APRN's supervising Medical Assistants

Dear esteemed colleagues:

There have been many recent queries from membership relative to APRN’s working with Medical Assistants. For guidance and clarification, I offer the following. On February 24, 2015, the APRN Advisory Committee of the Nevada State Board of Nursing discussed the issue. Subsequently on April 2, 2015, Executive Director Debra Scott gave written direction which is posted on our site under APRN Legislative Updates.

MA’s are regulated by the Board of Medical Examiners, not the Nevada State Board of Nursing (NSBN). NSBN does not have jurisdiction over MA’s. APRN’s may supervise MA’s but may not supervise them doing invasive procedures such as injections. They may only perform an invasive procedure under the direct supervision of a physician or physician assistant who is immediately available to exercise oversight. APRN’s may supervise an MA as long as they are doing things like vital signs, weights, preparing the room for the visit, etc.

Several members are expressing great displeasure with this and are viewing it as a barrier to practice. There is a misunderstanding that APRN’s cannot hire MA’s, which is not the case. Our membership wants a work-around but is not understanding what would need to be accomplished in order achieve this. We would have to secure a bill sponsor, promote a bill, educate all key stakeholders, move a bill through committees and houses, pay our lobbyist for time and travel, etc. Also, in order to transition all law, regulations and administration from Board of Medical Examiners to Nevada Board of Nursing, we would have to secure a fiscal note (funding).

I assure you I have discussed this with key stakeholders and legislators and there is no political or fiscal appetite for this issue at this time. The work-around is to simply conduct the invasive procedure yourself.

As leadership, we will not be pursuing this issue now as we do not view this as a true barrier to practice, but perhaps an inconvenience. We have other serious barriers such as reimbursement issues and several insurance companies that refuse to contract with APRN’s without a collaborating physician, even though we are and have been fully autonomous providers since 2013. These represent true barriers to providing care to Nevada’s most vulnerable healthcare recipients.

I hope this gives the membership clarity and direction. If you have any questions, please feel free to reach out.

Cindy Pitlock, DNP, CNM, APRN

President

Nevada Advanced Practice Nurses Association