A written cooperation agreement between a PN and a doctor is required. The plan describes procedures for consultation or referral to cooperating physicians or other health care professionals, as indicated by a patient`s health needs. The agreement must include the availability of the co-operative physician for consultation or referral or both, collaborative practice management methods, protocols for normative authority, satisfaction of a patient`s health needs in the event of a lack of emergency nurse or doctor, and quality assurance. Ark. Code Ann. 17-87-102, Ark. Code Ann. No. 17-87-310 What if we had repealed the mandatory cooperation agreement in 2017? Well, nurses would continue to work with their employer doctors, their fellow doctors and their nurses` colleagues, as they have done for 20 years. NPs would continue to work for doctors, clinics and hospitals. No nurse has changed anything. So why get rid of me? Some very good things would happen in Arkansas if this requirement were removed. What, can you ask? Well, some nurses want to practice in their small rural communities and would open a clinic where no one else wants to work.

However, under current legislation, they cannot practice it if they cannot find a collaborative doctor. What happens when an NP has its own clinic in a rural community and its employees retire? They cannot stay in this practice if they cannot find another doctor who meets the requirements of a collaboration agreement. Has it ever happened before? Yes, yes. A rural Arkansas SE NP had to close her practice in the Delta when her collaborative doctor retired. It was the only supplier in the region to serve thousands of Arkansans. We see that the clinics that belong to the PNs are closed because of this barrier. If nurses can practice in underserved areas, access to care in these areas is increased. Some call it full practice Authority (FPA); Nurses practice what they have educated, licensed and certified to do, nothing more. Does this mean that a nurse will have to open their own clinic? No way. A federal Senate committee failed because of a bill that would have given Arkansas nurses the power to write prescriptions without a practice agreement with a licensed physician. Licensing information is available from the Arkansas State Board of Nursing.

ASBN is available by email (humanservices.arkansas.gov/about-dhs/dms/office-of-long-term-care) or by phone at 501-686-2700. The recommended authority is given to an NP who completes a pharmacology course approved by the Board of Directors and who has a cooperation agreement with a licensed physician. The NP may prescribe drugs and devices in the practical field of NP and prescribe only controlled substances in the III-V scheme.