Public Records & Notices View a complete day’s public records and notices at memphisdailynews.com. www.chandlerreports.com Thursday, February 20, 2020 MemphisDailyNews.com Vol. 135 | No. 29 Rack–50¢/Delivery–39¢ Advanced nurses ready another fight to practice without doctor oversight JANE ROBERTS So, this year, for the fourth transition times, have passed authority to practice without a su- that advance-practice nurses Courtesy of The Daily Memphian time since 2014, a battle is pitched in 23 states and the District of pervising doctor’s authority. have to jump through,” said Tina More than three years ago, in the Tennessee Legislature to al- Columbia. Under current law, doctors Gerardi, TNA executive director. advanced-practice nurses and the low nurse practitioners and other The fight, led by the Tennessee must sign off on 20% of patient “It hasn’t proven to affect patient doctors who supervise them in advanced-level nurses to work Nurses Association, is designed charts and visit the clinic where care or outcomes. The review Tennessee agreed to try to work without physician oversight, in- to give nurse practitioners, nurse the care is being provided at least comes after the care has already out their differences. cluding prescribing drugs. anesthetists, certified midwives once a month. been provided; the diagnosis and They couldn’t. Similar laws, some with and clinical nurse specialists the “It’s not effective. It’s a hoop NURSES CONTINUED ON P2 May International Festival.“I don’t think there’s go- ing to be any massive reveal of new imagery that Tom Lee Park design retooled to feels very different from what you’ve already seen. It will just be modified relative to the constraints,” said Kate Orff, principal of the New York and New Orleans landscape architecture firm Scape.“Taking suit mediation, Corps of Engineers into account these two larger factors – the results of mediation and the kind of Army Corps constraints – by May we hope to have a plan that is checking ev- ery box,” said Orff.Scape founder Orff, Studio Gang principal William Emmick and design team mem- bers are in Memphis Tuesday and Wednesday, Feb. 18-19, to meet with the partnership, City Council members and administration, the Corps of Engi- neers and the team designing a new Memphis Brooks Museum of Art on Front Street.It’s their first visit since the partnership and Memphis in May agreed in December to design criteria assuring the festival’s future in the park while improving it for year-round visitors. The agreement ended nine months of me- diation ordered by Memphis Mayor Jim Strickland. The agreement spelled out adequate stage and view- ing areas for Beale Street Music Festival, provisions for the World Championship Barbecue Cooking Contest and facilities for staging the events, which draw tens of thousands each May.“What we will be making modifications to are primarily just the sizes and the locations of these large, open, generous lawn areas, ensuring as we did with the previous theme, generous truck access and staging access, for these big events,” Orff said. Mediation ditched a plan to convert four-lane, divided Riverside Drive into one lane in each direc- tion, but left intact a design theme of using landscap- ing and land forms to break up the park into distinct “rooms.”An expanded area honoring the legacy of park namesake Tom Lee would join a centrally lo- cated cluster of multipurpose athletic courts and a Tom Lee Park’s key designers, Kate Orff of Scape and William Emmick of Studio Gang, visit Beale Street Landing on Tuesday, Feb. nature area with a tower on the river at the 30-acre 18, 2020. The pair are in town this week to meet with stakeholders about the park’s redesign. (Mark Weber/Courtesy of The Daily Memphian) park’s south end. Orff and Emmick said the high level of detail in the MRPP-MIM mediation agree- WAYNE RISHER million project. and Army Corps of Engineers policy. ment had simplified the design process.“For us, it’s Courtesy of The Daily Memphian Principals in the two main consult- But the details should be familiar to a great point because it means we are charged, we The redesign of Tom Lee Park be- ing firms, Studio Gang and Scape, said those who were paying attention during have our marching orders and we’re ready to de- gan in earnest this week as consultants Tuesday they’re focused on delivering a a year-long feud between the Memphis liver this revised concept,” Orff said. picked up where they left off last spring new park design by May that’s consistent River Parks Partnership and Tom Lee when a civic controversy stalled the $60 with results of city-ordered mediation Park’s big-ticket user, the Memphis in TOM LEE PARK CONTINUED ON P3 INSIDE Public Records ................ 