Government affairs.
Subject: Occupational health and safety (Laws, regulations and rules)
Workplace violence (Laws, regulations and rules)
Nurses (Crimes against)
Author: Davis, Wilhelmina
Pub Date: 03/22/2012
Publication: Name: Tennessee Nurse Publisher: Tennessee Nurses Association Audience: Academic Format: Magazine/Journal Subject: Health care industry Copyright: COPYRIGHT 2012 Tennessee Nurses Association ISSN: 1055-3134
Issue: Date: Spring, 2012 Source Volume: 75 Source Issue: 1
Topic: Event Code: 930 Government regulation; 940 Government regulation (cont); 980 Legal issues & crime Advertising Code: 94 Legal/Government Regulation Computer Subject: Government regulation
Product: Product Code: 8000500 Employee Health & Safety; 8043100 Nurses NAICS Code: 62 Health Care and Social Assistance; 621399 Offices of All Other Miscellaneous Health Practitioners
Geographic: Geographic Scope: Tennessee Geographic Code: 1U6TN Tennessee
Accession Number: 283984742
Full Text: We are now into the second session of the 107th General Assembly and legislation is beginning to move through the committee system and on to the floor of both House and Senate for consideration and debate. Every bill of general application has now been introduced. TNA has made the membership aware of bills we are tracking this year, as well as bills from last session still pending. Listed in this article are those bills TNA's Government Affairs and Health Policy Committee targeted as bills of most significance and concern.

SB2658 sponsored by Sen. Tim Barnes and its companion HB2857 by Rep. Debra Maggart, seeks to enhance protection of healthcare providers in the healthcare workplace by increasing penalties for assault and battery by persons who intentionally or knowingly cause bodily injury to said worker while performing his or her assigned duties.

The proposed legislation would add healthcare providers to the existing Tennessee Code sections which address assault against law enforcement officers, transportation workers, and other public service individuals. Current law allows for enhanced penalties for Class A misdemeanor or Class B misdemeanor. Our efforts with this bill are only to have current language include healthcare providers, while acting in the discharge of the provider's duty.

Although a number of legislators have voiced their opposition to this legislation, stating the reason for opposing as "philosophical," these legislators believe that including healthcare providers to the code seeks to create a separate group of people to protect. TNA disagrees with such statements and refers to the empirical data as presented by credible agencies and studies. It has been well documented that the workers' healthcare sector have the highest incidents of assault while on the job. Some of the data we have shared with legislators include:

* The National Institute for Occupational Safety and Health (NIOSH) defines workplace violence as any physical assault, threatening behavior or verbal abuse occurring in the workplace

* The healthcare sector leads all other industries, with 45% all nonfatal assaults against workers resulting in lost work days (Bureau of Labor Statics, BLS)

* 2,050 assaults and violent acts were reported by RNs requiring an average of 4 days away from work (Emergency Nurses Association, ENA)

* In Tennessee in 2010, there were 369 claims made to workman's compensation due to workplace violence

* From 2003 to 2009, eight Registered Nurses were fatally injured at work (BLS 2011)

* The American College of Emergency Physicians (ACEP) believes that optimal patient care can be achieved only when patients, health care workers, and all other persons in the emergency department (ED) are protected against violent acts occurring within the department. As such, ACEP advocates for increased awareness of violence against health care workers in the ED and for increased safety measures in all EDs. Further, ACEP encourages all states to enact legislation that provides a maximum category of offense and criminal penalty against individuals who commit violence against health care workers in the ED. Revised and approved by the ACEP Board of Directors April 2008 and June 2011

TNA will continue to meet with legislators to advocate for the passage of SB 2658/HB2857. Our efforts to keep the membership informed will also be enhanced by the use of social media and email. It is imperative that legislators continue to hear from each of you, as you are their constituents and this legislation is much needed for the protection of those professionals on the front lines of providing healthcare.

Other bills TNA supports include the following:

SB2313 by Sen. Bell and HB2516 by Rep, Cobb - this legislation extends the Board of nursing and revises its membership. Both Senate and House Government Operations Committees have considered the bills and bills are now in the process for floor action.

SB2581 by Sen. Campfield and HB2549 by Rep. Hill - this legislation is an attempt to address the concerns brought to light during the lengthy debates around the use of interventional pain management. As you will recall for the past two years, legislation has been introduced and considered that would curtail the scope of practice and the ownership of clinics by APRNs, CRNAs, and PAs. This year's language set out the following;

* Authorizes the board of nursing to provide a certificate of competence in interventional pain management to a nurse practitioner if the nurse practitioner provides certain evidence to the board.

* Authorizes the board of nursing to provide a certificate of competence in interventional pain management to a certified registered nurse anesthetist (CRNA), which will allow the CRNA to perform invasive procedures involving any portion of the spine, spinal cord, sympathetic nerves or block of major peripheral nerves.

* Authorizes the committee on physician assistants to provide a certificate of competence in interventional pain management to a physician assistant if the physician assistant provides certain evidence to the commission. Specifies requirements for physicians practicing interventional pain management.

SB3536 by Sen. Crow and HB3073 by Rep. Casada is legislation which allows nurse practitioners to issue universal do not resuscitate orders.

