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After a nearly two-decade battle for advanced practice nurses in the Regis College community and across Massachusetts, a newly signed state law will lift practice restrictions and increase access to care.
Governor Charlie Baker signed the sweeping health care reform legislation on January 1, 2021.
The new law grants nurse practitioners, psychiatric mental health clinical nurse specialists, and nurse anesthetists independent authority over their practice after two years of supervision by a physician or qualified advanced practice nurse. Previously, supervision was required by a physician, limiting the ability of advanced practice nurses to deliver care permitted by their licenses and scope of practice.
“There have been a lot of people rooting for this legislation,” said Mary Ann Hart, director for the health administration graduate program and a registered lobbyist who has represented several nursing professional groups advocating for the legislation. “I think it is going to encourage more nurses to become advanced practice nurses because they will no longer have this barrier to practice.”
Twenty-two other states had already removed practice supervision restrictions, including every state in New England except for Massachusetts. Hart explained numerous factors made supervision requirement a barrier to practice, including a shortage of primary care physicians and psychiatrists to supervise a growing number of advanced practice nurses.
“You needed to get a physician willing to take you on to supervise you, but because there is a shortage of physicians in many specialties, it has gotten more difficult to find physicians willing to take on that responsibility,” said Hart.
Hart, who represented the Massachusetts Association of Advanced Practice Psychiatric Nurses on the most recent push for the legislation, pointed out an increasing number of advanced practice nurses, particularly in psychiatry, simply could not care for their patients because of they were unable to find physician supervisors.
“But attitudes have changed, said Hart. “The evidence shows that health outcomes for patients treated by advanced practice nurses are comparable to those who have been treated by physicians. People in health care are beginning to get that.”
A driving force behind the reform finally getting approved was the decision by the state earlier this year to temporarily lift the physician supervision requirement in response to the COVID-19 pandemic to optimize health care access during the once-in-a-generation public health crisis.
"This critical reform addresses the rising health care needs of patients and regional workforce challenges that were exacerbated by the COVID-19 pandemic," said Diane Welsh, dean of the Young School of Nursing. "Removing practice restrictions further empowers advanced practice nurses, including the next generation of nurse practitioners we educate at Regis College. This new law will increase access to high-quality care during this coronavirus pandemic and its resulting demands on our health care system, and expand access to care into the future.”