Assembly Bill No. 78–Assemblymen Dini,
Anderson, Price, Bache, Buckley, Chowning, Gibbons, Giunchigliani, Goldwater,
Humke, Koivisto, Marvel and Perkins
February 9, 2001
____________
Referred to Committee on Commerce and Labor
SUMMARY—Authorizes nurses to accept direction from
physicians’ assistants. (BDR 54‑153)
FISCAL NOTE: Effect on Local Government: No.
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EXPLANATION
– Matter in bolded italics is new; matter
between brackets [omitted material] is material to be omitted.
Green numbers along
left margin indicate location on the printed bill (e.g., 5-15 indicates page 5, line 15).
AN ACT relating to health care; revising the definitions of “practice of practical
nursing” and “practice of professional nursing” to specify that a nurse may
accept direction from a physician’s assistant; authorizing a registered nurse
to possess and administer certain drugs and medicines at the direction of a
physician’s assistant; and providing other matters properly relating thereto.
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
1-1 Section 1. NRS 632.017
is hereby amended to read as follows:
1-2 632.017 “Practice
of practical nursing” means the performance of
1-3 selected acts in the care of
the ill, injured or infirm under the direction of a
1-4 registered professional
nurse, an advanced practitioner of nursing, a
1-5 licensed physician, a licensed physician’s assistant, a
licensed dentist or a
1-6 licensed podiatric
physician, not requiring the substantial specialized skill,
1-7 judgment and knowledge
required in professional nursing.
1-8 Sec. 2. NRS 632.018 is hereby amended to read as follows:
1-9 632.018 “Practice
of professional nursing” means the performance of
1-10 any act in the observation,
care and counsel of the ill, injured or infirm, in
1-11 the maintenance of health or
prevention of illness of others, in the
1-12 supervision and teaching of
other personnel, in the administration of
1-13 medications and treatments
as prescribed by an advanced practitioner of
1-14 nursing, a licensed
physician, a licensed physician’s
assistant, a licensed
1-15 dentist or a licensed
podiatric physician, requiring substantial specialized
1-16 judgment and skill based on
knowledge and application of the principles of
1-17 biological, physical and
social science, but does not include acts of medical
1-18 diagnosis or prescription of
therapeutic or corrective measures.
2-1 Sec. 3. NRS 454.213 is hereby amended to read as follows:
2-2 454.213 A drug or medicine referred to in NRS 454.181
to 454.371,
2-3 inclusive, may be possessed
and administered by:
2-4 1. A practitioner.
2-5 2. A physician’s assistant
at the direction of his supervising physician
2-6 or a licensed dental
hygienist acting in the office of and under the
2-7 supervision of a dentist.
2-8 3. Except as otherwise
provided in subsection 4, a registered nurse
2-9 licensed to practice
professional nursing or licensed practical nurse, at the
2-10 direction of a prescribing
physician, physician’s assistant, dentist,
2-11 podiatric physician or
advanced practitioner of nursing, or pursuant to a
2-12 chart order, for
administration to a patient at another location.
2-13 4. In accordance with
applicable regulations of the board, a registered
2-14 nurse licensed to practice
professional nursing or licensed practical nurse
2-15 who is:
2-16 (a) Employed by a health care agency or health care facility that
is
2-17 authorized to provide
emergency care, or to respond to the immediate
2-18 needs of a patient, in the
residence of the patient; and
2-19 (b) Acting under the direction of the medical director of that
agency or
2-20 facility who works in this
state.
2-21 5. An intermediate
emergency medical technician or an advanced
2-22 emergency medical
technician, as authorized by regulation of the state
2-23 board of pharmacy and in
accordance with any applicable regulations of:
2-24 (a) The state board of health in a county whose population is less
than
2-25 100,000;
2-26 (b) A county board of health in a county whose population is 100,000
or
2-27 more; or
2-28 (c) A district board of health created pursuant to NRS 439.370 in
any
2-29 county.
2-30 6. A respiratory therapist
employed in a health care facility. The
2-31 therapist may possess and
administer respiratory products only at the
2-32 direction of a physician.
2-33 7. A dialysis technician,
under the direction or supervision of a
2-34 physician or registered
nurse only if the drug or medicine is used for the
2-35 process of renal dialysis.
2-36 8. A medical student or
student nurse in the course of his studies at an
2-37 approved college of medicine
or school of professional or practical
2-38 nursing, at the direction of
a physician and:
2-39 (a) In the presence of a physician or a registered nurse; or
2-40 (b) Under the supervision of a physician or a registered nurse if
the
2-41 student is authorized by the
college or school to administer the drug or
2-42 medicine outside the
presence of a physician or nurse.
2-43 A medical student or student
nurse may administer a dangerous drug in the
2-44 presence or under the
supervision of a registered nurse alone only if the
2-45 circumstances are such that
the registered nurse would be authorized to
2-46 administer it personally.
2-47 9. Any person designated by
the head of a correctional institution.
2-48 10. An ultimate user or any
person designated by the ultimate user
2-49 pursuant to a written
agreement.
3-1 11. A nuclear medicine
technologist, at the direction of a physician
3-2 and in accordance with any
conditions established by regulation of the
3-3 board.
3-4 12. A radiologic technologist, at the direction
of a physician and in
3-5 accordance with any
conditions established by regulation of the board.
3-6 13. A chiropractic
physician, but only if the drug or medicine is a
3-7 topical drug used for
cooling and stretching external tissue during
3-8 therapeutic treatments.
3-9 14. A physical therapist,
but only if the drug or medicine is a topical
3-10 drug which is:
3-11 (a) Used for cooling and stretching external tissue during
therapeutic
3-12 treatments; and
3-13 (b) Prescribed by a licensed physician for:
3-14 (1) Iontophoresis; or
3-15 (2) The transmission of drugs through the skin using ultrasound.
3-16 15. In accordance with
applicable regulations of the state board of
3-17 health, an employee of a
residential facility for groups, as defined in NRS
3-18 449.017, pursuant to a
written agreement entered into by the ultimate user.
3-19 16. A veterinary technician
at the direction of his supervising
3-20 veterinarian.
3-21 17. In accordance with
applicable regulations of the board, a registered
3-22 pharmacist who:
3-23 (a) Is trained in and certified to carry out standards and practices
for
3-24 immunization programs;
3-25 (b) Is authorized to administer immunizations pursuant to written
3-26 protocols from a physician;
and
3-27 (c) Administers immunizations in compliance with the “Standards of
3-28 Immunization Practices”
recommended and approved by the United States
3-29 Public Health Service
Advisory Committee on Immunization Practices.
3-30 H