Advanced Registered Nurse Practitioner Care
Internet Edition, February, 1996, Volume 7, Number 2
Copyright 1996, Nurse Practitioner Support Services
Official Newsletter of ARNPs United

Table of Contents

January ARNPs United Board of Directors Meeting
by Lyell Fox

The ARNP Board of Directors meets quarterly on a Tuesday from 12 noon to 5 pm. Meetings are in the greater Seattle area and all ARNPs United members are welcome to attend. Highlights of our January 9, 1996 meeting are:

  1. Review of bills now being considered by the WSNA & ARNPs United Legislative committees. Contact Tracy Lin at 206.383.5777 for information on bills.
  2. Review of the current contract between WSNA and ARNPs United.
  3. Bob Smithing to attend ACNP Summit Conference in Washington, DC, March, 1996 and will represent ARNPs United.
  4. Nurse Legislative Day - January 22, 1996. There will be a brief ARNP meeting to inform all members present of the general state of affairs.
  5. Bylaws were reviewed by Patti Varley, recommendations for changes noted and returned to Hazel Fleck for final draft.

Legislative Report
by Tracy Lin

The legislative committee along with Gail McGaffick, our lobbyist, was well prepared before the start of this legislative session. We are a constant presence and participant in the health care debate for the citizens of Washington. We support legislation which upholds the issue of clinical sovereignty and professional judgment by health care professionals to provide quality of care to clients. Clinical sovereignty allows the health care professional to empower consumers to take more responsibility for their health care decisions. As providers with full access and knowledge of health care services this will enable us to assist clients to make informed choices.

As the Legislative Chair of ARNPs United I am finding this session very challenging, rewarding and a pleasure to be working for the Nurse Practitioners of the State of Washington. If you have any questions, please contact me at 206.759.9640. You can also call your group's legislative committee representative.

Support

SB 6120 Postpartum Health Care Coverage: Sponsor Senator Quigley. Passes out of Health Care Committee with multiple amendments made by a joint effort with WSNA. Bill is in Ways and Means due to Fiscal impact, will more than likely pass onto the Senate floor for a vote. Call your Senator to support SB 6120. Coverage of 48 hours vaginal and 96 hours C-section. If a mother and newborn does not stay then they are eligible for up to 3 visits either in the home or in an outpatient setting. The visits are based on delivery not discharge so include mothers of home births.

HB 2639 Post Birth Health Care Coverage: Sponsor Representative Lambert Support the concept we will lobby for amendments to make bill look like the Senate version.

SB 6150 Incorporation: Sponsor Senator Thibaudeau. ARNPs United and Psychologists are working very closely together on this Bill. It allows 18 different types of health care professionals to be incorporated. The bill as currently written has no opposition. Will more than likely pass out of the Senate Health Care Committee without problems.

SB 6346, 6392, HB 2617, 2618, 2619 & 2173 Disclosure. These bills in their multiple forms establish the requirement for information to be disclosed to the consumers about the contracting process with providers.

HB 2486 Consumer Health Information Act: Sponsor Representative Backlund. Prohibits insurers from shifting liability for health care outcomes to providers via contractual conditions when decisions on payment for care are made by insurers. Prohibits “gag orders” regarding discussion of coverage and treatment options and penalizing provider for advocating on the patients behalf. The feeling is HB 2486 can be made stronger if it incorporates some of the concepts of the Disclosure Bills.

SB 5002 Violence Protection for Health Care Workers: Sponsor Senator Smith. If a health care worker in the line of his or her duties is assaulted regardless of the facility (hospital, clinic, home visits) the assault charge changes from misdemeanor to Class C Felony.

HB 2681 Work Place Violence Prevention Plans: Sponsor Representative Cody. This bill requires all health care settings to develop , implement, and file with the state “workplace violence prevention plans”. These plans would ensure that adequate safeguards are established, and all personnel in health care settings are appropriately trained, to prevent and respond to threatening or violent situations.

