Advanced practice registered nurses; authorize to sign death certificates and POLST orders.

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To: Public Health and Human
Services
MISSISSIPPI LEGISLATURE REGULAR SESSION 2026

By: Representative Oliver

HOUSE BILL NO. 1461

AN ACT TO AUTHORIZE AN ADVANCED PRACTICE REGISTERED NURSE 1
(APRN) TO COMPLETE, SIGN AND FILE A CERTIFICATE OF DEATH IF THE 2
APRN WAS THE PROVIDER IN CHARGE OF THE PATIENT'S CARE FOR THE 3
ILLNESS OR CONDITION THAT RESULTED IN DEATH, OR IF THE APRN IS 4
PROVIDING COVERAGE FOR THE PATIENT'S PRIMARY PROVIDER; TO AMEND 5
SECTIONS 41-57-13 AND 41-61-63, MISSISSIPPI CODE OF 1972, TO 6
CONFORM TO THE PROVISIONS OF THIS ACT; TO AMEND SECTION 41-41-302, 7
MISSISSIPPI CODE OF 1972, TO AUTHORIZE AN APRN TO SIGN AND EXECUTE 8
A PHYSICIAN ORDER FOR LIFE-SUSTAINING TREATMENT (POLST) FOR A 9
PATIENT UNDER THE NURSE'S CARE; TO AMEND SECTION 41-41-303, 10
MISSISSIPPI CODE OF 1972, TO CONFORM TO THE PRECEDING PROVISION; 11
TO AMEND SECTION 73-15-5, MISSISSIPPI CODE OF 1972, TO PROVIDE 12
THAT THE PRACTICE OF NURSING BY AN APRN INCLUDES THE AUTHORITY TO 13
SIGN, CERTIFY, OR ENDORSE DOCUMENTS AS REQUIRED BY LAW, INCLUDING 14
DEATH CERTIFICATES AND POLST ORDERS; AND FOR RELATED PURPOSES. 15
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI: 16
SECTION 1. (1) The certificate of death shall be filled out 17
and signed by the physician, the advanced practice registered 18
nurse (APRN), or by the coroner medical examiner in charge of the 19
case. 20
(2) An APRN licensed under Section 73-15-1 et seq. may 21
complete, sign and file a certificate of death if the APRN was the 22
provider in charge of the patient's care for the illness or 23
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condition that resulted in death, or if the APRN is providing 24
coverage for the patient's primary provider. 25
SECTION 2. Section 41-57-13, Mississippi Code of 1972, is 26
amended as follows: 27
41-57-13. (1) Death certificate errors in the recording of 28
personal information of the deceased may be corrected by affidavit 29
of the informant and the funeral director of the funeral home that 30
disposed of the body. Items in the medical certification or of a 31
medical nature may be amended upon receipt of the specified 32
amendment form from (a) the person originally certifying the 33
information or, if deceased or incapacitated, from the person 34
responsible for the completion of such items, or (b) the State 35
Medical Examiner. All other amendments to a death certificate 36
require adjudication by a chancery court in the county of 37
residence of the complainant or in any chancery court district in 38
the state if the complainant is a nonresident. In all such 39
proceedings, the State Department of Health, the State Medical 40
Examiner and the county medical examiner or county medical 41
examiner investigator who certified the information shall be made 42
defendants. No death certificate shall be changed or amended by 43
the State Medical Examiner or any county medical examiner or 44
county medical examiner investigator after he has resigned or been 45
removed from his office as the State Medical Examiner, county 46
medical examiner or county medical examiner investigator. 47
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(2) The local registrar of births and deaths in each county 48
in the state shall, at least monthly, supply the county registrar, 49
the tax assessor and the chairman of the county election 50
commission of each county a list of deaths in the counties of 51
individuals of voting age who have not been previously listed. 52
Such lists shall include the following information for each 53
deceased person: full name (as recorded on the death 54
certificate), social security number, date of death, sex, race, 55
age and usual place of residence. 56
(3) No such payment as is provided for in Section 41-57-11 57
shall be made by the board of supervisors unless and until the 58
local registrar shall certify that a list of all deaths of 59
individuals of voting age has been filed with the county voting 60
registrar, tax assessor and with the chairman of the county 61
election commission of the last county of residence of the 62
decedent in this state. 63
(4) In the event that the decedent is a female, who at the 64
time of her death was between the ages of ten (10) and fifty (50) 65
years old, the physician, advanced practice registered nurse, 66
medical examiner, coroner or other official who certifies the 67
decedent's cause of death shall indicate, where appropriately 68
designated, on the death certificate whether (a) the decedent was 69
pregnant at the time of her death; (b) the decedent had given 70
birth within the preceding ninety (90) days; or (c) the decedent 71
had a miscarriage within the preceding ninety (90) days. 72
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SECTION 3. Section 41-61-63, Mississippi Code of 1972, is 73
amended as follows: 74
41-61-63. (1) The State Medical Examiner shall: 75
(a) Provide assistance, consultation and training to 76
