CHEYENNE - Gov. Dave Freudenthal rejected proposed Wyoming Board of Nursing rules this week mainly on the ground that public discussion was inadequate.

The rules, which have the same effect as law, must be signed by the governor to be enforceable.

They would have changed training requirements for nurse anesthetists, increased fees for licensed nurses, changed curriculum requirements for nurse training programs, and created two different levels of training and authority for certified nursing assistants.

In his letter announcing his decision, Freudenthal said it would be better for the board to communicate with the people affected early on, to discuss whether there is a problem and, if so, options to solve the problem.

"If you wait for public discussion and input until after you have already drafted the rules and published them, it tends to alarm people, and perhaps makes you overly defensive of what you have proposed," the governor wrote.

"The board of nursing worked for over two years on these changes and is naturally disheartened at the governor's decision," Mary Kay Goetter, executive director of the Wyoming Board of Nursing, said Friday.

"However, a number of the governor's points were well taken. The board of nursing is committed to the proposed changes, and we will work diligently to present data and evidence that demonstrate the board's commitment to public protection," she added.

The legislative management council, which includes legislative leaders, removed the nursing board rules from its approval list at a May 13 meeting after Tom Jones of Cheyenne complained about the lack of notice until late in the process.

The council routinely reviews state agency rules to be sure they comply with the law and makes recommendations to the governor to approve or disapprove them.

Jones, who represents the Wyoming Health Care Association, an organization that includes nursing homes and assisted living facilities, said Friday the board members apparently involved only nurses who agreed with them during the rule-making.

"They basically were done in secret," he said. "I thought that was kind of a poor way to do business and was reflected in the quality of the rules they developed. That's why I got involved and complained about it."

His clients, he said, have advocated the concept of medication aides for years. The idea is to train nurses aides and certified nursing assistants to pass out certain medications to patients and free nurses for their other duties.

The proposed rules would have required a "great deal"of additional training, he said.

Jones noted that the aides cannot administer medications now except at the Wyoming State Training School at Lander. Medication aides are allowed at the institution for the developmentally disabled through a special law passed by the Legislature several years ago.

"It's worked very well there," Jones said.

In his letter to Kellie Clausen, chairwoman of the Wyoming Board of Nursing, Freudenthal suggested the board examine the Training School's medication aide program and see if it could be adapted to the board's rules.

Freudenthal also objected to:

* A proposed 50 percent increase in fees for licensed nurses because the board gave no justification for the hike.

* The proposed changes to require nurse anesthetists to obtain additional training in pharmacology and clinical management of drug therapy, and to become qualified to prescribe drugs in order to remain licensed. The nurse anesthetists said they neither need nor want the additional training, the governor wrote.

* The proposed change that would require nursing curriculum to include hands-on clinical experience.

This seemed like a good idea initially, the governor wrote, but would hamper a number of nursing students in Wyoming who are participants in a nursing program sponsored by Excelsior College in New York. This program does not presently have a hands-on clinical program but accepts only students with considerable experience in the medical care field and tests their competency in clinical care.

Freudenthal said he will be glad to reconsider this change in the future if the board can explain "why is it necessary for Wyoming with a nursing shortage and few nursing programs with clinical programs to join a small minority of states that have this requirement."

Contact Joan Barron at joan.barron@trib.com or by phone at 307-632-1244.