HB 2622 Disciplinary Process Reforms: Sponsor Representative Hymes. Complaint about a health care professional will not go on public record until formal charges are filed by their commission.

SB 6662 Health Insurance Benefits for Family Planning: Sponsor Senator Quigley. Require every health plan issued or renewed by a health carrier after July 1, 1996 that includes benefits for prescription drugs must include FDA approved prescriptive contraceptive drugs and devices.

SB 6129 Allowing Mental Health Practitioners and Clients to Contract for Services: Sponsor: Senator Fairley. After a client has completed the plans allowable visits they may continue to see their practitioner through a private contract.

Oppose

HB 2524, 2265, 2299 Anti-Abortion Bills. The sponsors of these bills deem the importance of this legislation as: “This act is necessary for the immediate preservation of public peace, health, morals, or safety, or support of the state government and its existing public institutions, and shall take effect immediately”. The subject of these bills are the ban of “Partial Birth Abortions”, Parental notification of a minor to have an abortion, hospitals and clinics to go on public record of how many abortions are performed at their facility, and limiting public funding.

HB 2330 Benefit Waiting Period for Preexisting Conditions: Sponsor Representative Backlund. The bill is asking to extend the waiting period from 3 months (passed into law in 1995) to 12 months. This bill has been changed to a study.

Definition of Surgery Sunrise Review

ARNPs United has worked hard in opposition to the definition of surgery put forth by WSMA. Findings by the Department of Health include:

  1. There seems to be no physical, mental, social or economic problems, as described in the Sunrise statute, with the current method of “defining” (or not defining) surgery.
  2. The proposed language concerning other health care professionals raises concerns about nearly every other health care provider regulated, and several who are unregulated.
  3. The notion advanced by the applicant (WSMA) that only properly trained and qualified persons should perform surgery is valid.
  4. The notion that MDs and DOs, as a group, are the only ones who could be properly trained and qualified for any current or future surgical technique is unsubstantiated.

Recommendations

  1. A restrictive definition of surgery as proposed for sunrise review should not be enacted.
  2. To review possible problems with laser surgery of the eye by optometrists and ophthalmologists, the Secretary will appoint a multi-disciplinary panel to assess the situation.
  3. A “New Technology and Practice Review Panel” should be established by the legislature. This panel could proactively assess the proper use of new technology before its widespread application.
  4. The legislature should consider mechanisms to be added or changed to Title 18 RCW that would bring the state closer to a competency-based, rather than credential-based, regulatory system.

Legislation regarding Surgical Technologist. New registered group regulated by the Medical Commission. Seems to be replacing surgical RNs.

To leave messages for your legislator call 1.800.562.6000. For a copy of a bill call the Bill Room at 360.786.7573.

ARNPs United Financial Statement
Prepared by: Ronald Young, Treasurer of ARNPs United

Assets

Total Assets $2,640

Liabilities

Accounts Payable:

Total Accounts Payable $5,985

Net Worth ($3,345)

Notes:

  1. As of February 8, 1996 ARNPs United is $3,345 in debt.
  2. Our lobbyist is paid through the end of February. Our contract is to pay her $1,200 each month when the legislature is out of session.
  3. There is a commitment of a $2,500 donation from an ARNP specialty group.

Synopsis of The Third Report of the PEW Health Professions Commission

In November of 1995, the Pew Health Professions Commission published a report which contained recommendations for Nursing. These recommendations may have significant ramifications for Advanced Practice Nursing, therefore it behooves us to be aware of them. It is also worth noting that the ANA was not given the opportunity to provide input to the Commission regarding the recommendations and the projected nursing surplus on which they have been based. In a Statement on behalf of the ANA, Geri Marullo, MSN, RN, Executive Director, observed that the ANA agrees with many of the conclusions related to need for a focus on primary care; increased commitment to cultural diversity and sensitivity; need to acquire skills in information technology, health promotion and disease prevention; and need for stronger presence in community based sites. However, the suggestion that there will be a decreased need for registered nurses because of the projected closure of inpatient hospital beds is rejected by the ANA. This is deemed to be short-sighted and influenced by the desire of the “current quick fix efforts by segments of the health care industry to realize short-term savings by decreasing quality and endangering safe patient care.”