county medical examiners, county medical examiner investigators 77
and law enforcement officials. 78
(b) Keep complete records of all relevant information 79
concerning deaths or crimes requiring investigation by the medical 80
examiners. 81
(c) Promulgate rules and regulations regarding the 82
manner and techniques to be employed while conducting autopsies; 83
the nature, character and extent of investigations to be made into 84
deaths affecting the public interest to allow a medical examiner 85
to render a full and complete analysis and report; the format and 86
matters to be contained in all reports rendered by the medical 87
examiners; and all other things necessary to carry out the 88
purposes of Sections 41-61-51 through 41-61-79. The State Medical 89
Examiner shall make such amendments to these rules and regulations 90
as may be necessary. All medical examiners, coroners and law 91
enforcement officers shall be subject to such rules. 92
(d) Cooperate with the crime detection and medical 93
examiner laboratories authorized by Section 45-1-17, the 94
University of Mississippi Medical Center, the Attorney General, 95
law enforcement agencies, the courts and the State of Mississippi. 96
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(e) Promulgate rules and regulations regarding the 97
manner in which county medical examiner investigators are required 98
to enter electronically the information for all deaths that occur 99
in the investigator's county. 100
(2) In addition, the medical examiners shall: 101
(a) Upon receipt of notification of a death affecting 102
the public interest, make inquiries regarding the cause and manner 103
of death, reduce the findings to writing and promptly make a full 104
report to the State Medical Examiner on forms prescribed for that 105
purpose. The medical examiner shall be authorized to inspect and 106
copy the medical reports of the decedent whose death is under 107
investigation. However, the records copied shall be maintained as 108
confidential so as to protect the doctor/patient privilege. The 109
medical examiners shall be authorized to request the issuance of 110
subpoenas, through the proper court, for the attendance of persons 111
and for the production of documents as may be required by their 112
investigation. 113
(b) Complete the medical examiner's portion of the 114
certificate of death within seventy-two (72) hours of assuming 115
jurisdiction over a death, and forward the certificate to the 116
funeral director or to the family. The medical examiner's portion 117
of the certificate of death shall include the decedent's name, the 118
date and time of death, the cause of death and the certifier's 119
signature. If determination of the cause and/or manner of death 120
are pending an autopsy or toxicological or other studies, these 121
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sections on the certificate may be marked "pending," with 122
amendment and completion to follow the completion of the 123
postmortem studies. The State Medical Examiner shall be 124
authorized to amend a death certificate; however, the State 125
Medical Examiner is not authorized to change or amend any death 126
certificate after he has resigned or been removed from his office 127
as the State Medical Examiner. Where an attending physician or 128
advanced practice registered nurse refuses to sign a certificate 129
of death, or in case of any death, the State Medical Examiner or 130
properly qualified designee may sign the death certificate. 131
(c) Cooperate with other agencies as provided for the 132
State Medical Examiner in subsection (1)(d) of this section. 133
(d) In all investigations of deaths affecting the 134
public interest where an autopsy will not be performed, obtain or 135
attempt to obtain postmortem blood, urine and/or vitreous fluids. 136
Medical examiners may also obtain rectal temperature measurements, 137
known hair samples, radiographs, gunshot residue/wiping studies, 138
fingerprints, palm prints and other noninvasive studies as the 139
case warrants and/or as directed by the State Medical Examiner. 140
Decisions shall be made in consultation with investigating law 141
enforcement officials and/or the State Medical Examiner. The cost 142
of all studies not performed by the Mississippi Forensics 143
Laboratory shall be borne by the county. County medical examiner 144
investigators shall be authorized to obtain these postmortem 145
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specimens themselves following successful completion of the death 146
investigation training school. 147
(e) In all investigations of deaths occurring in the 148
manner specified in subsection (2)(j) of Section 41-61-59, a death 149
investigation shall be performed by the medical examiners in 150
accordance with the child death investigation protocol established 151
by the State Medical Examiner. The results of the death 152
investigation shall be reported to the State Medical Examiner on 153
forms prescribed for that purpose by the State Medical Examiner 154
