Nurses Prescribing Medication: The Wrong Pill for the Wrong Ailment

California’s Governor Brown has signed a bill that allows nurses to prescribe medication.

That medication is birth control.

When a law is passed to fix a made up problem that flows from an invented crisis I have to wonder what the real purpose is.

The list of  primary care or family doctors in California who are willing to see California’s medicaid qualified members is short.  The list is short because California’s medicaid pays doctors so little that doctor practices lose money treating these patients.  It cost too much for primary care or family doctors to serve California’s medicaid members.  According to a recent survey less than 10% of California’s doctors are accepting medicaid patients.

You can  read more about doctors not accepting medicaid members and the results of that survey here. 

Part of the reason California’s medicaid program is financially strapped is because California spends too much of collected tax payer’s dollars on nonessential or politically expedient services.  As a result medicaid funding goes wanting.

Legislators in California are quick to cut funding for essential services, declare a crisis and then demand more tax payer money.  Fiscal conservatives who call this what it is, costly government sanctioned extortion, are labeled as right wing extremist by California’s complicit media.

One of those pet projects that illustrates this same political strategy used to justify nurses prescribing medication is seen in Governor Brown and high speed rail systems for California.  While high speed rail and birth control seem to be very different issues the setup or template used is the same.

The Left’s template, the setup and the fix, goes like this:  “There is a crisis and if we don’t fix it we are all doomed.  The crisis is due to some perceived injustice to  ___________  (fill in the blank with the Left’s latest victim be it the environment or women’s health care).  To apply the fix which will avoid this impending crisis the government needs more of your money.  If you are against a tax increase you are a heartless Nazi homophobic bigot right wing Tea Party extremist who will be responsible for the annihilation of the entire human race.”

Does that template sound familiar?

We needed huge and wasteful federal bailouts why?

Back to nurses prescribing medication…..

Letting politics drive public health care law, allowing unqualified nurses to prescribe medication impacts public health, sets a dangerous precedence.  Flip this process upside down if you will.  Would it be good public health policy to let political pressure from an anti-gay group stop the funding for HIV testing?  Of course not.  Politics driving public health care laws or policies sets a very dangerous precedence regardless of whose politics are involved.

When I did medical relief in East Africa on my first trip I arrived with the training, experience, mindset and license of a registered nurse. It took me 4 trips working with two medical doctors, one from Ireland and one from Seattle, WA, to learn to think like a provider, understand being a provider, be responsible for doing what a prescribing medical provider does. It took about 18 months of hands on training and the mentoring of two medical doctors to transition from a nurse mindset to being a qualified and safe “provider”.  Becoming a provider while being built on the foundation of my registered nurse training was in addition to my existing education.

Nurse Practitioners, NP’s, ARE qualified to prescribe medication in the U.S.  A Nurse Practitioner is essentially a Masters Degree level education which includes thorough on-the-job training with a physician.  Regular nurses, even with a Bachelors Degree, are not trained nor qualified to prescribe medication.

One has to wonder how the 0ther 49 states are going to react.  I can guess that states that are run by Democrats and have nurses unions are going to follow California’s lead.  One also has to wonder just how popular birth control tourism to California is going to be.   I can see the “Made in California” stamped on IUD’s all across the western plains.  At least Arnold won’t be in that “Come to California” commercial.  Paris Hilton would be a shoe-in though.

Nurses are educated and trained.  Our training is the best in the world.  That training positioned me so that I could learn what was additionally required  in order to serve the people of Sudan and meet their medical needs safely.  The education and training registered nurses receive is the foundation on which Nurse Practitioner programs are built.

Governor Brown’s new law allows regular nurses, not just nurse practitioners, to prescribe medication.

Nurses do not carry the kind of liability insurance doctors must carry to protect themselves from costly law suits filed claiming damage from improperly prescribed medication.  What California’s nurses are paying for liability insurance is about to sky rocket.

Again the issue, women having limited access to obtaining birth control, is an invented issue. Women in California are not burdened with unwanted pregnancies because they can’t get birth control.  They are getting pregnant because they aren’t utilizing existing access to birth control and as a result are having unprotected sex.

Women’s health care is not threatened because it is hard to obtain a prescriptions for various birth control methods.

For the Left of course “women’s health” generally means abortion.  There is no lack of abortion services in California.

A quick search for Planned Parenthood locations reveals that California is saturated with Planned Parenthood clinics.  In fact Governor Brown announced his signing of this law at a Planned Parenthood clinic.  Planned Parenthood is both a birth control method distributor and an abortion provider.  The combination has been very profitable.  So profitable that I bet Planned Parenthood could easily afford a doctor, probably two, at each of their many clinics.  The six figure salaries of their CEO’s might take a hit but isn’t meeting women’s health care needs worth a little cut in pay?

Because primary care or family practice doctors choose not to see these medicaid patients many of these patients end up using emergency rooms and urgent cares for routine health care needs.  The facilities that are contracted with medicaid are limited.  Almost all of us understand that some health care facilities take our insurance, others don’t.   It would be a half truth to characterize our access to health care as “limited” simply because our insurance has in network contracts.  Having providers who take our insurance does not mean our access to care is limited nor that we need nurses to write us prescriptions for birth control.

The difficulty women, men too, on medicaid have finding a primary care or family doctor is troubling.   The Forbes article linked above makes it clear this problem is growing in every state.  California is the worst but it is not the only problematic state for medicaid members.  A list showing all the reasons for the problem in each state is of course different.  What is common on each state’s list however is out of control unnecessary government spending.

