Oklahoma bill that would allow nurses to prescribe drugs heads to Gov. Stitt's desk

A bill allowing nurse practitioners, clinical nurse specialists and nurse midwives to prescribe medications in Oklahoma is headed to the governor's desk.

Advocates of the bill say the change allows nurses to work within their scope to improve access to health care in rural Oklahoma, but critics say it expands scope too far.

First introduced last year, Senate Bill 458 would allow prescriptive authority for a licensed advanced nurse recognized by the Oklahoma Board of Nursing as a certified nurse practitioner, clinical nurse specialist or certified nurse-midwife who has not obtained independent prescriptive authority.

Nurses could have prescriptive authority without needing the medical direction of a supervising physician after they complete a minimum of 6,240 hours of practice with supervised prescriptive authority.

The bill would allow nurses to order, select, obtain and administer schedules III through V controlled dangerous substances. That would mean a nurse could give a patient anabolic steroids, valium or Robitussin without physician supervision, but not oxycodone or Adderall.

SB 458 passed the Senate in a 33-13 vote on Tuesday.

Do other states allow nurses to prescribe drugs? Is it safe?

According to a study from Stanford Medicine, 32 states allow nurse practitioners to prescribe medications without physician supervision.

The study found that nurse practitioners are no more likely than primary care physicians to inappropriately prescribe drugs to older patients.

More: Where are the nation’s primary care providers? It’s not an easy answer

Researchers analyzed the prescribing patterns of over 73,000 primary care physicians and nurse practitioners in 29 states where nurse practitioners had prescriptive authority.

They calculated and compared rates of inappropriate prescribing to older patients by nurse practitioners and primary care physicians and found that both groups averaged approximately 1.7 inappropriate prescriptions for every 100 prescriptions written.

Why did Sen. Brenda Stanley write Senate Bill 458?

The author of SB 458, Sen. Brenda Stanley, R-Midwest City, said she wants nurses to be able to provide care within their scope of practice.

She told The Oklahoman her goal was to expand access to health care providers and lower the administrative cost of health care in Oklahoma, which she said the bill accomplishes both objectives.

"By bringing Oklahoma into alignment with the national standards for APRN practice, we will be more competitive when it comes to recruiting and retaining these critical health care professionals," Stanley said.

During debate, Sen. Darrell Weaver, R-Moore, argued that legislation cannot provide the education necessary to qualify nurses for providing prescriptions.

More: Physician assistant, nurse practitioner or doctor: What patients should know

Both Weaver and Sen. Jessica Garvin, R-Duncan, said the bill would expand the scope of practice for nurses despite arguments from Stanley.

Garvin said the bill's language leaves unanswered questions.

"It's hard for me to vote 'yes' on a bill that would give them more authority, expanding their scope," Garvin said. "Even though it's being said that's not what we're doing here, it is what we're doing here."

Health care shortage in rural Oklahoma

In Oklahoma, all but two Oklahoma counties are considered partially or entirely shortage areas for primary care.

Stanley said she hopes the bill would aid health care shortages in rural Oklahoma.

In her statement to The Oklahoman, she cited the 70% increase of nurse practitioners in rural Arizona after the state passed similar legislation to SB 458.

Julie Daniels, R-Bartlesville, said there's a shortage of primary care physicians in her community, adding that she's grateful for the advanced practice registered nurses in Bartlesville.

Advocating for the bill's passage, she said she needs someone to rely on in her community, like nurse practitioners, to provide prescriptions

"We need to always be looking to improve delivery and access for everyone in every community," Daniels said.

This article originally appeared on Oklahoman: SB 458 allowing nurses to prescribe drugs passes, heads to governor