and to appropriate authorities, including police and child 155
protective services, within three (3) days of the conclusion of 156
the death investigation. 157
(f) Electronically report all deaths, and all 158
associated toxicology reports, that occur in the examiner's county 159
to the State Medical Examiner in a manner prescribed by the State 160
Medical Examiner. 161
(3) The medical examiner shall not use his position or 162
authority to favor any particular funeral home or funeral homes. 163
SECTION 4. Section 41-41-302, Mississippi Code of 1972, is 164
amended as follows: 165
41-41-302. (1) As used in this section, the term "POLST" 166
means a physician order for life-sustaining treatment, which may 167
also be known as a provider order for life-sustaining treatment. 168
(2) An advanced practice registered nurse (APRN) shall have 169
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the authority to sign and execute a POLST order for a patient 170
under the nurse's care. 171
(3) All POLST orders executed in this state shall follow the 172
national best practice guidelines as established by the National 173
POLST Paradigm. This includes, but is not limited to: 174
(a) Ensuring that the order is voluntary and based on 175
shared decision-making between the provider and the patient (or 176
the patient's legal surrogate); 177
(b) Using the specialized, standardized form that is 178
easily identifiable and transferable across health care settings; 179
and 180
(c) Providing clear instructions regarding 181
cardiopulmonary resuscitation (CPR), medical interventions, and 182
artificially administered nutrition. 183
(4) A * * * POLST directing health care in the standardized 184
form provided by this section may be executed by the primary 185
physician of an individual or by the APRN for a patient under the 186
nurse's care, and: 187
(a) The individual, if an adult or emancipated minor 188
with capacity; or 189
(b) The agent, guardian, or surrogate having authority 190
to make health care decisions on behalf of the individual if the 191
individual is: 192
(i) An unemancipated minor; or 193
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(ii) An adult or emancipated minor who lacks 194
capacity. 195
( * * *5) The * * * POLST shall be executed, implemented, 196
reviewed, and revoked in accordance with the instructions on the 197
form. 198
( * * *6) The State Board of Medical Licensure shall 199
promulgate a standardized * * * POLST form in accordance with the 200
provisions in this section, adhering to the sequence in those 201
provisions and using checkboxes to indicate the various 202
alternatives. The board shall consult with appropriate 203
professional and advocacy organizations in developing the * * * 204
POLST form, including the Mississippi Hospital Association, the 205
Mississippi State Medical Association, Mississippians for 206
Emergency Medical Services, the Mississippi Health Care 207
Association, the Mississippi Independent Nursing Home Association, 208
the Louisiana-Mississippi Hospice and Palliative Care 209
Organization, Disability Rights Mississippi, Mississippi Right to 210
Life, the Mississippi Bar Association and the Mississippi Section 211
of American Congress of Obstetricians and Gynecologists. 212
The * * * POLST form shall begin with an introductory section 213
containing the name " * * * POLST, Physician Order for 214
Life-Sustaining Treatment," the patient's name, patient's date of 215
birth, the effective date of the form followed by the statement 216
"Form must be reviewed at least annually.", and containing the 217
statements "HIPAA permits disclosure of * * * POLST to other 218
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health care professionals as necessary" and "This document is 219
based on this person's current medical condition and wishes and is 220
to be reviewed for potential replacement in the case of a 221
substantial change in either. Any section not completed indicates 222
preference for full treatment for that section." 223
(a) Section A of the form shall direct provision or 224
withholding of cardiopulmonary resuscitation to the patient when 225
he or she has no pulse and is not breathing by selecting one (1) 226
of the following: 227
(i) Attempt Resuscitation (CPR); or 228
(ii) Do Not Attempt Resuscitation (DNR); and 229
include the statement "When not in cardiopulmonary arrest, follow 230
orders in B, C, and D." 231
(b) Section B of the form shall direct the sustaining 232
treatment when the patient has a pulse or is breathing by 233
selecting one (1) of the following: 234
(i) Full Sustaining Treatment, including the use 235
of intubation, advanced airway interventions, mechanical 236
ventilation, defibrillation or cardio version as indicated, 237
medical treatment, intravenous fluids, and comfort measures. This 238
option shall include the statement "Transfer to a hospital if 239
indicated. Includes intensive care. Treatment Plan: Full 240
treatment including life support measures"; 241
(ii) Limited Interventions, including the use of 242
medical treatment, oral and intravenous medications, intravenous 243
