>> THE FOLLOWING PROGRAMME IS A
PBS WISCONSIN ORIGINAL
PRODUCTION.
JANET PROTASIEWICZ IS SWORN IN.
LESS THAN 24 HOURS, A
REDISTRICTING LAWSUIT IS FILED
BEFORE THE NEW COURT.
I'M FREDERICA FREYBERG.
TONIGHT ON "HERE AND NOW," WE
SPEAK TO THE ATTORNEY WHO FILED
THE REDISTRICTING LAWSUIT AND
DISCUSS WISCONSIN'S CENTRAL ROLE
IN THE TRUMP INDICTMENT.
PLUS, A BILL ALLOWING ADVANCED
NURSES TO PRACTISE INDEPENDENTLY
HAS BROAD SUPPORT, BUT
PHYSICIANS WANT MORE SAFEGUARDS
IN PLACE.
IT'S "HERE AND NOW" FOR AUGUST
4.
>> FUNDING FOR "HERE AND NOW" IS
PROVIDED BY THE FOCUS FUND FOR
JOURNALISM AND FRIENDS OF PBS
WISCONSIN.
>> JANET PROTASIEWICZ WAS
ELECTED LAST APRIL IN THE MOST
EXPENSIVE COURT RACE IN OUR
NATION'S HISTORY.
HER 10-YEAR TERM ON THE COURT
STARTED TUESDAY WITH A
CEREMONIAL INVESTITURE AT THE
STATE KOVMENT "HERE AND NOW"
SENIOR APOLLO REPORTER, ZAC
SCHULTZ, TELLS US HER SUPPORTERS
HAVE HIGH EXPECTATIONS FOR THE
NEW LIBERAL MAJORITY ON THE
COURT.
>> AND WILL FAITHFULLY AND
IMPARTIALLY...
>> GENTILE PROTASIEWICZ TOOK THE
OATH OF OFFICE TO JOIN THE
WISCONSIN SUPREME COURT IN THE
CAPITOL ROTUNDA TUESDAY.
>> LADIES AND GENTLEMEN...
(Cheers and Applause).
>> IN HER SPEECH, SHE SAID ALL
THE THINGS THAT IMPARTIAL
JUSTICE SHOULD SAY.
>> THE WISCONSIN SUPREME COURT'S
EXECUTION OF OUR DUTIES WITHOUT
FAVOUR TO SPECIAL INTERESTS,
POLITICAL PRESSURE OR OUR OWN
PERSONAL BELIEFS IS VITAL TO
GIVING THE PEOPLE OF OUR STATE
TRUST AND CONFIDENCE IN OUR
JUDICIAL SYSTEM.
>> BUT EVERYONE IN THE CROWD OF
FRIENDS AND COLLEAGUES
UNDERSTOOD HER INVESTITURE MEANS
THE COURT WILL NOW HAVE A
LIBERAL MAJORITY AFTER 15 YEARS
OF CONSERVATIVES CONTROLLING THE
COURT.
>> HOW WONDERFUL.
WHAT AN AMAZING DAY.
>> JUSTICE ANN WALSH BRADLEY HAS
SERVED ON THE COURT FOR 28 YEARS
AND HINTED THAT CHANGES TO COME,
LIKE OPENING UP THE JUDICIAL
PROCESS TO MORE TRANSPARENCY.
>> OUR CHALLENGE, THE CHALLENGE
OF THE SEVEN JUSTICES, ALL OF US
ON THE SUPREME COURT, IS TO WORK
TO ENHANCE THE PUBLIC TRUST AND
CONFIDENCE OF THE PEOPLE IN THE
JUDICIARY AND RETURN THIS COURT
TO THE NATIONAL REPUTATION THAT
IT ONCE ENJOYED.
(Cheers and Applause).
>> PROTASIEWICZ CAMPAIGNED BY
TALKING ABOUT HER VALUES ON
ISSUES LIKE ABORTION AND
GERRYMANDERING, BUT HAS NOT
REFERENCED THOSE TOPICS BY NAME
SINCE HER ELECTION IN APRIL.
