Brief Description: Granting authority to psychiatric advanced registered nurse practitioners.

Sponsors: Senators Franklin, Prentice, Marr and Jacobsen.

Senate Committee on Health & Long-Term Care
House Committee on Health Care & Wellness

Background: Advanced registered nurse practitioners (ARNPs) are registered nurses with additional formal specialized training in areas such as pediatrics, midwifery, geriatrics anesthesiology, and psychiatry. ARNPs function more independently than registered nurses and assume primary responsibility and accountability for care of their patients. An ARNP can 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 Washington Nursing Care Quality Assurance Commission recognizes a specialty designation for psychiatric nurse practitioners or clinical specialists in psychiatric-mental health nursing.

Individuals suffering from mental illness who are found to be gravely disabled or present a likelihood of serious harm have the right to refuse anti-psychotic medication unless it is determined that: 1) the failure to medicate may: a) result in a likelihood of serious harm; b) result in substantial deterioration; or c) substantially prolong the length of involuntary commitment; and 2) there is no less intrusive course of treatment than medication in the best interest of the person. The Department of Social and Health Services (department) must adopt rules to address these issues which include an attempt to gain the informed consent of the patient, and the right to refuse anti-psychotic medications for up to 30 days unless there is an additional concurring medical opinion approving medication.

A court can appoint a psychiatrist, psychologist, or physician to examine and testify on behalf of a person who is involuntarily detained. A court 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: A psychiatric advanced registered nurse practitioner is permitted to admit a person to be examined or treated as a patient in a hospital. A psychiatrist, psychiatric advanced registered nurse practitioner, or physician in consultation with a mental health professional with prescriptive authority can provide the concurring medical opinion allowing for administration of anti-psychotic medication when a patient has the right to refuse such medication. A psychiatric advanced registered nurse practitioner can, as an alternative to a physician, offer an opinion as to whether a person's condition constitutes an emergency requiring treatment prior to obtaining a second medical opinion.

A psychiatric advanced registered nurse practitioner is added to the list of health professionals from which a court can appoint, to examine and testify on behalf of a person who is involuntarily detained. A psychiatric advanced registered nurse practitioner is added to the same list of health professionals from which a court must appoint, to testify if an order for electroconvulsant therapy is sought.
         

Votes on Final Passage:

Senate      45   0
House      93   0   (House amended)
Senate      44   0   (Senate concurred)

Effective: June 12, 2008