Advanced practice registered nurses (APRNs) include nurse practitioners, clinical nurse specialists and nurse midwives – and they often serve as primary caregivers to many patients.
Since Sept. 20, 2017, when HB313 (Public Act 100-0513) was signed into Illinois law, certain APRNs have been permitted to practice medicine without the necessity of a written collaborative agreement with a supervising doctor.
Which APRNs can operate without a collaborative physician agreement?
Under this law, advanced practice registered nurses still need a collaborative agreement with a supervising physician except when:
- They have completed 250 hours or more of additional training or continuing education
- They have achieved national certification in their area of practice
- They have completed a minimum of 4,000 clinical hours to gain experience
Once these requirements are met, both the APRN and their collaborating physician must certify in writing that all of the required training is complete. The written declaration must also be made available to the Illinois Department of Financial and Professional Regulation when requested.
What are the limitations to an APRN’s practice under HB313?
While APRNs will be able to order diagnostic testing, diagnose and treat patients, prescribe medications and even provide patient education about medical conditions and treatments, there are some restrictions to their new-found freedoms. For example, while an APRN may introduce themselves as a “doctor” to a patient they see in their clinic, they may not advertise themselves as such and must clarify that they are not an M.D.
Significantly, the law also prohibits APRNs from prescribing Schedule II narcotics, including benzodiazepines or opioids, without a consultation with a physician, which must be recorded in the state’s Prescription Monitoring Program. APRNs and their consulting physicians must also speak at least once a month about the treatment of any patients who receive such drugs. In addition to identifying the specific drugs provided, the APRN is prohibited from administering any Schedule II drugs by injection.
APRNs often pick up the slack in communities that are underserved by medical practitioners as a whole by providing affordable but quality care. If you’re an APRN, it may be wise to seek experienced legal guidance concerning your employment contracts and your prospective joint ventures with your consulting physicians so that you’re fully able to use your education and training to your (and your patients’) best advantage.