>> THE ISSUES THAT WILL COME
BEFORE THIS COURT ARE COMPLEX.
MANY OF THEM DEAL WITH OUR MOST
BASIC RIGHTS THAT ARE OUTLINED
IN OUR CONSTITUTION, DECISIONS
THAT THIS COURT WILL BE MAKING
WILL IMPACT SOME OF THE MOST
IMPORTANT ASPECTS OF OUR DAILY
LIVES.
>> AS WISCONSIN'S NON-PARTISAN
SUPREME COURT ELECTIONS HAVE
BECOME MORE PARTISAN, VOTERS
HAVE STARTED EXPECTING PARTISAN
RESULTS FROM THEIR CANDIDATES.
CONSERVATIVES HAVE BEEN ANGRY
WITH JUSTICE HAGEDORN FOR YEARS
BECAUSE HE OCCASIONALLY SIDES
WITH THE LIBERALS ON THE COURT.
WHAT DO PROTASIEWICZ'S
SUPPORTERS EXPECT OF HER ON THE
COURT?
>> WELL, WE EXPECT IT TO BE
LIBERAL NOW AND FOR WOMEN'S
RIGHTS ALSO, AND SHE'S FAIR, SO
WE EXPECT FAIRNESS.
>> AND I THINK THAT SHE'LL BE
ABLE TO REALLY UPHOLD HER IDEALS
THAT SHE RAN WITH, AS WAS STATED
IN HER CAMPAIGN.
SHE IS VERY, LIKE, MORAL -- SHE
STICKS TO HER MORALS.
>> CHRIS TAYLOR IS A FORMER
DEMOCRATIC LEGISLATOR AND IS NOW
A WISCONSIN APPELLATE COURT
JUDGE.
>> SHE HAS CERTAIN VALUES THAT
SHE HOLDS, THAT SHE TALKED A LOT
ABOUT THAT ARE SHARED BY THE
PEOPLE OF THE STATE OF
WISCONSIN.
I THINK SHE'S GOING TO BRING
THOSE VALUES TO THE BENCH
WITHOUT PREJUDGING.
WHAT'S BEFORE HER, BUT THE BIG
MESSAGE I THINK HERE IS FAIRNESS
AND GIVING EVERY PERSON A CHANCE
TO GET THE JUSTICE THEY NEED
FROM THE STATE SUPREME COURT.
>> PROTASIEWICZ DIRECTED ONE
PORTION OF HER SPEECH TO HER
COLLEAGUES, BUT THE MESSAGE
APPLIED TO ALL HER SUPPORTERS.
>> BUT I'M READY TO GET TO WORK
AND I'M READY TO DELIVER JUSTICE
AND COMMON SENSE AS A MEMBER OF
THIS COURT.
>> REPORTING FROM MADISON, I'M
ZAC SCHULTZ FOR "HERE AND NOW."
>> LITERALLY LESS THAN 24 HOURS
AFTER JUSTICE PROTASIEWICZ TOOK
THE BENCH, A LIBERAL LEANING
FIRM FILED A LAWSUIT IN THE
WISCONSIN SUPREE COURT OVER THE
STATE'S CURRENT LEGISLATIVE
VOTING MAPS.
BOARD PRESIDENT OF LAW FORWARD,
JEFF MANDELL, BROUGHT THE
REDISTRICTING LITIGATION.
HE'S HERE NOW.
JEFF MANDELL, THANK YOU FOR
BEING WITH US.
>> THANK YOU FOR HAVING ME.
>> SO YOU WASTED NO TIME IN
FILING THIS REDISTRICTING
LAWSUIT BEFORE THE WISCONSIN
SUPREME COURT NOW WITH ITS
BRAND-NEW LIBERAL MAJORITY, BUT
WHY GO THERE FIRST AND NOT A
LOWER COURT?
>> WELL, THERE'S REALLY NO TIME
TO WASTE.
THE ISSUE IS NOT HOW MANY DAYS
IN AUGUST.
