APRNs (Nurse Practitioners) are educated to take care of their patients as independent providers. All independent providers including physicians refer to other providers when it is in their patients best interest. The education of nurse practitioners includes this training. Full Practice Authority grants nurse practitioners who have either a Masters Degree in Nursing or a Doctorate in Nursing to practice to the full extent of their education. 

Currently in the US, there are 26 states that have passed a law granting APRNs Full Practice Authority. This allows nurse practitioners to practice to the full extent of their education without having to pay a physician to sign 20% of their charts. This is the model that is recommended by the National Academy of Medicine (aka Institute of Medicine) and the National Council of State Boards of Nursing.

The state of TN currently is a “restricted state” according to the American Academy of Nurse Practitioners (AANP). This means that the TN law requires a collaborating agreement contract between the APRN and a physician in order for the APRN to prescribe medications. TN APRNs can evaluate, diagnose, order and interpret diagnostic tests, initiate and manage other treatments that do not include prescribing medications.  

Physicians in TN often get paid up to several thousand dollars each month to have this collaborating agreement contract with APRNs. It has become a business model for many physicians which has nothing to do with taking care of patients. APRNs can open their own clinics in TN but have to have a collaborating agreement contract with a physician in order to prescribe medication to their patients. This physician has to sign all charts that involve prescribing a controlled substance and a minimum of 20% of all charts. This creates an extra workload for physicians in an already stressful work environment. This time could instead be used taking care of their own patients. If that physician changes their mind or dies, that APRN must close their clinic immediately. This would leave your constituents without a healthcare provider.

The TN Governor granted Full Practice Authority due to the Covid-19 pandemic which was then reversed. This proves that APRNs can effectively and safely take care of the citizens of TN at all times and not just during a pandemic. TN health outcomes are one of the lowest in the country. The states that have granted Full Practice Authority for their APRNs have the highest health outcomes in the country. The APRN education involves looking beyond the actual patient into their family and home life to help the patient conquer their optimal health.

Retiring this outdated collaborating agreement law would grant Full Practice Authority for APRNs in TN.  This would allow TN APRNs to practice to the full extent of their education by prescribing medications without a collaborating agreement contract with a physician who signs 20% of their charts. It is beyond time for TN to get on board with over half of our country and vote YES to SB0196/HB1455!