| Washington State House of Representatives Office of Program Research |
BILL ANALYSIS |
| Health Care & Wellness Committee | |
SB 6739
This analysis was prepared by non-partisan legislative staff for the use of legislative members in
their deliberations. This analysis is not a part of the legislation nor does it constitute a
statement of legislative intent.
Brief Description: Granting authority to psychiatric advanced registered nurse practitioners.
Sponsors: Senators Franklin, Prentice, Marr and Jacobsen.
Brief Summary of Bill |
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Hearing Date: 2/21/08
Staff: Chris Blake (786-7392).
Background:
Advanced Registered Nurse Practitioners
Advanced registered nurse practitioners are registered nurses with additional formal specialized
training in areas such as pediatrics, midwifery, geriatrics anesthesiology, and psychiatry.
Advanced registered nurse practitioners function more independently than registered nurses and
assume primary responsibility and accountability for care of their patients. An advanced
registered nurse practitioner may examine patients and establish medical diagnoses, admit
patients to health care facilities, order and interpret lab tests, implement a plan of care for
patients, prescribe medications and refer clients to other health care practitioners or facilities.
The Nursing Care Quality Assurance Commission recognizes a specialty designation for
psychiatric advanced registered nurse practitioners and clinical specialists in psychiatric-mental
health nursing.
Decisions Relating to the Use of Antipsychotic Medications
Individuals suffering from mental illness who are found to be gravely disabled or present a
likelihood of serious harm have the right to refuse antipsychotic medication. This right can be
overridden if it is determined that the failure to medicate may result in a likelihood of serious
harm or substantial deterioration of the patient or it will substantially prolong the length of
involuntary commitment and there is no less intrusive course of treatment than medication that is
in the best interests of the person. The Department of Social and Health Services (Department)
must adopt rules to address these issues which include an attempt to obtain the informed consent
of the patient and the right to refuse antipsychotic medications for up to 30 days unless there is
an additional concurring medical opinion approving medication.
A court may appoint a psychiatrist, psychologist, or physician to examine and testify on behalf
of a patient at a hearing to authorize the use of antipsychotic medications. A court, however,
must appoint a psychiatrist, psychologist, or physician to testify on behalf of a person
involuntarily detained where an order for electroconvulsant therapy is being sought.
Summary of Bill:
"Psychiatric advanced registered nurse practitioners" are defined as licensed advanced registered
nurse practitioners who are board certified in advanced practice psychiatric and mental health
nursing. Psychiatric advanced registered nurse practitioners are added to the terms "professional
person" and "developmental disabilities professional" who are individuals that perform many of
the evaluation and treatment activities for people in the inpatient mental health system.
Advanced nurse practitioners may admit individuals for examination or treatment as a patient in
a hospital.
As an alternative to a physician, the opinion of a psychiatric advanced registered nurse
practitioner may be used in determining that a person's condition constitutes an emergency that
requires the use of antipsychotic medications prior to the occurrence of a judicial hearing.
A psychiatrist, psychiatric advanced registered nurse practitioner, or physician in consultation
with a mental health professional with prescriptive authority is expressly authorized to provide
the concurring medical opinion to allow for the administration of antipsychotic medication in
short-term treatment situations.
Psychiatric advanced registered nurse practitioners are added to the list of health care providers
who may be appointed by the court to testify on behalf of a patient who is the subject of a
hearing regarding the administration of antipsychotic medications and must be appointed when
the hearing relates to the use of electroconvulsant therapy.
Appropriation: None.
Fiscal Note: Not requested.
Effective Date: The bill takes effect 90 days after adjournment of session in which bill is passed.