re: SB 435 would allow advanced practice nurses to not work under a physician

The reason NPs won’t allow themselves to fall under the medical board is because they don’t want their scope of practice dictated by the MDs. I can only imagine what NPs scope of practice would be if they fell under LSBME. That’s one of the perks of being a NP vs PA. PAs will never get any autonomy. If MDs want NPs to fall under their rules, doesn’t it seem logical that there should be a NP on the LSBME to ensure that NPs are being treated fairly? It’s a moot point. It’s never going to happen. NPs will continue to stay under the nursing board and as such will determine what their scope of practice will be.

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Actually no I have not read the entire bill. Have your senator?

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I've called his office and sent e-mails to find out if he has. I have.

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There is always a shortage in hospitals and nursing homes.

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Citation?

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What about the ER?

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This is one of the absolute last places I'd want unsupervised nurse practitioners that aren't held to the same standard as a board-certified doc.

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How many Dr. Do you know who are at the nursing home multiple hours a day everyday ?

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A handful. They bounce NH to NH, see patients regularly as required + when needed/asked for by family or nursing staff. And, of course, on the SNF side, at least weekly.

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Advanced Practice Nurses are not just mid-level providers, you are the one saying they are

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In Louisiana, they are mid-level providers. They are trying to remove the title with the bill. The burden of proof that they should do more while being unsupervised is on them.

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They are nurses, who went back to school for a multiple years

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So, in the old days, it required several hundreds to thousands of hours of clinical experience as a nurse before going back. Many programs today are online-only and allow them to attend part-time while remaining employed full-time. Here is Georgetown's online program (as an example). The full-time program is 19 months and requires 650 clinical hours (4 months and 1 week of clinical experience) while the part-time program is 27 months.
Contrasting it with medical school:
Term begins in August and ends in May with 4-6 weeks of off time before restarting in July and running through the following June (22 months) plus an additional, using LSU New Orleans as a guide, 18 months (July of 1 year rolling through to May of the 2nd year following) of clinical rotations. If averaged at 40 hours per week (and that's lowballing most of them), you're talking about ~2880 hours of patient contact before graduating from medical school. Then, you must complete a minimum of an intern year- we average 60 hours per week over a 52 week year with 2 weeks of vacation in my program. That's roughly average. There are about 3000 contact hours there, by those numbers before you are even eligible for a license. As said in a previous post, the LSBME has noted a higher instance of malpractice cases against people with a license that have not completed a residency, so they are currently looking to increase that to completion of a full residency (~9000 patient contact hours) because they don't currently feel that physicians who haven't completed a residency in the State of Louisiana are fit to treat patients.

Now, if this were the days of old where someone had 5-10 years of bedside/ICU nursing experience who was leaving that job to go to school full-time and spend a year or more under a structured academic curriculum for clinical hours, I would tend to think more like you. I still agree with you that they are trained professionals that are very capable- not once have I questioned their ability to do a darn thing. What I want, though, is equal protection under the rules for patients:

They need to be held to the same standard as physicians if they want to practice without physician oversight.

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Do they have stupid ones? YES but we all know Stupid Dr too.

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Another way of stating this argument is to say "Even people at the highest level of training can be less than great, so we should allow people with less than great training to practice at the higher level." I disagree with it because of the double standard. Hold them under one board, and I'm all for it. Make their curriculum more rigorous and have their patient contact hours significantly extended and performed in an accredited academic center rather than with any old Joe Blow doc or NP, and I'd entertain it but still think there should be one board, one standard of care for patients.

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They will be held to the standards of the state nursing board which is hands out punishments much faster than the medical board for malpractice or negligence.

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Anything to support this? My personal experience is the opposite.