THE ISSUE IS THAT FOR 12 YEARS,
THE PEOPLE OF WISCONSIN HAVE
BEEN LIVING UNDER THIS EXTREME
PARTISAN GERRYMANDER, AND EVERY
DAY THAT THE GERRYMANDER
CONTINUES TO DISTORT POLITICS
AND POLICY IN THE STATE OF
WISCONSIN IS AN AFFRONT TO OUR
CONSTITUTION AND A FRONT TO OUR
DEMOCRACY AND A VIOLATION OF THE
RIGHTS OF THE PEOPLE OF
WISCONSIN.
SO WE WANT TO GET THIS
GERRYMANDER TAKEN DOWN AND FIXED
SO THAT WE CAN HAVE FAIR MAPS
AND A WORKABLE DEMOCRACY AFTER
THE 2024 ELECTION.
IF WE WANT THAT TO HAPPEN, WE
NEED THE COURT TO MOVE QUICKLY
AND HE NEED TO ASK IT QUICKLY.
>> WHAT ARE THE LEGAL PRONGS OF
YOUR SUIT?
>> THIS SUIT IS REALLY ABOUT THE
WISCONSIN EXECUTION CONSTITUTIOE
FACT THAT THE GERRYMANDER AND
THE CURRENT MAPS VIOLATE THE
WISCONSIN CONSTITUTION.
NO ONE HAS ASKED THESE QUESTIONS
BEFORE.
WE BELIEVE THAT THE EXTREME
PARTISPARTISAN GERRYMANDER WE HE
VIOLATES SEVERAL PROVISIONS OF
OUR STATE CONSTITUTION,
INCLUDING THE EQUAL PROTECTION
CLAUSE, THE RIGHT TO FREE
SPEECH, THE RIGHT TO FREE
ASSEMBLY, AND THE PRESERVATION
OF FREE GOVERNMENT CLAUSE THAT
IS IN ARTICLE 1, SECTION 22 OF
THE CONSTITUTION.
IN ADDITION, THERE ARE OTHER
PROBLEMS WITH OUR CURRENT MAPS,
INCLUDING THAT THEY FAIL TO MEET
EVEN THE BEDROCK REQUIREMENT IN
THE CONSTITUTION THAT THE
DISTRICTS BE CONTIGUOUS.
THAT IS THAT ALL THE PEOPLE WHO
LIVE WITHIN A DISTRICT AND HAVE
ONE REPRESENTATIVE ALL LIVE
WITHIN ONE BLOCK ON A MAP.
THAT'S NOT THE CASE.
AND, ON TOP OF IT, THE WAY THESE
MAPS WERE IMPOSED BOOT SUPREME
COURT LAST YEAR VIOLATES OUR
SEPARATION OF POWERS.
OF THE 99 ASSEMBLY DISTRICTS IN
THE STATE OF WISCONSIN, 55 OF
THEM ARE NON-CONTIGUOUS, AND OF
THE 33 SENATE DISTRICTS, 21 ARE
NON-CONTIGUOUS.
RIGHT HERE IN THE MADISON AREA,
ASSEMBLY DISTRICTS 47, 77 AND 78
ALL HAVE CLEAR
NON-CONTIGUOUSITIES AND ISLANDS
OF TERRITORY FLOATING APART, BUT
IT'S NOT JUST HERE IN THE
MADISON AREA.
DISTRICT 88 IN THE GREEN BAY
AREA, DISTRICT 9 IN THE
EAU CLAIRE AREA, AND THOSE ARE
ALL JUST EXAMPLES.
AS I SAID, THE VAST MAJORITY OF
THEM ARE LIKE THIS.
>> HERE'S WHAT, SPEAKING OF THE
SENATE, HERE'S WHAT REPUBLICAN
SENATE MAJORITY LEADER DEVIN
L‘E‘MAY SAID ABOUT YOUR LAWSUIT.
HE SAID LIBERAL DEMOCRATS ARE
COUNTING ON JUDICIAL FIAT TO
HELP THEM GAIN POWER.