Marullo emphasized the need to prepare nurses for practice in a changing health care environment, and to increase the access that associate degree and diploma nurses have to baccalaureate education. I would suggest that this be expanded to encouraging advanced practice education in primary care and specialty roles. Both of these education access positions appear to be consistent with the PEW Report.

In summary the ANA invites the Commission to work with them to “examine future needs for new nurses and the assumption that underlie such projections;” as well as to “examine means of ensuring the accountability of the health care industry for the safety and quality of the care that is provided for the American people.”

The Commission makes the following recommendations for Nursing:

A. Recognize the value of the multiple entry points to professional practice available to nurses through preparation in associate, baccalaureate and masters programs; each is different, and each has important contributions to make in the changing health care system.

B. Consolidate the professional nomenclature so that there is a single title for each level of nursing preparation and service.

C. Distinguish between the practice responsibilities of these different levels of nursing, focusing associate preparation on the entry level hospital setting and nursing home practice, baccalaureate on the hospital based care management and community based practice, and masters degree for specialty practice in the hospital and independent practice as a primary care provider. Strengthen existing career ladder programs in order to make movement through these levels of nursing as easy as possible.

D. Reduce the size and number of nursing education programs (1,470 basic nursing programs as of 1990) by 10-20%. These closings should become in associate and diploma degree programs. These closing should pay attention to the reality that many areas have a shortage of educational programs and many more have a surplus.

E. Encourage the expansion of the number of masters level nurse practitioner training programs increasing the level of federal support for students.

F. Develop new models of integration between education and the highly managed and integrated systems of care which can provide nurses with an appropriate training and clinical practice innovation and health care work re-design.

G. Recover the clinical management role of nursing and recognize it as an increasingly important strength of training and professional practice at all levels.

Classified Ads

Pediatric Nurse Practitioner

Part-time or full-time opportunity for a PNP to join our premier pediatric practice of 5 Peds and 2 PNPs in twin city community of Longview and Kelso, WA, one hour north of Portland. Good schools and great community with all advantages of rural living. Competitive salary and benefits package with exceptional working environment. Contact Blaine E. Tolby, MD, Ph.D, 971 11th Ave, Longview, WA 98632, phone 360.577.1771.

Nurse Practitioner

Seeking NP to join primary care/subspecialty internal medicine group, Bellevue, WA. Experience in adult medicine preferred; no pediatrics. Terms negotiable. Send letter and CV to S.C. Rice, MD; 1535 116th Ave NE #200, Bellevue, WA 98004.

ARNP

Experienced ARNP wanted for Stroke Prevention and Assessment Clinic. 4 FTE. Individual will be responsible for managing the clinic and clinical evaluation of patients. Must have excellent clinical and organizational skills. Salary commensurate with experience. Please contact David W. Newell, M.D. Associate Professor of Neurosurgery, Harborview Medical Center, Seattle, WA 206.521.1841.

Certified Nurse Midwife

The Deaconess Women's Clinic is seeking a third midwife to assist in working in our midwifery clinic. Qualified candidates must be certified. Excellent opportunity for a positive, outgoing, hardworking individual. Will function independently and in collaboration with OB/GYN physician's in a free-standing clinic associated with Deaconess Medical Center. Delivery privileges are granted at Deaconess Medical Center. Deaconess is located in Spokane, Washington and is a 388-bed acute, tertiary care hospital that offers state-of-the-art technology. The community of Spokane enjoys year-round activities provided by the many lakes and mountains surrounding the area. Competitive salary and excellent benefits are offered. Qualified and interested candidates should contact: Jim Ringwood, Nurse Recruiter, Deaconess Medical Center, 800 W. 5th Ave, Spokane, WA 99210, 509.458.7110.

