Please Support HB 1061

By Rep. Roberts

HB 1061 recognizes that Advanced Practice Nurses (APNs) are the logical person to sign certain documents for the patients in their care. While advanced practice nurses are qualified to diagnose specific conditions and provide treatment for those conditions, some other agencies do not recognize or accept the signatures of the APN. In essence, this bill recognizes that APNs must “treat the paperwork” as well as the patient. Requirements for such signatures are:

· The document must relate to a diagnosis or patient that is within the scope of practice of that APN (pregnancy related documents for nurse midwives, pediatric documents for pediatric nurse practitioners, for example)

· There must be an APN -patient relationship (the APN has examined the patient, knows their history)

Documents that are included are those that:

· Document current health status (such as school physical and immunization records, pregnancy status, jury duty forms)

· Authorize continuing treatment, tests, services, or equipment (such as wheelchairs, nebulizers for asthmatic patients, laboratory tests, nutritional assistance for diabetics)

· Give directives for end-of-life care (do not resuscitate requests by the patient, most commonly)

· Apply for handicapped parking placard (Section 2 of the bill)

These documents do not expand the scope of practice of the APN, but are often included in the overall treatment of the patient who is already in the nurse’s care. The alternative, in many cases, is to request a signature by another health care provider, often a physician, who either has never seen the patient, or whose knowledge of the patient is out of date.

Prepared by:

Charlotte Hebeler, Dr.P.H.

On behalf of The Colorado Nurses’ Association

January 13, 2008