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4 N A T I O N A L N U R S E W W W . N A T I O N A L N U R S E S U N I T E D . O R G A P R I L | M AY 2 0 1 5 MINNESOTA M innesota nurses are opposing a state legislative proposal that could have damaging repercus- sions for the scope of practice of RNs throughout the country. The bill creates a certification for "Community Emergency Medical Techni- cians" and authorizes them to perform duties normally assigned to nurses, including inter- ventions intended to prevent avoidable ambulance transportation or hospital emer- gency department use, care coordination, diagnosis-related patient education, and population-based preventive education. Similar proposals have been floated in Cali- fornia and other states, which National Nurs- es United views as ill-conceived stop-gap approaches to public health instead of invest- ing in and hiring more registered nurses. The author, Rep. Tara Mack, says her goal is to prevent hospital readmissions by sending a CEMT to visit a patient within a day of discharge from the hospital. But the bill doesn't specify what CEMTs can and cannot do, creating the potential for CEMTs to infringe on the work RNs are trained, qualified, and prepared to do. The Minnesota Nurses Association shares the goal of improving public health by giving patients more time and more care, but nurses are concerned that the new CEMT would usurp the duties of a public health nurse, which CEMTs are not educat- ed or trained to do. MNA members gave powerful testimony at a March legislative hearing on the bill, raising serious concerns. "The core problem isn't how can we take better care of patients at home," MNA member and RN Stacy Enger testified. "What we really need to address here is how we can take better care of patients before they ever leave the hospital. We need to make sure nurses, doctors, and staff have the time they need to assess, educate, and coun- sel every patient properly when they're discharged. We're so rushed at the hospital handling more and more patients at one time that the basic chores of taking care of people are slipping by. Every extra hour somebody can spend with a patient before they go home means 10 hours saved in their recovery time and their time asking for help again on how to get better. In many cases, that means calling 911 again." MNA member and RN Carolyn Jorgenson was so concerned about the issue she wrote a blog, saying, "RNs value and support the important work EMTs perform. They are a critical part of our healthcare system. However the bill in the Legislature does not reduce read- missions; and it could put patients in jeopardy." Jorgenson, who's been a nurse for more than 36 years, pointed out there are signifi- cant differences in the training and educa- tion that RNs and EMTs receive. "EMTs and paramedics are very knowl- edgeable about emergency treatment and medicines," according to the blog. "Do they know about medication and treatment for chronic diseases?" "We are concerned this idea could gain traction in more states," said MNA President Linda Hamilton, RN. "RNs must protect their licenses and their patients." —Barb Brady NEWS BRIEFS Minnesota Community EMT proposal endangers RN scope