Wisconsin expands nursing practice authority

Editor's Note

Wisconsin nurses—including Certified Registered Nurse Anesthetists (CRNAs)—gain more autonomy under legislation signed August 8 by Governor Tony Evers, according to an August 8 report in the Milwaukee Journal Sentinel.

Under the new legislation, nurse practitioners, clinical nurse specialists, CNRAs and certified nurse-midwives who meet certain qualifications may obtain state board of nursing licensure as advanced practice registered nurses (APRNs), which generally possess authority to prescribe medication and oversee other employees. Licensed APRNs who meet specific criteria, including a minimum of 3,840 hours worked under physician or dentist supervision, can practice independently under the law (nurse mid-wives are exempt from that requirement but must submit plans for births outside hospitals).

According to a press release from the American Association of Nurse Anesthesiology, which supports the move, the law defines CRNA scope of practice to include "providing anesthesia care, pain management care for persons across their lifespan.” APRNs treating pain must work "in a collaborative relationship with a physician" unless the APRN “has qualified for independent practice and is practicing in a hospital/hospital-associated clinic or holds hospital privileges,” the organization reports. 

As reported by the Milwaukee Journal Sentinel, the bipartisan move is intended to address nursing shortages while expanding healthcare access across the state.  Nearly 40% of Wisconsin's primary care provider needs currently remain unmet, according to Kaiser Family Foundation data cited in the report. A 2018 projection indicated Wisconsin will likely require more than 740 additional primary care professionals to meet growing care demand, while primary care physician numbers are expected to grow by just 4% by 2035.

Wisconsin now joins nearly 30 states granting "full practice" authority to advanced practice registered nurses. Under the legislation, as detailed in the article, Wisconsin has approximately 8,000 registered nurses who qualify as APRNs under this law, with about 80% serving as nurse practitioners.

The full report offers additional detail on the background of similar legislative proposals in the state, particularly how the COVID-19 pandemic impacted APRNs' roles.