The American Nurses Association (ANA) hailed today’s  Iowa Supreme Court decision affirming Advanced  Registered Nurse Practitioners’ (ARNPs) ability to supervise a certain high-tech X-ray and imaging procedure as a victory for Iowa residents, who will benefit from having broader access and choice in obtaining important health care services.

The appeal to Iowa’s highest court by three nursing organizations was spurred by an Iowa District Court judge’s ruling that supervision of fluoroscopy was not “recognized by the medical…profession as proper to be performed by the registered nurse,” as required by Iowa Nursing Law. Fluoroscopy is a real-time X-ray imaging technique used to guide a variety of diagnostic and interventional procedures. The legal issue involves “scope of practice” – the range of services that nurses are educated and licensed and/or certified to provide.

 “We believe the district court erred in second-guessing the department of public health and nursing board on the adequacy of ARNP training to supervise fluoroscopy,” the Iowa Supreme Court wrote.  “Significantly, nowhere in the voluminous record is there any report of an injury resulting from ARNP-supervised fluoroscopy, although the practice has been ongoing in parts of Iowa for many years. The record affirmatively shows ARNPs have been safely supervising fluoroscopy and are adequately trained to do so…[A]llowing ARNP supervision of fluoroscopy improves access to health care for rural Iowans and helps lower costs.”

ANA President Karen A. Daley, PhD, RN, FAAN, commended the decision for recognizing Iowa ARNPs’ appropriate scope of practice. “In today’s high-demand health care environment, we need nurses and all other health care professionals working to the top level of their capabilities and licenses. The court’s decision will help Iowans get the health care services they need in a timely, efficient, and effective way.”

The Iowa Nurses Association (INA) had initially intervened in the case along with the Iowa Association of Nurse Anesthetists on the side of the Iowa Board of Nursing, which defended its regulation against claims of illegality by the Iowa Society of Anesthesiologists and the Iowa Medical Society.  The Board of Nursing ultimately appealed the decision by the district court that invalidated the Board’s regulations providing educational requirements for ARNPs to order and supervise fluoroscopy, and INA again intervened. 

ANA has supported its state affiliate, INA, in the legal actions. An ANA member, attorney Lynn Boes, represented INA in the appeal.