Women's Health, Geriatric, Family NP

Women's Urology Center needs ARNPs interested in incontinence and women's health to do patient evaluations, urodynamic testing and provide a range of treatment alternatives as well as general OB/GYN care. We offer flexible hours and a full benefit package. To be part of our growing team, please send a CV to 4740-44th Ave SW, Seattle, WA 98103 or fax to 206.682.6778.

Nurse Practitioner Faculty

Part time adjunct nurse practitioner faculty. Reproductive women's health focus: April through May. Pediatric focus: June through August 15th. Will consider hiring two faculty (one for each focus). Involves 40-50 hours of work during 8-10 week period. Involves traveling to student sites, talking with preceptors, and observing and evaluating student-client visits. Time commitment is 40-50 hours of time in a 10 week period. Schedules are worked out with the students. Must be Masters prepared FNP, Women's Health Care NP, Certified Nurse Midwife, or PNP. Deadline for applications February 29th. Call Martha Worcester 206.281.3530, School of Health Sciences, Seattle Pacific University, Seattle, WA 98119.

Nurse Practitioner

24 hours/week position with SW Washington Health District. Comprehensive health care to women and men: history, physical, counseling and education; primarily Women's Health Care (birth control methods, testing/treatment of STDs). Requires WA State ARNP certification, prescriptive privileges, one year of clinical practitioner experience. Submit District application form to Personnel Coordinator, 2000 St. Vancouver Way, Vancouver, WA 98663. 360.695.9215 EOE.

SALE! SALE! SALE

Barbara Schneider, ARNP PNP closed her pediatric office at Crossroads in Bellevue. Medical diagnostic equipment, and four antique dining chairs are for sale. For further information and viewing sale items, please call Barbara Schneider at: 206.882-1768.

Nurse Practitioner

Seeking NP to join primary care/subspecialty internal medicine group, Bellevue, WA. Experience in adult medicine preferred; no pediatrics. Terms negotiable. Send letter and CV to S.C. Rice, MD; 1535 116th Ave NE #200, Bellevue, WA 98004.

Pediatric Nurse Practitioner

Part-time or full-time opportunity for a PNP to join our premier pediatric practice of 5 Peds and 2 PNPs in twin city community of Longview and Kelso, WA, one hour north of Portland. Good schools and great community with all advantages of rural living. Competitive salary and benefits package with exceptional working environment. Contact Blaine E. Tolby, MD, Ph.D, 971 11th Ave, Longview, WA 98632, phone 360.577.1771.

Continuing Education

Colposcopy, Endometrial Biopsy & IUD Insertion

March 4-8 1996. Presented by CME Solutions, LLC. (Formerly the Woman's Health Network). CEUs available for all courses. Colposcopy $600, Endometrial biopsy $250, & IUD insertion $150. Special rates for enrollment in more than one course. For more information or to register call Karen Taylor at 206.895.9005. Location Las Vegas, NV.

Colposcopy, Endometrial Biopsy & IUD Insertion

March 18-20, 1996. Presented by CME Solutions, LLC. (Formerly the Woman's Health Network). CEUs available for all courses. Colposcopy $600, Endometrial biopsy $250, & IUD insertion $150. Special rates for enrollment in more than one course. For more information or to register call Karen Taylor at 206.895.9005. Location Seattle, WA.

Eleventh Annual Primary Care Conference Pharmacology and Current Topics

March 22, 1996. Mukogawa-Fort Wright Conference Center, Spokane, WA. For more information call Susan Norwood at 509.328.4220 Ext 3246 or fax 509.324.5827.

Center for Health Training Reproductive Health `96 Conference

March 27-29, 1996. The Center for Health Training (TCHT) will hold its annual continuing education conference for nurse practitioners, physician assistants, nurse midwives, nurses and physicians involved in women's health at the Red Lion Hotel/Bellevue, Washington. Pharmacology CEs will be offered. For additional information please call TCHT at 206.447.9538.

