Nurse practitioners may no longer perform abortions: Issue of patient safety

By Howard Fischer
Capitol Media Services
Published/Last Modified on Friday, April 4, 2008 3:14 PM MDT


 PHOENIX — Calling it an issue of patient safety, a Senate panel voted Thursday to legally bar nurse practitioners from performing abortions.


 The 4-2 vote came after Michael Urig, a Phoenix obstetrician and gynecologist, told members of the Senate Committee on Public Safety and Human Services he does not doubt they can do uncomplicated procedures, saying he even could train his 17-year-old son to do it.

 He said, though, they are not in any way prepared for the kind of complications that can result from an “invasive surgica procedure.’’ That, he said, requires the kind of training that comes with a four-year surgical residency program.

 But Angela Golden, vice president of the Arizona Nurse Practitioner Council, said people with her kind of specialized training already do complicated procedures, including those that require a patient to be sedated.

 “To suggest that nurse practitioners can’t recognize complications is simply unfair,’’ she said. And Golden, who works in Flagstaff, said any procedure performed in a clinic can result in complications. She told lawmakers that’s when any medical practitioner, doctor, nurse or otherwise, gets a patient to a hospital.

 But the debate in many ways transcends patient safety and spills over into the two perennial political fights.

 One deals with how easy it should be to get an abortion in Arizona. Backers of the measure admit HB 2269 is aimed at Planne Parenthood — and, specifically, at the fact that more than hal the abortions at the organization’s Tucson clinic are performe by a nurse practitioner.

 So far the state Board of Nursing, which generally decides what is the accepted scope of practice of regular and advance training nurses, has yet to rule whether abortions are within the skill set of all nurse practitioners or, at the very least, those with specialized training. This measure, crafted with the help of the anti-abortion Center for Arizona Policy, takes the question out of the hands of the board.

 Urig also admitted after the hearing he not only does not perform abortions but is personally opposed to the practice.

 Foes of the bill have said it will make abortions less available, with Rep. Linda Lopez, D-Tucson, suggesting more pregnant women may turn to self-induced or “back alley’’ abortions.

 The other goes to the fights that doctors traditionally have at the Capitol with other medical specialties over who is qualified to perform certain procedures.

 In previous years those fights have been with groups as diverse as optometrists and chiropractors. Karen Holder, a Flagstaff nurse practitioner, said efforts by doctors to get lawmakers to trim the powers of nurse practitioners “may open Pandora’s Box’’ and start a new turf war.

 The measure, which already has been approved by the House, now goes to the full Senate.

 Figures for 2006 from the state Department of Health Services show there were 10,506 abortions performed in the state. Of that total, 3,088 were non-surgical procedures which involve prescription drugs to induce abortion without surgical intervention.

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