With the growing concerns of the over use of controlled substances, the Administration introduced legislation addressing the use of the controlled substance database. TNA is working with other providers and stakeholders to amend the bill, so that legislation when enacted will be applicable and workable to all parties.

SB2253 by Sen. Norris and HB2391 by Rep. McCormick - TN Prescription Safety Act of 2012.-Enacts "Tennessee Prescription Safety Act of 2012." Expands and clarifies the "Controlled Substances Monitoring Act of 2011." Authorizes the commissioner of health to promulgate rules on the sharing and dissemination of data and information in the database with other states and enter into such agreements. Requires all prescribers, dispensers, and physician extenders in practice for more than three calendar days per year in Tennessee to be registered in the controlled substance database. Requires prescribers and dispensers to submit information on dispensed controlled substances, including whether the prescription is new, the date the prescription was issued, and the source of payment, to the database within 24 hours, instead of monthly. Requires the controlled substance database committee to review the information in the database and notify law enforcement of any violations of law. Adds to the list of who confidential database information may be available to and requires each database user to have a separate authentication access code. Requires prescribers and dispensers to check the controlled substance database prior to prescribing or dispensing a controlled substance at the beginning of a new treatment and least every six months after that.

Again this year, numerous bills have been introduced causing grave concerns for TNA which if enacted would be detrimental to the nursing scope of practice and if passed and enacted could be counterintuitive to the nursing profession, and to the safety of all Tennesseans.


SB2406 by Sen. Randy McNally and HB3406 by Rep. David Shepard - Adoption of rules regulating nurse practitioners - legislation which drastically changes the rules regulating nurse practitioners. Passage of this legislation would eliminate the requirement that the board of medical examiners and the board of nursing jointly adopt rules to regulate supervision of nurse practitioners. The bill further deletes the provision that grandfathers in advanced practice nurses if they hold a registered nurse license in good standing and current national specialty certification in the advanced practice specialty prior to May 22, 2002.

* This would allow another profession, Medicine, the ability to determine nursing practice.

* This is an attempt by organized medicine to restrict the scope of APRN practice.

* The IOM report's first recommendation is the removal of barriers to practice, this bill goes completely contrary to those recommendations.

SB2275 by Sen. Tracy and HB2558 by Rep. Sparks - Cosmetic Procedures - this legislation attempts to redefine persons who practice medicine and who may perform cosmetic or aesthetic procedure or treatment. It further seeks to redefine who may have ownership of facility. The bill authorizes board of medical examiners to promulgate rules. TNA's concerns and opposition include the followings:

* NPs provide quality care ... no evidence to the contrary

* Job loss ... aestheticians who are trained to perform procedures will be out of work

* Increased costs of simple cosmetic procedures

* Restraint of trade

* NP owned clinics could not use supervising physician ... would be unable to continue to provide cosmetic procedures.

SB3627 by Sen. Watson and HB2801 by Rep. Johnson - Supervision and performance of hormone replacement therapy. - Allows the board to deny, revoke, or suspend the license of any physician who supervises a non-physician performing hormone replacement therapy, if such physician is employed by or contracted with an entity not owned or controlled by physicians licensed in this state.

SB2419 by Sen. McNally and HB2573 by Rep. Dunn - Federal drug indictment - emergency suspension of practitioner. - Authorizes the commissioner of health or the practitioner's licensing board to suspend on an emergency basis the license of a practitioner who is under any state or federal indictment involving controlled substances.

SB2542 by Sen. Campfield and HB2672 by Rep. Faison - Gun ownership by applicant or insured. - Prohibits health care providers and facilities for inquiring about a patient's or a patient's family member's firearm or ammunition ownership or storage. Allows emergency medical providers to inquire in cases where the information is necessary to treat a patient in an emergency, or to protect the patient or others from immediate danger. Prohibits insurance providers from discriminating against an applicant based on gun ownership.

SB2541 Bell and HB2661 Matheny, and SB2540 Bell and HB2661 Matheny - No helmet required for motocycle drivers over 21. TNA opposes for the following reasons:

* Data shows increased brain injury and death when not wearing a helmet

* Increased costs to healthcare system and tax payers ... long term costs of care for brain injured patients is high

* No different than requiring seat belts in autos.

As you can see, this legislative session has been and will continue to be a busy one-TNA needs the support of the membership as we advocate for the nursing profession and healthcare for all citizens of Tennessee.

One of the goals this year by TNA is to have as many Nurses as possible to visit Legislative Plaza. Thus far, APRNs from across the state and Nurses from Middle Tennessee have had their respective days on the Hill.

As we continue to inform and educate legislators of the profession of nursing, Wednesday, March 14, 2012, has been designated as East Tennessee Nurses Day on the Hill. We encourage those who can to join us on Capitol Hill. This will be an opportunity for you to visit with legislators and to meet staff.

Other dates and events to take place include:

Tuesday, April 10, 2012 - TNA Legislative Day on the Hill

Wednesday, May 2, 2012 - West Tennessee Day on the Hill (date subject to change if by chance session ends before this date)

We take this opportunity to thank each and everyone for your continued support of TNA's efforts, and we hope to see you in Nashville.

by Wilhelmina Davis, Manager, Government Affairs
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