Topping the legislative wish list for the Georgia Nurses Association this year is prescriptive authority for advanced practice registered nurses. GNA President Linda Easterly, RN, BSN, MS, is “guardedly hopeful” that this may be the year a bill gets out of committee. “There’s a different committee structure in the legislature, and we are hoping to persuade legislators [of] the value of giving APRNs the right to write prescriptions,” she said.

The GNA would like to see legislation that would allow APRNs to issue a written or verbal prescription drug or device order pursuant to a collaborative practice agreement with an authorizing physician. Georgia is the only state does not allow an APRN to write a prescription.

The 4,000 Georgia APRNs (certified nurse midwives, nurse practitioners and clinical nurse specialists in psychiatric-mental health nursing) have sought passage of such a bill for almost 10 years. In the past, major opposition has come from Medical Association of Georgia lobbyists who argue that the right would increase nurses’ liability and possibly mean loss of income for doctors, but Easterly argues “that prescriptive authority would give us more avenues to provide health care in rural communities.”

Many clinics bring in nurse practitioners to do primary care of patients, and having to get a prescription co-signed by a physician who is also seeing patients slows down the process.

“This legislation would allow more patients to be seen and, in light of threatened cuts in PeachCare and Medicaid, we need to be spreading our health care dollars as far they’ll go,” Easterly said. “At this point, [at press time], no bill has been introduced, but we continue to educate the legislators and we are optimistic.”

A second priority for the GNA is legislation to protect RNs who report unsafe patient and work conditions. “Gov. Perdue put together an ethics package that covers almost every other line of work, but not health care,” Easterly said. “Currently, when a nurse calls in to report an incidence of fraud, abuse or neglect, it may be the RN who suffers.”

A nurse may be blackballed at work and have trouble finding another job when recommendations aren’t forthcoming, she added.

Hospital human resource departments have mixed feelings about such a bill because it would protect some employees from being rightfully fired for other reasons, Easterly noted. “But whistle-blowing legislation needs to be there to protect patients. Nurses need to know that they can pick up the phone and report unsafe conditions,” she said.

Another legislative priority for the GNA is protection of RNs against mandatory overtime.

“Mandatory overtime is a health care hot button right now, especially as hospitals are busiest in the winter months and there’s still a nursing shortage,” Easterly said. “Research shows that people who work more than 50 hours a week make more mistakes. Other states have mandated hours, but we hate to see that happen in health care because it takes away the flexibility an organization needs to have to deliver good service.”

While the GNA supports protection against mandatory overtime for RNs as a safe staffing issue, the organization also knows that hospitals are making positive changes in this direction because they want to retain the nurses they have.

“Nurses are like diamonds right now — you don’t hire them to work them to death with too many hours,” Easterly said.

The GNA also will be watching budgetary measures that would impact negatively on the health of Georgia citizens. It supports continuation of funding for school nurses and adequate levels of funding for PeachCare and Medicaid, so that people can get the health care they need.

“Last year, the state did a good job of increasing nursing scholarships and we want to maintain that level of funding,” Easterly said. The University System is lobbying for new nursing facilities and higher salaries for faculty, but in a tight budget, the efforts face stiff competition for the dollars.

“We always deal with a two-year session and this year we have the change to a Republican majority and new speaker. It’ll probably take half the session to iron out those growing pains,” Easterly said. “Our game plan is to lay the ground work this year, work all summer talking to legislators and then hope next year to get everything we want.”