Summary:

 House Bill178 (HB178) modifies the Nurse Practice Act to clarify the scope of practice for different categories of licensed nurses regarding the administration of general anesthesia, anesthetics and sedatives while making changes to the licensing process and expanding the powers of the Board of Nursing and modifying the administration of certain disciplinary actions.  

Legislation Overview:

 House Bill178 (HB178) modifies the Nurse Practice Act to clarify the scope of practice for licensed nurses regarding anesthesia, anesthetics and sedatives. 
A new definition is provided to state that an:  "advanced practice registered nurse" means a certified nurse practitioner, certified registered nurse anesthetist or certified clinical nurse specialist licensed pursuant to the Nursing Practice Act, also,  "anesthetics" means a substance that causes the entire or partial loss of the feeling of pain, temperature or other sensations, with or without the loss of consciousness, including topical, local or intravenous anesthetics but excluding general anesthesia and "artificial intelligence" means a broad category of existing, emerging and future digital technologies that involves using algorithms to drive the behavior of agents such as software programs, machines and robotics;

A "certified clinical nurse specialist" means a registered nurse who is licensed by the Board for advanced practice as a certified clinical nurse specialist and whose name and pertinent information are entered on the list of certified clinical nurse specialists maintained by the Board. The term “certified” is new language for this Section. 
Another new term is provided as: "general anesthesia" which means a drug-induced loss of consciousness where: (1)  patients are not arousable, even by painful stimulation; (2)  the ability to maintain an adequate airway and respiratory function is affected; and (3)  the cardiovascular function may be impaired.
Other new language referencing anethesia practice now includes: "sedation" which means the administration of medication to produce various levels of calmness, relaxation or sleep, including: (1)  minimum sedation, during which a patient responds normally to verbal commands and may have impaired cognitive function or coordination and respiratory and cardiovascular functions remain stable; (2)  moderate sedation, during which a patient responds purposefully to verbal commands, either alone or accompanied by light tactile stimulation; respiratory functions remain stable; and cardiovascular functions are usually maintained; (3)  deep sedation, during which a patient cannot be easily aroused but responds purposefully, following repeated or painful stimulation; respiratory functions may be impaired, requiring assistance in maintaining the airway, including intubation and mechanical ventilation; and cardiovascular functions are usually maintained; or (4)  palliative sedation, an end-of-life intervention used to provide a patient with relief of symptoms that cannot be controlled in a tolerable time frame despite the use of therapies and that are unlikely to be controlled by further therapies without excessive, intolerable, acute or chronic side effects or complications, but not to intentionally hasten death.
A modification to  Section 2 of the Act  pertaining to anesthesia is now expanded to include general anesthesia and for a registered nurse currently licensed pursuant to the Nursing Practice Act may, upon the successful completion of required training programs, administer anesthetics or moderate sedation to any person. Reference to completion of training, may administer anesthetics or moderates sedation to any person. 
The Board may now expand inactive status to include designating an inactive reserve category for registered nurses and licensed practical nurses for activation during an emergency for limited functions at no cost to the nurse.
Another modification will now allow the Board to promulgate a rule creating a retired registered nurse license category without a licensing fee for retired registered nurses who can serve on advisory and policymaking community and nonprofit organization Boards.
Also, the Board shall ensure that New Mexico nursing data collected by the Board is owned by the Board, and shall develop and maintain a system that assists all schools of nursing with the coordination of pre-licensure clinical placements.
The Board shall provide a nurse applying for a first-time license a single-state license; and upon renewal, a nurse may apply for a multistate license for an additional fee; and shall promulgate rules establishing standards for the use of artificial intelligence in nursing .
In the area of fees. The charge for a license without testing will now be two hundred dollars. For initial licensure as a certified nurse practitioner, certified registered nurse anesthetist or certified clinical nurse specialist, a fee not to exceed two hundred dollars ($200).
The Board may waive the fee for an initial license for a registered nurse who has graduated from a New Mexico public school of nursing. In addition, the Board may waive the fee for an initial license for an applicant who has graduated from a New Mexico public school of nursing. 
Upon receipt of an application, a fee of one hundred fifty dollars ($150) , a license valid for two years  is to be  issued. Upon initial licensure, or upon renewal, a licensee may apply for a multistate license for an additional fee not to exceed fifty dollars ($50.00). The above application fee has been increased from  $100 to $150. 
New language in regard to disciplinary action now states: all written and oral communications made by any person to the Board relating to potential disciplinary action, including complaints made to the Board, are confidential communications and are not public records for the purposes of the Public Records Act.  
All data, communications and information acquired, prepared or disseminated by the Board relating to actual or potential disciplinary action or an investigation of complaints shall not be disclosed except to the extent necessary for: (1)  carrying out the purposes of the Board; (2)  appealing the actions of the Board to a court of law; or (3)  referring the case to law enforcement agencies, national database clearinghouses or other licensing Boards.





 

Amendments:

 Amended February 12, 2025 in HHHC
HHHCa/HB178: The House Health and Human Service Committee amends the with two changes:
1. On page 9, line 23, strike "or" and insert in lieu thereof ", as ordered by a licensed physician or independent provider or per employing organization protocol, up to and including". 
2. On page 14, strike lines 14 through 16 and insert in lieu thereof: "X. shall provide a nurse applying for a first-time license, or upon renewal of a license, the option for a single or multistate license, which may incur an additional fee; and"., 
and thence referred to the Judiciary Committee.