Mitzi M. Saunders, PhD, APRN, ACNS-BC, president of the National Association of Clinical Nurse Specialists (NACNS) and the Board of Directors issued the following statement strongly opposing the American Medical Association House of Delegates (AMA HOD) recent policy that “certified nurse practitioners, certified registered nurse anesthetists, certified nurse midwives, and clinical nurse specialists shall be licensed and regulated jointly by the state medical and nursing boards.”1(p7)
NACNS embraces collective decision-making based on the best available evidence, health care needs of the present and future, and respect for multiple perspectives before solutions are considered.2 The above referenced policy1 was thoroughly reviewed and provides no existing evidence that oversight by state medical boards at any level of nursing practice would benefit patient outcomes. Such oversight could lead to increasing health care access challenges, increasing health care disparities, and a worsening of patient outcomes created by unnecessary regulation from the boards of medicine in an attempt to govern advanced nursing practice. Professions are autonomous in regulating their own ethical standards, competencies of practice, regulations, and legal standards that align with their educational, certification, and licensure requirements. Nursing is a highly regulated and trusted profession practiced at various levels (RN and APRN) and therefore, only nursing truly understands how to effectively regulate nursing practice.
At this point in time, there is no foundational evidence to support the AMA HOD’s policy. Regulation of nursing licensure (even joint regulation) by a profession outside of nursing poses unnecessary oversight, the risk for incorrect regulation, and potential for harm to patients which must remain central in all decisions that impact nursing practice. The cost of making decisions based on opinions, emotions, beliefs, and preferences instead of evidence-informed decisions might have devastating results for patients.
Respectfully,
NACNS Board of Directors
References
- Geline, R. American Medical Association House of Delegates (A-23) Report of Reference Committee B. Accessed June 23, 2023. https://www.ama-assn.org/system/files/a23-refcomm-b-annotated.pdf
- National Association of Clinical Nurse Specialists. Mission and Goals. Accessed June 23, 2023. https://nacns.org/about-us/mission-and-goals/