Nurses get freedoms with change

A measure allowing advanced practice nurses to work more independently has taken effect.

Jessie Bekker

Jaclyn Guetzko will stay in Minnesota after graduating from the University of Minnesota’s Doctor of Nursing Practice program this May, now that she’ll have the prospect of practicing independently with a bit of experience under her belt.

As of this month, advanced practice registered nurses like Guetzko can now work autonomously in Minnesota after the state lifted a restriction that previously sent some nursing students to states with more liberties, saving nurses money and hassle.

The change was passed last legislative session, and it allows the advanced practice nurses to prescribe medication and perform their daily tasks without a doctor’s supervision, said Mary Chesney, director of the University’s Doctor of Nursing Practice program.

Previously, she said, an APRN had to set up a clinic near a physician’s home or office.

Chesney said she believes the new law will help to increase patient care in urban and rural areas statewide.

The law has two stipulations: new practitioners must spend about a year working full time under the supervision of a physician or experienced nurse practitioner, and certified registered nurse anesthetists must collaborate with a physician when they provide chronic pain management services.

When Guetzko graduates in May, she’ll still have to complete her required hours.

Carina Noecker, a 2014 graduate from the University’s Doctor of Nursing Practice program, is currently finishing her hours at Bluestone Physician Services.

She said she thinks the stipulation is a fair requirement, considering that it allows her to practice while she makes the adjustment from classroom to workplace.

“I feel that the required hours will provide a bit of support as a new grad, which is always needed,” she said. “The learning process is continual.”

Gretchen Moen, a pediatric nurse practitioner and executive director at the nonprofit Dakota Child and Family Clinic, is taking advantage of her newfound freedom in her own practice.

The clinic became independent after 12 years of paying for a collaborating physician and their malpractice insurance.

The clinic lost its supervising physicians from time to time, and Moen had to reach out to community members to find a replacement to oversee the clinic.

“There [were] times when it was really difficult to find someone to collaborate. Without a collaborative doctor, we couldn’t work,” she said.

Moen said the requirement was a nuisance when it came to running the practice day-to-day.

“They just sign a piece of paper,” Moen said, adding that the nurses met with their supervising physician only a few times each year.

But some APRNs say that the law doesn’t change how they do their job.

Guetzko is still working under the supervision of a physician in her clinicals at Fairview Southdale Hospital. She said doctor-nurse teamwork is a regular part of the job.

“Just because there’s no collaborative agreements anymore, doesn’t mean that we, as providers, shouldn’t collaborate anymore in order to provide the best possible care for our patients,” she said.

Currently, there are 19 states, along with the District of Columbia, that allow all nurse practitioners to have full practice authority, like Minnesota. Tennessee and Kansas are also in the process of creating similar legislation, Chesney said.

“The collaborative agreement, as it existed, was a really expensive formality,” Guetzko said. “It was a barrier to practice.”