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fluids, cardiac monitoring as indicated, noninvasive bi-level 244
positive airway pressure, a bag valve mask, and comfort measures. 245
This option excludes the use of intubation or mechanical 246
ventilation. This option shall include the statement "Transfer to 247
a hospital if indicated. Avoid intensive care. Treatment Plan: 248
Provide basic medical treatments"; or 249
(iii) Comfort Measures, including keeping the 250
patient clean, warm, and dry; use of medication by any route; 251
positioning, wound care, and other measures to relieve pain and 252
suffering; and the use of oxygen, suction, and manual treatment of 253
airway obstruction as needed for comfort. This option shall 254
include the statement "Do not transfer to a hospital unless 255
comfort needs cannot be met in the patient's current location 256
(e.g., hip fracture)," and include a space for other instructions. 257
(c) Section C of the form shall direct the use of oral 258
and intravenous antibiotics by selecting one (1) of the following: 259
(i) Antibiotics if life can be sustained; 260
(ii) Determine use or limitation of antibiotics 261
when infection occurs; 262
(iii) Use antibiotics only to relieve pain and 263
discomfort; and include a space for other instructions. 264
(d) Section D of the form, which shall have the heading 265
"Medically Administered Fluids and Nutrition: Administer oral 266
fluids and nutrition if physically possible," shall include the 267
following options: 268
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(i) Directing the administration of nutrition into 269
blood vessels if physically feasible as determined in accordance 270
with reasonable medical judgment by selecting one (1) of the 271
following: 272
1. Total parenteral nutrition long-term if 273
indicated; 274
2. Total parenteral nutrition for a defined 275
trial period, which option shall be followed by "Goal:" and a 276
blank line; or 277
3. No parenteral nutrition; 278
(ii) Directing the administration of nutrition by 279
tube if physically feasible as determined in accordance with 280
reasonable medical judgment by selecting one (1) of the following: 281
1. Long-term feeding tube if indicated; 282
2. Feeding tube for a defined trial period, 283
which option shall be followed by "Goal:" and a blank line; or 284
3. No feeding tube; 285
and shall include a space for other instructions; or 286
(iii) Directing the administration of hydration, 287
if physically feasible as determined in accordance with reasonable 288
medical judgment, by selecting one (1) of the following: 289
1. Long-term intravenous fluids if indicated; 290
2. Intravenous fluids for a defined trial 291
period, which option shall be followed by "Goal:" and a blank 292
line; or 293
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3. Intravenous fluids only to relieve pain 294
and discomfort. 295
(e) Section E of the form, which shall have the heading 296
"Patient Preferences as a Basis for this * * * POLST Form," shall 297
include the following: 298
(i) A direction to indicate whether or not the 299
patient has an advance health-care directive as defined in Section 300
41-41-203 and if so, the date of the advance directive's 301
execution, and, a certification that the * * * POLST is in 302
accordance with the advance directive, followed by the printed 303
name, position, and signature of an individual so certifying; 304
(ii) If the patient is an unemancipated minor, an 305
indication of by which one or more of the following directions 306
were given in accordance with Section 41-41-3: 307
1. Minor's guardian or custodian; 308
2. Minor's parent; 309
3. Adult brother or sister of the minor; 310
4. Minor's grandparent; or 311
5. Adult who has exhibited special care and 312
concern for minor; and 313
(iii) If the patient is an adult or an emancipated 314
minor, by which one or more of the following directions were given 315
in accordance with Section 41-41-205, 41-41-211 or 41-41-213: 316
1. Patient; 317
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2. Agent authorized by patient's power of 318
attorney for health care; 319
3. Guardian of the patient; 320
4. Surrogate designated by patient; 321
5. Spouse of patient (if not legally 322
separated); 323
6. Adult child of the patient; 324
7. Parent of the patient; 325
8. Adult brother or sister of the patient; or 326
9. Adult who has exhibited special care and 327
concern for the patient and is familiar with the patient's values. 328
(f) A signature portion of the form, which shall 329
include lines for the printed name, signature, and date of signing 330
for: 331
(i) The patient's primary physician or the APRN 332
for a patient under the nurse's care; 333
(ii) The individual or individuals described in 334
paragraph (e)(ii) or (iii) of this subsection; and 335
(iii) The health care professional preparing the 336
form, if other than the patient's primary physician or the APRN 337
for a patient under the nurse's care, with contact information. 338
(g) A section entitled "Information for patient or 339
