By The Star Staff
Susan Figueroa González, president of the Nursing Professionals Association of Puerto Rico (CPEPR by its initials in Spanish), wrote to Alliance gubernatorial candidate Juan Dalmau Ramírez this week instructing him on the qualifications of the advanced practice nursing with a specialty in nurse practitioner, after he publicly opposed a bill allowing those professionals to prescribe medications on the island.
Figueroa González, who represents 40,000 nursing professionals, reacted with surprise and disappointment at Dalmau Ramírez’s position during the recent forum of candidates for governor on health proposals organized by the Physicians and Surgeons Association of Puerto Rico.
The pro-independence candidate stated that allowing nurse practitioners to prescribe medications “is an external concept that they want to bring to Puerto Rico, like so many others, and I do not agree that that is the case.”
“We assume, from your response, that you did not have the necessary information to answer adequately and correctly,” Figueroa González said. “Through this letter, we would like to advise you on who nurse practitioners are, their academic preparation, functions established by law and what was proposed in [Senate][ Bill 1390.”
According to Figueroa González’s letter, the measure filed during the most recent legislative session proposed amendments to Law 247-2004, known as the Puerto Rico Pharmacy Law, to recognize the figure of the nurse practitioner as a prescriber authorized to issue prescriptions.
“It is important that Dalmau and the other candidates for governor know that Law 254-2015, which regulates the practice of nursing, authorizes nurse practitioners to issue prescriptions and medication orders under a collaborative agreement with a duly licensed physician, as long as the medications are not listed under category I and II of the Controlled Substances Law,” she said. “However, the Pharmacy Law has never been tempered to recognize the statutory faculty of these health professionals.”
She added that the aforementioned nursing professionals, as defined by law, have a license from the Nursing Examining Board in the generalist category and a doctorate degree in clinical nursing practice, a master’s degree in nursing with a focus on advanced practice, or a postgraduate certification, after having a master’s degree in nursing with a focus on advanced practice. This category includes practice specialties such as clinical specialist, obstetrics-midwifery, anesthesia, nurse practitioner and any other specialty that emerges within the concept of advanced practice.
“Advanced practice personnel must have academic training in pathophysiology, physical examination and advanced pharmacology, from an institution recognized by the Puerto Rico Education Council and the Nursing Examining Board,” Figueroa González said in her letter. “In addition, they must have passed a revalidation issued by the Board of Examiners, or have a certification from the American Nurses Credentialing Center, American Academy of Nurse Practitioners, American Association of Nurse Anesthetists or another specialized association in the corresponding area recognized by the Board of Examiners of Nursing, to obtain a license in this category.”
The CPEPR president added that nurse practitioners can perform advanced physical examinations, issue orders for laboratories, sonograms, x-rays, nuclear medicine studies, electrocardiograms, pulmonary function tests, diagnostic tests, cervical cancer screening, prostate cancer and skin biopsy, among other studies. Likewise, they are authorized to establish treatment plans according to the needs of patients and previously approved by a physician through collaborative agreements between a physician and a nurse practitioner.