IT'S CLEAR LIBERAL INTEREST
GROUPS ARE COMING TO COLLECT
FROM JANET PROTASIEWICZ.
WHAT DO YOU SAY TO THAT?
>> WELL, YOU KNOW, LAWYERS HAVE
A SAYING THAT WHEN THE FACTS ARE
ON YOUR SIDE, YOU YELL ABOUT THE
FACTS.
WHEN THE LAW IS ON YOUR SIDE,
YOU YELL ABOUT THE LAW.
AND WHEN NOTHING IS ON YOUR
SIDE, YOU POUND THE TABLE.
IT SOUND LIKE A LOT OF POUNDING
OF THE TABLE.
WHAT WE DIDN'T HEAR IS ANYONE
COMING OUT AND TRY TO DEPE DEFEE
EXTREME GERRYMANDERING BECAUSE
IT IS SIMPLY INDEFENSIBLE.
>> FALSE ELECTORS FROM VERY
EARLY ON AFTER THE 2020
ELECTION, AND BEING CURRENTLY IN
COURT WITH YOUR OWN LAWSUIT ON
THIS, WHAT'S YOUR REACTION TO
THE FEDERAL INDICTMENT AGAINST
DONALD TRUMP AS IT TREATS
FRAUDULENT ELECTORS IN
BATTLEGROUND STATES, INCLUDING
WISCONSIN?
>> I GUESS MY REACTION IS REALLY
THAT I WAS GRATIFIED TO SEE THE
UNITED STATES DEPARTMENT OF
JUSTICE TAKING THE FRAUDULENT
ELECTOR SCHEME SO SERIOUSLY.
I DON'T HAVE STRONG FEELINGS
ABOUT -- AND I'M NOT A CRIMINAL
PROSECUTOR AND I TRUST THE
PROSECUTORS TO DO THEIR JOB SO I
DON'T HAVE STRONG FEELINGS OR
OPINIONS ABOUT THE DETAILS OF
THE INDICTMENT OR THE SPECIFIC
CHARGES AGAINST FORMER PRESIDENT
DONALD TRUMP, BUT WHAT I TOOK
FROM IT, AS SOMEONE WHO HAS BEEN
LITIGATING THE FRAUDULENT
ELECTORS HERE IN WISCONSIN IS
JUST HOW SERIOUSLY THE UNITED
STATES DEPARTMENT OF JUSTICE
TAKES THIS SCHEME AND HOW MUCH
THE INDICTMENT SHOWS THAT THIS
REALLY WAS A SERIOUS ATTACK UPON
AND THREAT TO OUR DEMOCRACY.
>> WHAT ARE YOU SEEKING IN THAT
LAWSUIT?
>> WE'RE LOOKING TO MAKE SURE
THAT HAPPEN NONE OF THESE FOLKS
WHO ABUSE THE TRUST OF THEIR
NEIGHBOURS IN WISCONSIN, WE'RE
TALKING ABOUT 10 PEOPLE WHO
DECIDED THEY KNEW BETTER THAN
ALMOST 3.3 MILLION OF THEIR
NEIGHBOURS, AND EVEN THOUGH JOE
BIDEN AND KAMALA HARRIS HAD WON
THE FREE FAIR ELECTION IN THE
STATE OF WISCONSIN, THEY WERE
GOING TO DEDICATE THE VOTES.
THE ONLY REAL PARTICIPATION
CHOOSING THE NEXT PRESIDENT,
THEY WERE GOING TO GIVE THAT TO
DONALD TRUMP AND MIKE PENCE.
WE WANT TO MAKE SURE THAT
BECAUSE THEY ABUSED THE PUBLIC
TRUST THAT WAY, THEY NEVER HAVE
THE CHANCE TO SERVE AS ELECTORS
AGAIN.
>> JEFFREY MANDEL, THANKS VERY
MUCH.
>> THANK YOU FOR HAVING ME.
