Via Community News Service, a University of Vermont journalism internship
Jade Kaplan, a certified nurse-midwife, told Vermont lawmakers that for years, patients have been admitted to the hospital under a physician’s name, even when a midwife is actually the one providing the care.
Kaplan, who works at Northeastern Vermont Regional Hospital in St. Johnsbury, said at some hospitals, a physician’s name may still appear as the provider on paper, even if the patient is cared for by a midwife.
“They will be attended to by the midwife, delivered by the midwife, discharged by the midwife,” she told the House Committee on Health Care on March 18. “They were fully attended to safely by the midwife in her scope of practice. And that data then gets lost.”
S.163 aims to solve that problem. Supporters say the bill would bring state law in line with how hospital care is already being delivered.
S.163, which has been reviewed in both chambers, would update Vermont law to recognize advanced practice registered nurses as providers who can coordinate a patient’s care in a hospital and would be identified as the attending provider.
The bill’s sponsor, Rep. Becca White, D-Windsor-15, said the new legislature is not meant to expand what the nurses are allowed to do; it would simply align state law with what is already seen in practice.
White said she introduced S.163 after hearing from nurses in her district who said existing law does not reflect the work they are trained and authorized to do.
“This would provide consistency within their scope of practice,” she said in an interview with Community News Service.
Michelle Wade, president of the Vermont Nurse Practitioners Association said advanced practice nurses already play a major role in hospitals, particularly in rural areas. She said they have the education, training and legal authority to admit and attend to patients in a hospital setting, but their work isn’t always recognized.
“What we’re really trying to do is clean up bill language,” she told the House Committee on Health Care on March 18.
Jessa Barnard, executive director of the Vermont Medical Society, said the organization took a neutral position on the bill. She said even though S.163 would not change the nurses’ scope of practice, it could still affect how care is structured in hospitals.
“Our members in general do feel like team-based care is the best approach for hospitalized patients,” Barnard told lawmakers on March 18.
She said that current law makes sure that a physician is involved in a patient’s care and that having them as a “touch point” supports a patient’s safety, accountability and care.
Barnard also pointed out that the bill could affect how patients receive insurance, saying that Medicare patients must be under the care of a physician for hospitals to receive payment. She said that if the state law changes, hospitals would need to adjust to comply with those federal requirements.
For White, S.163 is about recognizing the work that advanced practice nurses do in Vermont’s health care system.
“We are willing to make the appropriate technical changes to reflect what their profession does on a daily basis,” she said.
The bill has returned to the Senate with a recommendation for an amendment by the House. If passed, S.163 would take effect on passage.