Court Opinion

ID: 9880295
Source: CourtListenerOpinion
Date Created: 2023-09-27 19:11:54.573044+00
Date Added: 2024-06-11T07:48:11.802615
License: Public Domain

CADY, Chief Justice
(dissenting).
I respectfully dissent. I would affirm the decision of the district court.
Our legislature authorized the Iowa Board of Nursing (Board) to enact rules governing the nursing profession, including rules that address what constitutes the practice of the profession of a registered nurse. In addition to other acts, the Board may authorize registered nurses to *844perform acts “which are recognized by the medical and nursing professions ... as being proper to be performed by a registered nurse.” Iowa Code § 152.1(6)(d) (2009). Our legislature directed that both professions must recognize the act as proper for registered nurses to perform.
The question in this case is whether the nursing board properly found that the supervision of fluoroscopy by registered nurses is recognized by the medical profession as being proper for registered nurses to perform. The question is not whether the Board disagrees or agrees with the medical profession, but whether the medical profession approves the procedure as proper, for registered nurses.
The medical profession clearly does not approve the procedure at issue. Every Iowa medical professional society, board, or association that has weighed in on the question in this case has concluded the procedure should not be approved for registered nurses. The evidence to the contrary is merely anecdotal and basically limited to some opinions from individual doctors, and evidence that numerous hospital credentialing committees in Iowa have credentialed individual registered nurses to supervise fluoroscopy. See Iowa Admin. Code r. 481 — 51.5(4).
There can be no doubt that the evidence in support of the Board action falls far short by any standard as a voice of the medical profession. Credentialing committees are not only comprised of physicians, but also include hospital administrators and medical staff personnel. Their collective voice is not the voice of the medical profession. Additionally, credentialing committees only address questions of the qualifications of individuals to perform particular procedures. A credentialing committee does not address the larger issues identified by the legislature in section 152.1(6) of whether the medical profession as a whole has approved a procedure as being properly performed by registered nurses.
Registered nurses may be qualified to supervise fluoroscopy. Yet, the legislature has left it for the medical profession to make this decision, in partnership with the nursing profession. The legislature, however, did not leave it to the nursing board to decide. The Board clearly acted well beyond its authority, contrary to a clear legislative directive.