>> GIVEN A HEALTHCARE PROVIDER
SHORTAGE IN WISCONSIN, PROPOSED
LEGISLATION WOULD, FOR THE FIRST
TIME, CREATE A SEPARATE LICENSE
FOR ADVANCED PRACTISE REGISTERED
NURSES.
THOSE KIND OF NURSES INCLUDE
CERTIFIED NURSE MIDWIFE,
CERTIFIED REGISTERED NURSE
ANESTHETIST, CLINICAL NURSE
SPECIALIST AND NURSE
PRACTITIONER.
UNDER THE BILL, THEY WOULD BE
ABLE TO TO PRACTISE WITHOUT
PHYSICIAN OVERSIGHT.
MEDICAL SOCIETY OF WISCONSIN
OPPOSES THE MEASURE IN ITS
CURRENT FORM AND WE'LL HEAR FROM
A PHYSICIAN FROM THAT GROUP IN A
MOMENT.
BUT FIRST, WE HEAR FROM ONE OF
THE BILL'S AUTHORS AND A NURSE
HERSELF, SENATOR RACHAEL
CABRAL-GUEVARA.
THANK YOU FOR BEING WITH US,
SENATOR.
>> THANK YOU FOR HAVING ME HERE
TODAY.
>> SO WHY IN YOUR MIND SHOULD
WISCONSIN ALLOW ADVANCED
PRACTISE REGISTERED NURSES TO
PRACTISE INDEPENDENTLY WITH
REALLY FEWER RESTRICTIONS?
>> YEAH.
SO WHEN YOU LOOK AT THE
RESEARCH, THERE ISN'T A LOT OUT
THERE THAT SAYS WE CAN'T
PRACTISE AUTONOMOUSLY.
CURRENT IN THE STATE OF
WISCONSIN, WE HAVE OVER 8,000
NURSES HERE -- NURSE
PRACTITIONERS HERE IN THE STATE
OF WISCONSIN AND WE'RE DOING A
FANTASTIC JOB.
WE WORK COLLABORATIVELY WITH
PHYSICIANS AS IT IS CURRENTLY
AND WE DON'T ANTICIPATE WITH
THIS BILL PASSING WITH THE
AUTONOMY THAT WE STILL WOULDN'T
WORK IN COLLABORATION WITH
PHYSICIANS HERE IN THE STATE OF
WISCONSIN.
27 OTHER STATES DO THIS AND THE
OUTCOMES HAVE BEEN ABSOLUTELY
AMAZING.
WHEN WE TALK WITH PATIENTS,
PATIENTS ARE ALSO ASKING FOR
THIS.
THERE ARE MANY NURSE
PRACTITIONERS HERE IN THE STATE
OF WISCONSIN THAT WOULD LOVE TO
OPEN UP CLINICS WITHIN RURAL
DISTRICTS AND CURRENTLY, BY THE
WAY LEGISLATION IS WRITTEN, IT'S
ALMOST IMPOSSIBLE FOR THAT TO
HAPPEN.
AND SO BY DROPPING THESE
REGULATIONS THAT WE CURRENTLY
HAVE, IT WILL OPEN THE DOOR FOR
AFFORDABILITY, IT WILL OCHOA THE
DOOR FOR ACCESS -- DOOR FOR
ACCESS AND IT WILL CONTINUE TO
PROVIDE VALUABLE SERVICE THAT
MANY PATIENTS HERE IN WISCONSIN
SEEK.
>> SO THE WISCONSIN MEDICAL
SOCIETY WANTS SUCH NURSES TO
HAVE FOUR YEARS OF EXPERIENCE,
NOT THE TWO CALLED FOR IN THE
LEGISLATIVE BILL.
IS THAT UNREASONABLE?
>> WELL, WHEN YOU LOOK AT THE 27
OTHER STATES, NONE OF THOSE
STATES HAVE FOUR YEARS FOR
REGULATION.
EVERY STATE IS A LITTLE BIT
DIFFERENT.
