As an advanced practice registered pediatric nurse practitioner licensed in the state of Florida, I now face a challenge that many other NPs do not yet — Florida House Bill 155 (HB 155).
Passed in July, the law prohibits health care providers from inquiring about the presence of firearms or ammunition in the home of a patient. Even if the patient/parent self-discloses this information, healthcare providers are not allowed to document it in the medical record unless it is “relevant to the patient’s medical care or safety or the safety of others.”
I personally believe that having firearms in a home with children is relevant to the health and safety of everyone in that home. I guess I should be grateful that there are certain circumstances that are considered an exception to the law. For instance, if pediatricians believe that a patient is potentially suicidal, they may still ask about access to weapons, including firearms that can be used to cause harm to self or others.
This practice is in line with the American Academy of Pediatrics (AAP) Bright Futures Guidelines, which recommend asking about the presence of firearms in the homes of children through the late adolescent/young adult visit.
Whether or not you believe that guns kill people or people kill people, some sobering statistics remain:
- Homicide and suicide are the second and third most frequent causes of death in teenagers aged 15 to 19 years
- 85% of homicides and 43% of suicides involved the use of a firearm, the CDC reported in 2007
I believe that if guns were not present in the first place, or parents were counseled about appropriate gun safety, many of these deaths could have been prevented.
Despite lobbying efforts from the AAP and many other organizations that support the best in child health, along with the general belief among members of the health care community that HB 155 could not logically be passed, it was.
HB 155 should serve as a cautionary tale for those of you who are still able to speak freely with your patients. Similar legislation has also been proposed in Virginia, West Virginia, North Carolina and Alabama.
Joining your state nurses association or advanced practice council can help you stay informed of potential legislative actions that may impact your practice. Additionally, the American Academy of Nurse Practitioners is your advocate at local, state and national levels. These organizations usually employ lobbyists that will work on your behalf. HB 155 happened first in Florida. Don’t let legislation like this happen in your state, too.
Editor’s Note: On September 14, 2011, a federal district judge granted a preliminary injunction to block enforcement of HB 155, after the American Academy of Pediatrics, the American Academy of Family Physicians and the American College of Physicians challenged the law on the grounds that it violated First Amendment rights to free speech.
“The AAP is pleased the court recognized the confidential nature of the physician-patient relationship and the critical importance of this counseling, which is a cornerstone of pediatric care. Parents often do not realize how easily a child can access a gun that is not locked, and we too often hear about the tragic consequences,” AAP President O. Marion Burton, MD, FAAP, said in a statement released following the ruling.