representative of patient named on this form," which shall include 340
the following language: 341
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"The * * * POLST form is always voluntary and is usually for 342
persons with advanced illness. * * * POLST records your wishes 343
for medical treatment in your current state of health. Once 344
initial medical treatment is begun and the risks and benefits of 345
further therapy are clear, your treatment wishes may change. Your 346
medical care and this form can be changed to reflect your new 347
wishes at any time. However, no form can address all the medical 348
treatment decisions that may need to be made. An advance 349
health-care directive is recommended for all capable adults and 350
emancipated minors, regardless of their health status. An advance 351
directive allows you to document in detail your future health care 352
instructions and/or name a health-care agent to speak for you if 353
you are unable to speak for yourself. 354
If this form is for a minor for whom you are authorized to 355
make health-care decisions, you may not direct denial of medical 356
treatment in a manner that would make the minor a "neglected 357
child" under Section 43-21-105, Mississippi Code of 1972, or 358
otherwise violate the child abuse and neglect laws of Mississippi. 359
In particular, you may not direct the withholding of medically 360
indicated treatment from a disabled infant with life-threatening 361
conditions, as those terms are defined in 42 USCS Section 5106g or 362
regulations implementing it and 42 USCS Section 5106a.". 363
(h) A section entitled "Directions for Completing and 364
Implementing Form," which shall include the following four (4) 365
subdivisions: 366
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(i) The first subdivision, entitled 367
"Completing * * * POLST," shall have the following language: 368
* * * POLST must be reviewed and prepared in consultation 369
with the patient or the patient's representative. 370
* * * POLST must be reviewed and signed by a physician, or 371
by the APRN for a patient under the nurse's care, to be valid. Be 372
sure to document the basis for concluding the patient had or 373
lacked capacity at the time of execution of the form in the 374
patient's medical record. The signature of the patient or the 375
patient's representative is required; however, if the patient's 376
representative is not reasonably available to sign the original 377
form, a copy of the completed form with the signature of the 378
patient's representative must be placed in the medical record as 379
soon as practicable and "on file" must be written on the 380
appropriate signature on this form. 381
Use of original form is required. Be sure to send the 382
original form with the patient. 383
There is no requirement that a patient have a * * * POLST. 384
(ii) The second subdivision, entitled 385
"Implementing * * * POLST," shall have the following language: 386
If a health care provider or facility is unwilling to comply 387
with the orders due to policy or personal objections, the provider 388
or facility must not impede transfer of the patient to another 389
provider or facility willing to implement the orders and must 390
provide at least requested care in the meantime unless, in 391
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reasonable medical judgment, denial of requested care would not 392
result in or hasten the patient's death. 393
If a minor protests a directive to deny the minor 394
life-preserving medical treatment, the denial of treatment may not 395
be implemented pending issuance of a judicial order resolving the 396
conflict. 397
(iii) The third subdivision, entitled 398
"Reviewing * * * POLST," shall have the following language: 399
This * * * POLST must be reviewed at least annually or 400
earlier if; 401
The patient is admitted or discharged from a health care 402
facility; 403
There is a substantial change in the patient's health status; 404
or 405
The patient's treatment preferences change. 406
If * * * POLST is revised or becomes invalid, draw a line 407
through Sections A-E and write "VOID" in large letters. 408
(iv) The fourth subdivision, entitled "Revocation 409
of * * * POLST," shall have the following language: 410
This * * * POLST may be revoked by the patient or the 411
patient's representative. 412
(i) A section entitled "Review of * * * POLST," which 413
shall include the following columns and a number of rows 414
determined by the State Board of Medical Licensure: 415
(i) Review Date; 416
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(ii) Reviewer and Location of Review; 417
(iii) MD/DO Signature (Required); and 418
(iv) Signature of Patient or Representative 419
(Required). 420
(j) A section entitled "Outcome of Review," which shall 421
include descriptions of the outcome in each row by selecting one 422
(1) of the following: 423
(i) No Change; 424
(ii) FORM VOIDED, new form completed; or 425
(iii) FORM VOIDED, no new form. 426
SECTION 5. Section 41-41-303, Mississippi Code of 1972, is 427
