The Iowa Supreme Court has reversed a district court ruling in a case that pits doctors against nurse practitioners.
Several physician associations, including the Iowa Medical Society, went to court seeking to throw out two administrative rules that permit advanced registered nurse practitioners to supervise technicians during fluoroscopy.
Fluoroscopy uses x-rays to help with the insertion of needles and other procedures.
The physicians argued the Iowa Board of Nursing and the Iowa Department of Public Health exceeded their authority in approving the rules to allow the supervision. The district court agreed, and threw out the rules.
The Iowa Supreme Court ruling says the district court erred in second-guessing the Department of Public Health and nursing board. It says ARNP’s have been supervising the procedure for many years and nowhere in the voluminous record is there any report of an injury resulting from the practice, so the record shows ARNPs are adequately trained to safely supervise fluoroscopy.
The ruling went on to say the visual images provided by the fluoroscopy improve patient safety, and the practice also improves access to health care for rural Iowans while helping lower costs.
Justice Mark Cady wrote a dissent to the opinion, saying registered nurses may be qualified to supervise fluoroscopy, but the legislature has left it for the medical profession to make this decision, in partnership with the nursing profession and did not leave it to the nursing board to decide.
Cady says the nursing board clearly acted well beyond its authority, contrary to a clear legislative directive.
See the full ruling here: ARNP ruling PDF