ON AVERAGE, I SEE AROUND TWO,
MAYBE A LITTLE BIT MORE, MAYBE
THREE, BUT WISCONSIN WOULD BE
THE ONLY STATE THAT REQUIRES
FOUR YEARS PRIOR TO AUTONOMY,
AND SO WE'RE JUST ASKING IF
OTHER STATES ARE DOING THIS AND
THEY'RE DOING JUST FINE AND NOT
SEEING INCREASE IN CONCERN OR
LITIGATION, WHY DO WE SEEK FOUR
YEARS?
MANY NURSE PRACTITIONERS THAT
HAVE GONE ON -- MANY NURSES THAT
HAVE GONE ON TO BE NURSE
PRACTITIONERS, MOST OF THESE
INDIVIDUALS HAVE BEEN NURSES ON
THE FLOOR, HAVE WORKED WITH
PHYSICIANS, HAVE MANAGED THESE
KIND OF THINGS FOR FIVE, 10, 20
YEARS, SOMETIMES EVEN 30 YEARS
THEY'VE WORKED AS A NURSE AND
NOW WE'RE ASKING TO HAVE FOUR
YEARS OF PRIOR EXPERIENCE WHEN
NO OTHER STATE IS ASKED THAT.
>> CURRENTLY, A.P.R.N.s HAVE
TO HAVE THESE COLLABORATIVE
AGREEMENTS TO WORK WITH
PHYSICIANS.
FIRST, WHAT ARE THOSE AND WHY
DON'T YOU WANT THEM?
>> YEAH.
SO WHAT THEY ARE IS AN AGREEMENT
BETWEEN THAT NURSE PRACTITIONER
AND THAT PHYSICIAN THAT IS KIND
OF ALMOST AN OVERSIGHT.
RIGHT?
SO IF I HAD A QUESTION AND I
DIDN'T KNOW HOW TO MANAGE A
PATIENT, I WOULD CALL MY
COLLABORATING PHYSICIAN AND SAY,
"HEY, GIVE ME SOME INVITE ON
THIS."
NOW, THE CATCHER WITH THAT IS
THIS COLLABORATING PHYSICIAN
AGREEMENT IS NEVER FREE AND
THEIR COSTS CAN BE FROM A FEW
HUNDRED DOLLARS TO A FEW
THOUSAND DOLLARS OR EVEN A
PARTICULAR PERCENTAGE OF YOUR
BUSINESS.
I HAVE SEEN I THAT IN SOME
SITUATIONS.
THAT CAN BE TRICKY, PARTICULARLY
IF YOU'RE A SMALLER CLINIC, OR
THE OTHER PROBLEM IS, TO FIND
THAT COLLABORATING PHYSICIAN.
QUITE OFTEN, WHAT YOU FIND IS
PHYSICIANS NOWADAYS WORK FOR
LARGE SYSTEMS AND THOSE LARGE
SYSTEMS HAVE NON-COMPETES.
SO LET'S SAY YOU'RE A NURSE
PRACTITIONER IN A RURAL AREA OF
WISCONSIN OR EVEN AN URBAN AREA
OF WISCONSIN AND UPDATE TO OPEN
A CLINIC, WORK AUTONOMOUSLY AND
YOU START ASKING AROUND FOR EYE
COLLABORATING PHYSICIAN.
SOMETIMES IT'S IMPOSSIBLE TO
FIND IT.
YOU HAVE TO GO OUT OF STATE EVEN
TO FIND SOMEBODY THAT CAN WORK
AS A COLLABORATING PHYSICIAN
BECAUSE OF THE NON-COMPETE.
I HAD A NEIGHBOUR WHO IS A
PHYSICIAN, COULDN'T DO THIS.
I HAVE AN EX-HUSBAND WHO IS A
PHYSICIAN OF COULDN'T DO THIS.
BECAUSE OF THE NON-COMPETES THAT
ARE HERE IN THE STATE OF
WISCONSIN.