amended as follows: 428
41-41-303. (1) A physician, advanced practice registered 429
nurse (APRN) or other health-care provider acting in good faith 430
and in accordance with generally accepted health-care standards 431
applicable to the physician, APRN or health-care provider is not 432
subject to civil or criminal liability or to discipline for 433
unprofessional conduct for: 434
(a) Executing a physician order for life-sustaining 435
treatment (POLST) in compliance with a health-care decision of a 436
person apparently having authority to make a health-care decision 437
for a patient, including a decision to provide, withhold or 438
withdraw health care; 439
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(b) Declining to execute a * * * POLST in compliance 440
with a health-care decision of a person based on a belief that the 441
person then lacked authority; or 442
(c) Complying with an apparently valid * * * POLST on 443
the assumption that the order was valid when made and has not been 444
revoked or terminated. 445
(2) A health-care provider or institution that intentionally 446
violates Section 41-41-302 is subject to liability to the 447
aggrieved individual for damages of Five Hundred Dollars ($500.00) 448
or actual damages resulting from the violation, whichever is 449
greater, plus reasonable attorney's fees. 450
(3) A person who intentionally falsifies, forges, conceals, 451
defaces, or obliterates an individual's * * * POLST or a 452
revocation of a * * * POLST without the individual's consent, or 453
who coerces or fraudulently induces an individual to give, revoke, 454
or not to give a * * * POLST, is subject to liability to that 455
individual for damages of * * * Two Thousand Five Hundred Dollars 456
($2,500.00) or actual damages resulting from the action, whichever 457
is greater, plus reasonable attorney's fees. 458
(4) On petition of a patient, the patient's agent, guardian, 459
or surrogate, a health-care provider or institution involved with 460
the patient's care, or surrogate for the patient as described in 461
Section 41-41-211(2) or (3), any court of competent jurisdiction 462
may enjoin or direct a health-care decision related to a physician 463
order for scope of treatment, or order other equitable relief. A 464
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proceeding under this section shall be governed by the Mississippi 465
Rules of Civil Procedure. 466
SECTION 6. Section 73-15-5, Mississippi Code of 1972, is 467
amended as follows: 468
73-15-5. (1) "Board" means the Mississippi Board of 469
Nursing. 470
(2) The "practice of nursing" by a registered nurse means 471
the performance for compensation of services which requires 472
substantial knowledge of the biological, physical, behavioral, 473
psychological and sociological sciences and of nursing theory as 474
the basis for assessment, diagnosis, planning, intervention and 475
evaluation in the promotion and maintenance of health; management 476
of individuals' responses to illness, injury or infirmity; the 477
restoration of optimum function; or the achievement of a dignified 478
death. "Nursing practice" includes, but is not limited to, 479
administration, teaching, counseling, delegation and supervision 480
of nursing, and execution of the medical regimen, including the 481
administration of medications and treatments prescribed by any 482
licensed or legally authorized physician or dentist. The 483
foregoing shall not be deemed to include acts of medical diagnosis 484
or prescriptions of medical, therapeutic or corrective measures, 485
except as may be set forth by rules and regulations promulgated 486
and implemented by the Mississippi Board of Nursing. 487
(3) "Clinical nurse specialist practice" by a certified 488
clinical nurse specialist means the delivery of advanced practice 489
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nursing care to individuals or groups using advanced diagnostic 490
and assessment skills to manage and improve the health status of 491
individuals and families; diagnose human responses to actual or 492
potential health problems; plan for health promotion, disease 493
prevention, and therapeutic intervention in collaboration with the 494
patient or client; implement therapeutic interventions based on 495
the nurse specialist's area of expertise and within the scope of 496
advanced nursing practice, including, but not limited to, direct 497
patient care, counseling, teaching, collaboration with other 498
licensed health care providers; and, coordination of health care 499
as necessary and appropriate and evaluation of the effectiveness 500
of care. 501
(4) "Advanced nursing practice" means, in addition to the 502
practice of professional nursing, the performance of 503
advanced-level nursing approved by the board which, by virtue of 504
graduate education and experience are appropriately performed by 505
an advanced practice registered nurse. "Practice of nursing" by 506
an advanced practice registered nurse means the delivery of 507
expanded clinical resources, including, but not limited to, the 508
