Nurse Practitioner Association New York State
 Commends Approval of Advance Directive Legislation

Patients Can Now Rely on Nurse Practitioners to Issue
Do Not Resuscitate and Other Life Decision Related Orders 

Nurse practitioner leaders from across New York State are announcing an important legislative change that will have far-reaching impact on patients and families in the state. On November 29th, 2017, Governor Cuomo signed S.1869 (Hannon)/A.7277 (Gottfried), advance directive legislation enabling nurse practitioners to execute orders not to resuscitate and other orders pertaining to life-sustaining treatment, as Chapter 430 of the laws of 2017. 

Chapter 430 amends the Public Health Law to add “attending nurse practitioner” to the list of health care providers with whom patients and families can not only consult, but also look to for assistance in completing certain advance directives, as they contemplate end-of-life decisions. 

“We are pleased and grateful that the Legislature passed, and Governor Cuomo signed, this important legislation,” said Stephen Ferrara, DNP, FNP, FAANP, Associate Dean of Clinical Affairs at Columbia University School of Nursing and Executive Director of the Nurse Practitioner Association New York State. “We extend our thanks and appreciation to the Assembly and the State Senate, the legislation’s sponsors, Senate Health Committee Chair Kemp Hannon (R-Nassau) and Assembly Health Committee Chair Dick Gottfried (D-Manhattan), as well as to Governor Cuomo,” Ferrara added.

“Decisions about life-sustaining treatment and orders not to resuscitate are deeply personal ones,” he continued. “Once this new law takes effect in May 2018, patients can contemplate these decisions in consultation with their primary care provider which, in many instances, is a nurse practitioner, and then actually complete the requisite orders.” 

Close ties to patients
According to the New York State Education Department Office of Professions, approximately 24,000 nurse practitioners are licensed in the state, and many are primary healthcare providers for their patients. With advanced education at the master’s and doctoral level, nurse practitioners are authorized to independently diagnose illness and physical conditions, perform therapeutic and corrective measures, order tests, and prescribe medications, among other responsibilities.
 
“With their education and experience,” says Ferrara, “nurse practitioners not only fully understand the medical conditions of their patients, but also work closely with those patients and their family members, so they’re in a unique position to help them deal with life-sustaining or end-of-life decisions.” 

With nurse practitioners having the authorization to execute these orders “patients are in a better position to make clear and informed choices about advanced directives,” Ferrara explained. Enacting this legislation in New York, he notes, is also consistent with federal policy. In January 2016, Medicare began reimbursing for advance care planning as a separate service provided by health care practitioners – including nurse practitioners, physicians, and others. 

The Nurse Practitioner Association New York State 
Nurse Practitioners (NPs) are registered nurses who have completed advanced education, at a Master’s or Doctorate level, plus additional preparation. These professionals are authorized to independently diagnose illness and physical conditions, perform therapeutic and corrective measures, order tests, prescribe medications, devices and immunizing agents, and refer patients to other health care providers. The Nurse Practitioner Association New York State (NPA), the only statewide professional association of nurse practitioners, promotes high standards of healthcare delivery through the empowerment of nurse practitioners and the profession throughout New York State. For more information, visit: www.TheNPA.org.