SO IT REALLY CAUSES A LOT OF
PROBLEMS, NOT ONLY FOR COST WHEN
YOU'RE TALKING ABOUT TRYING TO
PROVIDE AFFORDABLE CARE TO
PATIENTS AND YOU HAVE TO PAY
THESE EXORBITANT FEES, BUT ALSO
FINDING THAT PARTICULAR
INDIVIDUAL THAT CAN EVEN OFFER
TO DO THESE SERVICES.
>> I THINK WE NEED TO LEAVE IT
THERE A LOT MORE QUESTIONS TO
ASK, BUT THANKS VERY MUCH FOR
YOUR TIME TODAY, SENATOR RACHAEL
CABRAL-GUEVARA.
THANK YOU.
>> THANK YOU.
LOOKING GARD FORWARD TO GETTINY
SAY PASSED AND CONTINUE
PROVIDING GREAT CARE FOR THE
FOLKS OF WISCONSIN.
>> SOME PHYSICIANS SAY THEY ARE
WARY ABOUT THE BILL AND WANT
MORE PATIENT PROTECTIONS,
INCLUDING OUR NEXT GUEST,
DR. DON LEE.
DR., THANK YOU FOR BEING WITH
US.
>> THANK YOU FOR HAVING ME.
>> SO WHY DOESN'T THE MEDICAL
SOCIETY SUPPORT THIS BILL IN ITS
CURRENT FORM?
>> WELL, FIRST, LET ME SAY I'M
JUST SO HAPPY TO BE HERE.
I'M PROUD TO BE A PHYSICIAN AND
PART OF IT IS JUST LETTING THE
PUBLIC KNOW THAT WE'RE HERE FOR
YOU REGARDLESS, THAT WE CARE
ABOUT PATIENTS.
I WANTED TO BE A DOCTOR SINCE I
WAS FIVE YEARS OLD AND LEARNED
HOW TO SPELL ANESTHESIOLOGIST.
MY DAD IS A PRACTISING -- WAS A
PRACTISING ANESTHESIOLOGIST AND
LOVED EVERY MINUTE OF IT AND
FELT MEDICINE WAS THE BEST
PROFESSION AND I WANTED TO
FOLLOW THIS FOOTSTEPS.
HE TOLD ME TO STUDY HARD, AND I
DID.
I'M HERE TO DEFEND OUR MEDICAL
PROFESSION BECAUSE WE SAVE LIVES
AND HELP PATIENTS.
>> AND SO ARE YOU SUGGESTING
THAT DOCTORS HAVE SUCH A HIGH
BAR TO BECOME A LICENSED
PHYSICIAN THAT IT'S NOT RIGHT
THAT THESE OTHER KINDS OF
REGISTERED NURSES, THE ADVANCED
PRACTICES REGISTERED NURSES
SHOULD HAVE PARITY?
>> NO, NOT AT ALL.
I WORK WITH ADVANCED PRACTISE
CLINICIANS WHICH INCLUDES
A.P.R.N.s, AND IT HAS BEEN
GREAT.
I ALSO WORK WITH RNs, AND
THERE'S NOT JUST A PHYSICIAN
SHORTAGE CRITICAL, BUT THERE'S A
CRITICAL NURSING SHORTAGE ALSO.
WHAT I'M SAYING IS IT'S HARD TO
COMPARE MEDICAL SCHOOL WITH A
MASTER'S DEGREE NURSE
PRACTITIONER AND IT'S HARD TO
COMPARE RESIDENCY, WHERE WE
DON'T SEE PATIENTS BY OURSELVES.
WE'RE IN AN ACADEMIC CENTRE
WHERE AN ATTENDING OVERSEES ALL
OF OUR WORK AND WE HAVE TO PASS
A MEDICAL LICENSE, STEP ONE,
STEP TWO, STEP THREE, TO EVEN
PRACTISE INDEPENDENTLY.
SO I DIDN'T PRACTISE
INDEPENDENTLY, IF YOU WILL,
UNTIL I WAS 32.