Psychopharmacology of Anti-Depressants Seminar

April 20, 1996. This Saturday seminar for psychosocial/mental health clinical specialists and ARNPs will address a variety of topics related to the use of antidepressants. How do abnormal lab values affect prescriptive decisions? What is the role of polypharmacy in treating depression: Where do antidepressants fit in with hormone replacement therapy for perimenopausal and menopausal women? A panel of practitioners will discuss prescribing for the depressed patient using selected case studies. The panel members will facilitate discussion groups at the luncheon. Contact Pacific Lutheran University CCNL, Phone 206.535.7683, Fax 206.535.7590, Internet bennettl@PLU.edu.

Washington State Chapter of the National Association of Pediatric Nurse Associates and Practitioners

May 2 &3, 1996. This seminar is titled “Pediatric Update 1996” Keeping our Kids Safe and Healthy”. CEUs: May 2-7.2 advanced practice credits, May 3-7.0 pharmacology credits. Location: Shoreline Conference Center. Contact: Susan Kline, phone/fax 206.781.3287, for further information e-mail skline@u.washington.edu.

Current Concepts in Pediatric Acute Care

May 4, 1996. Saturday at Jackson Hall Auditorium in Tacoma, WA. Presented by Mary Bridge Children's Hospital, MultiCare's Department of CME & Pediatric Critical Care, P.S. For more information please call 206.552.1493.

Pharmacotherapeutics for ARNPs

May 17, 1996 Friday. A variety of pharmacotherapeutic topics of interest to all ARNPs specialties will be presented in general and concurrent sessions. Location: Best Western Executive Inn, Tacoma, WA. Contact Pacific Lutheran University CCNL, Phone 206.535.7683, Fax 206.535.7590, Internet bennettl@PLU.edu.

Editorial Information
ARNP Care Office
212 Railroad Ave N, Kent, WA 98032
206.852.9042 Fax 206.480.0002
care@nurse.net

Editors:
Susan Caverly, MA, ARNP
Robert T. Smithing, MSN, ARNP
Madeline D. Wiley, MSN, ARNP

Production Staff:
Melanie Finley, Kelly Libby, &
Pete Mullin
Contributing Editors:
Ted Ritter, MN, ARNP 		Publisher:
Nurse Practitioner Support Services

Ad Information

Copy deadline is the second Tuesday of the month prior to publication. Ads may be accepted later then this on a space available basis. Position Available Ads per insertion of less than 66 words are $45, of 66 to 130 words are $75. Continuing Education Announcements per offering for up to three (3) insertions of a BRIEF description are $35, sponsoring organizations of ARNPs United may publish CE announcements at no charge. New Product Announcements per product for one insertion of 130 words or less are $75. Ad Inserts are $480 for one issue. All ads are subject to space limitations and editing. Call for detailed rate information. Mail copy to ARNP Care, 212 Railroad Ave N, Kent, WA 98032. Phone 206.852.9042. Fax 206.480.0002. E-mail care@nurse.net

Please Join Us

You may believe that because this newsletter arrives every month you are a member of ARNPs United. That is wrong. Since 1989 ARNP Care has been sent to every ARNP in Washington regardless of membership status. This is in imminent danger of stopping due to a lack of funds. Remember the number of members is what makes an organization strong and credible with the legislature and others. So join us today. Individual memberships are $150 per year. Lifetime memberships are $1000. Student currently enrolled in a ARNP program may join for $50 per year. Make your check out to ARNPs United and mail it to: ARNPs United, 212 Railroad Ave N, Kent WA 98032.

Member Thank You!

Thank you for being one of the ARNPs in this state who have joined ARNPs United. Without your support it would not have been possible to have hired a lobbyist and had such a successful legislative session in 1995. It is also clear that without your support the organization would not have been capable of moving forward in developing a solid framework to build on the grassroots efforts of the ARNPs in this state. ARNPs who are not members of ARNPs United have received ARNP Care printed on lavender paper to let them know they are not members.

Nurse Practitioner Support Services
212 Railroad Ave N, Kent, WA 98032. Phone: 253.852.9042 Fax: 253.852.7725
npss@nurse.net
Copyright 1998 Nurse Practitioner Support Services