Doctors choosing not to see medicaid patients does not mean there is an alarming shortage of doctors in California which demands an urgent extraordinary fix.  I can assure you registered nurses writing prescriptions is extraordinary.

It also does not mean women have limited access to prescriptions for birth control methods.

The fix for California’s medicaid health care provider problem, the real health care risk,  is for California’s state government to remember why government exists and cut funding for nonessential services.  Pet projects have to go.  Political expedient spending has to go.  The “extra” money left in the budget would be available to increase medicaid funding so medicaid payments to doctors could be increased to a reasonable level.   The issue behind the real health care risk for folks on medicaid would be fixed and would be so permanently.

You can read about California’s waste of tax payer money and state fraud here.

The necessary fix is not to be found in telling half truths to invent a crisis to justify the wrong solution.  The fix for the real problem has nothing to do with nurses writing prescriptions for birth control.  Nurses writing prescriptions fixes an invented problem and as a solution smells with the stench of political expediency.

Are you sure this doesn’t sound familiar?

We still need more tax payer money for more bailouts even now Mr. Bernanke?

California is a perfect illustration on a smaller scale of what is at stake for our national economy in November’s election.  This election is going to set the direction this country takes fiscally for many decades to come.

Fixing “problems” that aren’t problems nor the government’s business costs us tax payers dearly.  Every dollar commandeered by government is one less dollar available to invest in the private sector.   The private sector drives our economy.  Bigger costly tax eating governments, state or federal, weaken our economy because taxes divert the fuel that drives our economic engine, your and my money, from business to government coffers.

I can speculate that at least one reason behind allowing nurses to prescribe medication in California is the desire to grow government.  Extending government’s reach is a key strategy of today’s Democratic Party.

It is also the case that:

  • the California nurses union, yes they are unionized,  is basically a Democratic Party organization.  Putting union interest ahead of what is best for most Americans is a key strategy of today’s Democratic Party.
  • inventing a crisis whose fix is our tax dollars is a key strategy of today’s Democratic Party.
  • increasing prepaid, as in free to them, abortion is a key strategy of today’s Democratic Party.

Those Democratic Party strategies are costing us dearly.

As a citizen I do not want my federal government going the way California’s state government has gone and is going.

As a registered nurse I am concerned about three things:

  • I am concerned that women will be prescribed medication in an unsafe manner.  As a nurse patients are my first and foremost concern.   How many women will have their health put at risk with this new law?
  • I am concerned for my fellow nurses in California and hope they obtain the kind of liability insurance needed to cover the risk their prescribing birth control measures encompasses.  I have to wonder if the coming increase in their liability insurance will also increase mine.  (I am amazed at how the folks on the Left continue to wonder why health care cost keep going up.)
  • I am concerned that other nurses will be so mesmerized by being able to prescribe medication that the bigger issues will go unexamined and real fixes will allude us.  We nurses will be enjoying playing doctor so much we won’t take the time to see today’s real Democratic Party through the smoke and mirrors that they use “women’s health care issues” to create.

 

Comments

  1. Well, as a nurse but not a NP I would not want to risk my license and a law suit. I have seen physicians write scripts that came back to bite them. One was for birth control. The dr did not listen to the patient or realize the importance of what her medical hx said. Her mother had had a stroke, as did her brother, uncle and father. The patient had a major stroke. So mistakes are made – I would rather the dr made the mistake and not me.

    1. My thoughts exactly! I am an RN and I will not practice out of the scope of my training and practice.

      1. Was assessment always part of a nurse’s scope of practice back in the day. I doubt. So why not consider this Nursing evolution and advancement.

  2. This is another idiotic move that will result in more costs rather than less costs. Medicaid patients can get birth control without a presciption at any family planning facility and don’t even need to make an appointment. PAs and NPs are already allowed to write RX, however, their orders must be overseen by an MD. IF RNs are allowed to write prescriptions, will their orders also be overseen by an MD? If not, will the law be changed for NPs and PAs? If all three, RNs, NPs and PAs, are allowed to write prescriptions, how long will it be before they have to carry higher malpractice insurance? End result. . .more $$ into the insurance companies pockets.

  3. And who will treat the women who develop pulmonary emboli due to their birth control pill ? Where is the continuity of care for other women’s issues? Is there no advanced education to prepare nurses for this responsibility? ( I purposely did not use the term “trained”. Dogs are trained. Nurses are educated.) NPs are doing a fine job. Let’s utilize their services as efficiently as possible, rather than giving RNs responsibilities for which they are unprepared.

    1. I’m ok with education and training. I’m not so sure I want a nurse who can claim being “educated” but not train to be starting an IV or a PICC line on me or a loved one.

  4. Sorry, but this is not correct information…at all.

    Actually, the bill does NOT allow non-advanced nurses (NPs / NMWs) to prescribe medication. How this opinion-post arrived at that conclusion, simply means that it was misinterpreted; as I will submit that I thought it originally suggested the same thing. In digging deeper (the actual bill), I found that it allowed RNs (under the order of a Physician, Nurse Practitioner, Nurse Midwife, or Physician’s Assistant) to DISPENSE birth control in special facilities (e.g. Planned Parenthood), to meet a growing need (time) in California. This does not mean the RN is suddenly making independent medical decisions at all.

    As Jim wrote: “Governor Brown’s new law allows regular nurses, not just nurse practitioners, to prescribe medication.” This is absolutely false. You need to read the actual bill, and avoid being duped by other opinion and editorial driven articles that are out to seed the masses with this kind of silliness.