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Nurses fighting for rights

By Kathy Jefcoats

When Paulette Cloud moved to Georgia more than four years ago, she was stunned to learn she had come to the only state in the union that keeps her from writing prescriptions to her patients without a doctor's consultation.

Cloud, a nurse practitioner for 10 years, holds a master's degree in advance practice from the University of South Florida at Tampa. She had the authority to write prescriptions as an Army nurse and in practice in Florida.

"This is very important to me," said Cloud. "It's humiliating to have to go to a doctor to authorize a prescription. We have no autonomy in writing prescriptions. It's archaic and Georgia needs to be more progressive."

Hundreds of Advanced Practice Registered Nurses, including nurses from Henry and Clayton counties, descended on the state Capitol Wednesday to plead their case. The battle for the right to write prescriptions has been a long one, said state Sen. Mike Crotts, R-Conyers.

"They've been trying a long, long time to get this passed through," said Crotts, a former member of the Health and Human Services committee. "I think the doctors have pretty much come to a point where they are not as against it as they used to be."

But the Web site for the Medical Association of Georgia lists the nurse prescribing bill as one of four before lawmakers this year that the group opposes.

"Each of these proposals has been too risky for the safety and well-being of Georgia's patients," states the Web site. "Although nurses contend that 49 states allow nurses to prescribe, and that only Georgia prohibits such activity by nurses, this statement dies not accurately reflect the current state of affairs for nurses practicing in most of the country."

The Web site goes on to state that current Georgia law allows nurses to practice much more freely than many other states' laws because the law does not limit the type of patient the nurse can see or what type of drug the nurse can transmit.

According to the Web site, the association also opposes expanding prescribing rights for optometrists and granting such authority to psychologists.

The prescriptive right for nurses does not extend to all nurses, only those with advanced training. There are nearly 3,000 such nurses in Georgia. The role of such advance nurses requires extra responsibility, critical thinking and judgment.

The four general categories include nurse practitioners, certified registered nurse anesthetists, psych-mental health clinical nurse specialists and certified nurse midwives. Such nurses are licensed and certified by their professional organizations, and require a master's degree to practice in Georgia.

Cloud practices under a doctor's supervision at McIntosh Trail Family Practice offices in Stockbridge and Griffin. She is considered a mid-level provider and has her own patients.

"All nurse practitioners are hooked up with a doctor but we already see patients and evaluate, diagnose and write prescriptions," said Cloud. "But we have to have a doctor co-sign it."

Crotts said the wording of the legislation in years passed would have allowed nurses to practice medicine on their own, which is why the doctors opposed it.

"In the early days, they wanted full prescription rights and to practice with a shingle," he said. "We told them back then that if they wanted to practice medicine, go back to school and get their medical degree or work under the supervision of a doctor."

Cloud said she doesn't want to be a doctor.

"We're not asking to hang up a shingle," she said. "We're just asking to be respected."