Saturday, March 19, 2011

Nurse Practitioners Should Be Able To Determine That A Person Is Dead Or Not

Read the below information and then if you agree, contact your Florida Senator and your Congressmen/women and let them know that you are fed up with Nurse Practitioners not being able to practice according to our full abilities. Come on! Don't you think that I can't figure out if someone is dead? It doesn't take a rocket scientist to know when a patient's heart has stopped beating and that they have stopped breathing. Of course, in ICU settings, brain waves can be checked. 

"Talking Points for ARNP’s to Sign Florida Death Certificates
Support of HB 1067/ SB 1544
* Relating to Death and Fetal Death Registration *
Representative Mayfield/Senator Jones
· This legislation gives Licensed Advanced Registered Nurse Practitioner (ARNP) the authority and responsibility to complete and sign a death certificate unless there is a non-natural cause of death. In the case of a non-natural death, a physician is required to sign the death certificate.
· Currently, only physicians, medical examiners and coroners have the authority and responsibility in Florida. This legislation will require Licensed ARNPs to have been in charge of the deceased patient’s care, and to have completed a special training course regarding the completion of a death certificate.
· ARNPs are registered nurses who have advanced graduate and doctoral education, clinical preparation to provide acute and primary care, diagnose and treat acute and chronic illnesses in a variety of specialties. Under current law, they are able to pronounce death, ascertain the cause of death and provide the medical information required by the death certificate, but by Florida law, they are not authorized to sign the death certificate.
· This legislation stems from combined efforts to get certification done promptly and correctly to ensure timely completion in the final act of patient care and alleviate the burden of a loved one who must wait for a death certificate to be signed. As many of you may know from personal experience with the death of a loved one, the death certificate serves many purposes for the survivors of the deceased.
· There are nearly 15,000 licensed and certified Advanced Practice Nurses in the state of Florida, capable of accurately and completely certifying the cause of death, recognizing natural versus unnatural death, and referring deaths to the medical examiner when appropriate.
· Allowing ARNPs to sign death certificates, including the cause of death section will strengthen the accuracy of vital statistic information required by the state and federal government to guide public health efforts. According to a recent study in the American Journal of Forensic Medicine and Pathology (2010; vol 31(3), 232-5), 48% (N=371) of death certificates issued from Broward County had at least 1 of the 5 types of errors in the cause of death section. ARNPs can help reduce errors as
they are actively involved in the health status of the patient at time of death.
· In Hospice care, The ARNP is designated as the “Attending Physician” and is responsible for care until death and maybe the only licensed provider to examine and care for the individual. Hospice care addresses not only physical, emotional, and spiritual suffering, but provides support to families during the final months of life and in the bereavement period after death.
Allowing the ARNP the authority to sign the death certificate, reduces delays, eases the hardship and strain on the family bereavement process. Some rural communities of Florida, where there is a shortage of physicians, rely on ARNPs to care for thousands of patients.
· Nurse practitioners are often the last caregiver in attendance when a patient dies. If the state deems them qualified to diagnose and treat a person while they are living, it is also logical to grant these qualified and capable health care professionals authority to complete the certificate of death.
· Currently Advanced Registered Nurse Practitioners (ARNPs) are authorized to sign death certificates in Arizona, Connecticut, Iowa (introduced 3/9/11), Maine, Maryland, Massachusetts, Montana, New Hampshire, New Jersey, New Mexico, North Dakota, Oregon, South Carolina, South Dakota, Utah (introduced in 2011) and Washington.
· Since death certificates must be signed within a specific period of time after death, ARNPs would be able to facilitate the delivery of appropriate and timely postmortem care and help ease the impact of death on a patient's family.
· Certified and Licensed Nurse Midwives have long been authorized to sign Florida fetal death who expired during or immediately following birthing.
· The bill is also expected to help reduce patient, estate and state costs by avoiding unnecessary referral to doctors and/or unnecessary autopsies if deemed coroner cases because of inability to locate a physician to sign the death certificate in a timely manner, while remaining sensitive and responsive to the needs of families and loved ones at the time of death."