4 Public Notices ............... 14 memphisdailynews.com chandlerreports.com Marriage licenses are unavailable ©2020 The Daily News Publishing Company A division of The Daily News Publishing Company while Shelby County Clerk’s O ce Memphis, Tennessee The standard for premium real estate Established 1886 • 135th year information since 1968 reviews internal policies for its digital Call 901.523.1561 to subscribe Call 901.458.6419 for more information platforms. Page 2 MemphisDailyNews.com Thursday, February 20, 2020 I SHOULD PROBABLY GET A RIDE HOME. Kailee M. BUZZED DRIVING IS DRUNK DRIVING Everything you say and do creates an impact. becauseofyou.org NURSES CONTINUED FROM P1 close the next one is,” he said.He also says the cost could be mitigated if the nurse’s treatment plan has been made; treatment practice were connected by telemedicine has been given. After 30 days are complete, for the requisite approvals. the doctor is looking at the charts.”The The TNA bill in the Senate was intro- oversight and red tape, she says, not only duced by Jon Lundberg, a Republican from increase the cost of care for the patient be- Bristol. cause the nurses in private practice have The House sponsor is Bob Ramsey, a Re- to pay for the oversight, but the mandate publican from Maryville.Nationally, the is- requires physicians to take time away from sue started showing up in statehouses after their own clinical practices to conduct the the Patient Protection and Affordable Care reviews. “We’ve heard figures of $1,000 to Act was passed in 2010. $5,000 a month for the review. If you run One of its tenets was to lower the cost your own clinic or practice, that is a signifi- of health care by creating more training cant amount,” said Gerardi, who notes that opportunities for nurse practitioners.From mandatory supervision for other members the mid-1990s to mid-2000s, the number of the medical team, including pharmacists of advanced-practice nurses increased and physical therapists, is not required. 9% per capita compared to 1% for primary She says it’s a power play to keep nurses care physicians, according to data from the under physician control.Dave Chaney, vice TNA.“Some of nurse practitioners trained president of the Tennessee Medical Asso- before 2010 were very well trained,” said Dr. Family nurse practitioner Kristen Anderson of New Life Medical Center checks the vitals of a ciation, says doctors in Tennessee “feel we Purvi Parikh, board member of Physicians patient in Lakeland. Advanced-practice nurses are seeking more autonomy to treat patients need more collaboration, more integration for Patient Protection, a grassroots group without the mandatory burden of phyisician oversight. (Courtesy of The Daily Memphian) and coordination in health care, not less.” of doctors, retired doctors and medical “The entire industry is moving to more students fighting against less supervision They will say, ‘They are not educated the 10 states where laws have been changed to integrated care. Everyone has an important for nurses.“Our concern is legislators are same; they don’t have the clinical hours.’ allow advanced-practice nurses to practice role to play on the team,” Chaney said.Data legislating the practice of medicine rather They can’t show you the data,” Gerardi said. without supervision, legislators mandated show the team approach costs less and de- than it coming through the proper chan- “They can’t show data that shows the qual- a range of 1,000 to 4,000 hours of supervi- livers higher-quality care because there are nels of education, training and licensure,” ity of care is abhorrent because it doesn’t ex- sion first. TNA, starting at the low end for fewer opportunities for misdiagnoses, un- Parikh said. Last year, Gov. Bill Lee included ist. We have evidence-based data to support negotiation purposes, has proposed 1,400 necessary testing and complications that $8 million in his budget to pay to train more what we want to do.” Research published in hours in Tennessee, Gerardi said. could have been preventable, he said. In ru- doctors in Tennessee. 2014 by the Department of Veterans Affairs “We have always said if the TMA gave us ral areas, Chaney said, the danger is that the “Patient quality and patient outcomes Health Service Research & Development a reasonable proposal, we would be willing nurses may have to treat a complex medical are the same,” Gerardi said about met- found in primary and urgent care settings, to sit down and talk to them as a compro- issue and have no recourse but to later send rics that break down care by the type of there was no difference in health status, mise,” Gerardi said. “That’s what we are the patient to the nearest hospital.“With provider.