One of the crazier parts about doing a blog is choice of material. There are so many things in the news daily, but quite often, it’s just too much to write about everything. Although, we certainly try to do that. Many little things this week have reared their ugly heads, but none so ugly as this year’s legislative session.
This ugliness goes back to the beginning of this blog when I talked about people winning popularity contests. Many politicians “mean well”. However, a lot of interests get ahold of the legislation before it is finalized. While I’m not in every state, I try to be active in my own. Sometimes dealing with our legislature would make a nun mad enough to become a stripper. Many of the bills that roll through are small messages to localities, and some are honest to goodness bills that seek a change in policy.
This year, Utah saw a voter-led ballot initiative to legalize medical cannabis. The Utah Nurse Practitioners association was against this measure. From their site:
Utah Nurse Practitioners was “Unofficially” AGAINST Proposition 2. No, that is not a misprint. The board of directors were in the process of drafting a statement to state that Utah Nurse Practitioners would be against Proposition 2. However, when we discovered that the proposition was being reworked, we held our statement to see what the outcome would be. Then the controversial Prop 2 was voted in. However, the proposition was being reworked by various parties. UNP was not invited to be part of these discussions and nurse practitioners was removed from the bill.
It’s funny because the national association is in favor of this. They reasoned that NP’s were removed from this bill. Because our legislature can tweak ballot initiatives, there was a rework that ended up making the law more palatable for the church which has a huge influence in Utah. The surprise was that NP’s were put back into the law that passed and have that authority to recommend for cannabis cards. To show how popularity contests and special interests play into things, there is a large contingency of social workers in this state that have a lobby. Apparently, they felt like they should have the same privilege…what? Prescriptive authority is just that, and social workers have no clue about medications and medical conditions. Our state NP association let this one slide, and I am not sure why. Now this new session, HB106, seeks to tweak the law again. It mainly adds more diagnosis, many of which there is evidence to support the conditions covered by medical cannabis. Notedly, it also adds psychologists (who never prescribe) and takes away cannabis recommendations from all APRNs and leave them just to APRNs that practice in the psychiatry setting. I work with those folks, and they are great, but most of them couldn’t treat hypertension or chronic pain without a 2 hour look up in a medical text. The bottom line is that these bills are not being thoughtful about who should and should not be prescribing. I am not a fan of non-prescribers such as Social Workers and Psychologists involved in this. They should not be given leeway to “prescribe” here.
New in Utah this year is a bill to give the right to die or Physician-assisted suicide. Basically, a doctor (there is no option of other practitioners) can prescribe medications that can bring about the end of a patient’s life. There are a lot of checks and balances. The patient takes the medications themselves, and they have to make written requests and the MD, of course, is also absolved from responsibility provided that he follows the law. Many states have this, and the NP association has not weighed in on this, yet. The dominant religion that truly runs this state (over 80% of all legislators here are LDS) has already come out against this bill. This means it has the same chance as our nun working in a strip club. There has been no real indication from the NP Association or the Medical Association on this bill.
It is a mixed feeling for me. I spend a lot of time-saving lives, it’s what I was trained to do. I was also trained to let people die with dignity in the manner that they wanted. So, there is the dichotomy. People should be allowed to go in certain situations and in a manner that is gentle and kind. Some medication and into the great sleep is a nicer end than my patient last night who wanted to step in front of a light rail train (on a note, if you feel that way, come get help. You may kill yourself, but that motorman has to live with your death as well).
Well off to tend the bats in my belfry. We will soon be making changes that are exciting, at least to us.