Nursing Board Revamp Referred Back to Committee

Attempts to gut the nursing board and stitch it back together fell apart in the House Thursday after lawmakers from both sides of the aisle asserted the proposal went too far.

The Board of Nursing will dissolve June 30 without some sort of nod from the Legislature to continue setting standards for the profession. But the board has become notorious for butting heads with the General Assembly.

“In the last two years we’ve been round and round from the abuses of our nurses by that board, period,” said bill sponsor Rep. Tony Shipley, R-Kingsport, who wants to revamp the panel and says some of those issues “have been worked out” in his bill.

“There’s absolutely no retaliatory premise in this,” he continued.

Shipley and Rep. Dale Ford, R-Jonesborough, were the focus of a Tennessee Bureau of Investigation probe for pressuring the Board of Nursing last year to rescind disciplinary action against three area nurses the board had punished for allegedly over-prescribing medication. Ultimately, though, the Davidson County District attorney who requested the TBI investigation ultimately concluded the legislators broke no laws.

The board also went toe-to-toe with Hendersonville Republican Debra Maggart in 2009 and 2010. The fight was over the Legislature wanting to expand authority for administering drugs to nursing-home patients, a rule the board for a time refused to enforce, saying it wasn’t safe for the public. Critics of the board said its members were just trying to protect what they regard as their own turf — that the dispute was more about shielding the economic interests of registered nurses than patient safety.

But House lawmakers in the medical profession said they’re worried SB2313’s requirement that members be chosen geographically from the state’s nine congressional districts is too narrow.

“I think that this bill may have some retaliatory intent, and that does concern me,” said Rep. Joanne Favors, the nursing board’s chief defender and herself an experienced nurse.

Selecting members based on where they live, namely outside urban areas, will mean “problems in the future with selecting people who would be the most representative of what we need in this state,” said the Chattanooga Democrat, contending major nursing schools and hospitals reside in the state’s big cities.

Shipley argues the current board is too “Nashville Basin-centric,” and wants to ensure nurses from rural corners of the state are equally represented on the panel. Members of other professional boards with geographic selection rules usually break up the appointments by the three grand divisions.

The governor currently appoints members to the board with help from recommendations by the profession’s interest groups, such as the Tennessee Nurses Association, which also takes issue with the “geographic distribution being that tightly controlled.”

“If we get hamstrung into doing just the congressional districts, we’ll find qualified people, but… it’s incredibly difficult to find people who have the ability to spend time away from their workplace,” said Sharon Adkins, executive director of the nurses association. She said the association is OK with other terms of the bill, such as shortening the amount of time members can sit on the board.

Pharmacist and state Rep. David Shephard, D-Dickson, and Republican Rep. Joey Hensley, a doctor from Hohenwald, also expressed reservations.

Shephard contends the conflict of interest requirements banning members who have a direct or indirect financial interest in health care services would be too stringent given that nurses naturally benefit from the medical industry. Hensley added he disliked the switch that could weight the board more heavily with advanced practice nurses, a classification of registered nurse.

In a narrow 47-44 vote, lawmakers agreed to send the bill back to the Government Operations Committee, with 14 Republicans siding with the Democrats. The measure cleared the Senate earlier this month on a 20-9 vote, so the ball is entirely in the House’s court.