prescriptions introduces a dangerous barrier between patients and doctors. Health maintenance organizations could use nurses to further limit patients' access to doctors, a threat that concerns many physicians who are already acutely aware that oftentimes patients' health care choices are being decided outside of the doctor-patient relationship.

In the waning days of the legislative session, the Georgia Assembly should not rush to pass this bill, which is currently in the Senate. Legislators should closely evaluate whether they'd be flinging the barn door wide open to other health care providers who are eager to expand their practices.

Being able to prescribe presumes being able to diagnose, and that's a doctor's job. If nurses want to set up their own practices and have their own patients, they need to attend and complete medical school.