following: (a) the performance of acts that are appropriate to 509
the nurse's specific specialty and education; * * * (b) authority 510
to diagnose, treat and manage medical conditions * * *; (c) 511
authority to prescribe medications and treatments as identified by 512
the board * * *; and (d) authority to sign, certify, or endorse 513
documents as required by law, including death certificates and 514
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provider orders for life-sustaining treatment (POLST). Advanced 515
practice registered nurses must practice in a 516
collaborative/consultative relationship with a physician or 517
dentist with an unrestricted license to practice in the State of 518
Mississippi and advanced nursing must be performed within the 519
framework of a standing protocol or practice guidelines, as 520
appropriate. 521
(5) The "practice of nursing" by a licensed practical nurse 522
means the performance for compensation of services requiring basic 523
knowledge of the biological, physical, behavioral, psychological 524
and sociological sciences and of nursing procedures which do not 525
require the substantial skill, judgment and knowledge required of 526
a registered nurse. These services are performed under the 527
direction of a registered nurse or a licensed physician or 528
licensed dentist and utilize standardized procedures in the 529
observation and care of the ill, injured and infirm; in the 530
maintenance of health; in action to safeguard life and health; and 531
in the administration of medications and treatments prescribed by 532
any licensed physician or licensed dentist authorized by state law 533
to prescribe. On a selected basis, and within safe limits, the 534
role of the licensed practical nurse shall be expanded by the 535
board under its rule-making authority to more complex procedures 536
and settings commensurate with additional preparation and 537
experience. 538
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(6) A "license" means an authorization to practice nursing 539
as a registered nurse or a licensed practical nurse designated 540
herein. 541
(7) A "registered nurse" is a person who is licensed or 542
holds the privilege to practice under the provisions of this 543
article and who practices nursing as defined herein. "RN" is the 544
abbreviation for the title of Registered Nurse. 545
(8) A "licensed practical nurse" is a person who is licensed 546
or holds the privilege to practice under this article and who 547
practices practical nursing as defined herein. "LPN" is the 548
abbreviation for the title of Licensed Practical Nurse. 549
(9) A "registered nurse in clinical practice" is one who 550
functions in any health care delivery system which provides 551
nursing services. 552
(10) A "clinical nurse specialist" is a person who is 553
licensed or holds the privilege to practice under this article in 554
this state to practice professional nursing and who in this state 555
practices advanced nursing as defined herein. "CNS" is the 556
abbreviation for the title of Clinical Nurse Specialist. 557
(11) An "advanced practice registered nurse" is a person who 558
is licensed or holds the privilege to practice under this article 559
and who is certified in advanced practice registered nurse or 560
specialized nursing practice and includes certified registered 561
nurse midwives, certified registered nurse anesthetists and 562
certified nurse practitioners. "CNM" is the abbreviation for the 563
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ST: Advanced practice registered nurses;
authorize to sign death certificates and POLST
orders.
title of Certified Nurse Midwife, "CRNA" is the abbreviation for 564
the title of Certified Registered Nurse Anesthetist. "CNP" is the 565
abbreviation for the title of Certified Nurse Practitioner. 566
(12) A "nurse educator" is a registered nurse who meets the 567
criteria for faculty as set forth in a state-accredited program of 568
nursing for registered nurses, or a state-approved program of 569
nursing for licensed practical nurses, and who functions as a 570
faculty member. 571
(13) A "consumer representative" is a person representing 572
the interests of the general public, who may use services of a 573
health agency or health professional organization or its members 574
but who is neither a provider of health services, nor employed in 575
the health services field, nor holds a vested interest in the 576
provision of health services at any level, nor has an immediate 577
family member who holds vested interests in the provision of 578
health services at any level. 579
(14) "Privilege to practice" means the multistate licensure 580
privilege to practice nursing in the state as described in the 581
Nurse Licensure Compact provided for in Section 73-15-201. 582
(15) "Licensee" is a person who has been issued a license to 583
practice nursing in the state or who holds the privilege to 584
practice nursing in the state. 585
SECTION 7. This act shall take effect and be in force from 586
and after July 1, 2026. 587