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Health Committee approves bill to give nurses authority to sign medical documents

Brandon Moseley

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By Brandon Moseley 
Alabama Brandon Moseley

Wednesday, the Senate Health Committee approved a bill, Senate 46, which would allow nurse practitioners to sign many documents that currently can only be signed by a physician.

The President of the Alabama State Nurses Association (ASNA) Dr. Rebecca Huie wrote, “The Alabama State Nurses Association applauds Senate Bill 46, which unanimously passed the Senate Health and Human Services Committee today.  The Bill grants Nurse Practitioners signing authority on certain medical documents that previously could only be signed by a physician.   Since NP’s are trained in these areas and work in collaborative practice with a physician, the Bill will help thousands of patients have easier access to care and reception of needed authorization forms.  ASNA has worked with the Nurse Practitioner Alliance of Alabama and other medical advocacy groups to diminish clinical and administrative bottlenecks that have placed unnecessary burdens on providers and patients.”

HB46 was sponsored by Senator Jim McClendon, R-Springville, who chairs the Senate Health Committee.

Sen. McClendon said that the Alabama Medical Association had been the primary opponent of the bill; but he sat down with them at dinner the night before to draft a compromise which they could accept.  There were three major changes to the bill that the Alabama Medical Association insisted on.

McClendon said that the doctors were concerned that some of the language would supersede the previous agreement requiring that nurse practitioners operate only with a collaborative agreement with a doctor.  The SB46 changes the bill so that everything is subject to the collaborative agreement.  The new SB46 does not grant them the authority to sign these documents.  Instead the bill gives doctors the authority to grant the signing documents authority to the nurse practitioners.  In the previous version of the bill, the nurses had the authority to sign do not resuscitate (DNR) orders.  That was removed.  The previous version of the bill gave the nurse practitioners the authority to admit someone to a skilled nursing home. That came out of the bill.  “They are still subject to the collaborative agreement.”

Senator Gerald Dial, R-Lineville, said that the changes to the bill resolved some concerns that he had with the bill.  Dial addressed the crowd of nurses present.  “There was a perception that I was anti-nurse practitioners and nothing could be farther from the truth.”  I was over the 127th medical group in the National Guard and I greatly appreciated what nurses do.  I also represent rural Alabama and in many of our counties there are not enough doctors.  Nurses are helping us fill those gaps in our healthcare system.  Yesterday, I was getting fifty emails an hour from people supporting this bill.  I applaud you for your efforts.

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ASNA Executive Director John Zeigler said that the association represents the interests of over 90,000 Alabama nurses.

The bill was given a favorable report on an 11-0 vote.

Chairman McClendon thanked the Alabama Medical Association, “For working with us on this.”

The bill now goes to the full Senate for its consideration.

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