>> AND SO SUPPORTERS SAY
REQUIRING FOUR YEARS OF REAL
WORLD TEAM-BASED EXPERIENCE
INSTEAD OF THE TWO THAT'S IN
THIS BILL BOXES OUT ADVANCED
PRACTISE REGISTERED NURSES.
WHY IS THAT LEVEL, THAT FOUR
YEARS OF EXPERIENCE, NEEDED, IN
YOUR MIND?
>> OUR POSITION IS TO REQUIRE
FOUR YEARS OF REAL-WORLD
TEAM-BASED EXPERIENCE BEFORE AN
APRN CAN PRACTISE.
WE SUPPORT NOT THE -- IF YOU GET
WHAT I'M SAYING.
LIKE WE HAVE MOVED IN SUPPORTING
INDEPENDENT NURSING PRACTISE
WITH MODIFICATIONS.
>> DO YOU THINK THAT PATIENT
CARE SAFETY IS AT RISK UNDER THE
PROPOSAL THAT'S BEING CONSIDERED
RIGHT NOW?
>> RIGHT.
SO THERE'S BEEN A LOT OF STUDIES
ABOUT COST AND QUALITY OF CARE,
AND I WANT TO CITE -- AND I WANT
TO CITE NATIONAL BUREAU OF
ECONOMIC RESEARCH IN NOVEMBER OF
2022, THE PRODUCTIVITY OF
PROFESSIONS EVIDENCED FROM THE
KNOWLEDGE DEPARTMENT, AND THEY
USE THREE YEARS OF VETERANS
HEALTH, EMERGENCY DEPARTMENT
VISITS, AND IT FINDS THAT NPs
USE MORE RESOURCES AND ACHIEVE
WORSE OUTCOMES THAN PHYSICIANS,
ESPECIALLY WHEN DEALING WITH
COMPLEX PATIENTS, BUT AS A
PHYSICIAN, ME PERSONALLY, I SEE
A PHYSICIAN AS MY PRIMARY CARE
DOCTOR.
MY DAD, IF HE HAS A PHYSICIAN,
BUT I GET IT, THERE'S A
PHYSICIAN SHORTAGE.
IT CAN TAKE THREE TO SIX MONTHS
TO SEE HIS PHYSICIAN SO HE SEIZE
AN APC, WHICH IS EARLIER, BUT
THAT ABC IS WORKING DIRECTLY
TOGETHER WITH A PHYSICIAN THAT
INTRODUCES HERSELF AS I WORK
WITH THIS PHYSICIAN AND THIS
BILL WOULD COMPLETELY UP END
THAT.
>> WHAT ABOUT THOSE
COLLABORATIVE AGREEMENTS?
YOU THINK THAT'S IMPORTANT?
>> I MEAN, IF I'M WORKING WITH
AN APC, I AND THAT APC IS GOING
TO WORK OUR BUTT OFF TO PROVIDE
THE BEST PATIENT CARE.
DOCTORS ARE NOT IN HEALTHCARE TO
SIMPLY MAKE MONEY.
THAT'S NOT WHY WE BECAME
DOCTORS.
AND SO THE VAST MAJORITY OF
PHYSICIANS WORK COLLABORATIVELY,
WORK WITH CARE WITH NURSE
PRACTITIONERS AND APCs TO HELP
PATIENTS.
>> DR. LEE, THANKS VERY MUCH.
>> LAST WEEK, WE SPOKE WITH A
CIVIL RIGHTS LAWYER ABOUT NEW
DATA THAT SHOWS THOUSANDS OF
INSTANCES OF GRADE SCHOOL
CHILDREN WITH DISABILITIES BEING
SECLUDED AND RESTRAINED IN
WISCONSIN SCHOOLS IN THE LAST
ACADEMIC YEAR.
ATTORNEY JEFF SPITZER-RESNICK
CALLED THE PRACTICES ABUSIVE AND
SAID THE DEPARTMENT OF PUBLIC
INSTRUCTIONS RESPONSE HAS BEEN
INADEQUATE.
TONIGHT WE HERE FROM ABIGAIL
SWETZ, D.P.I. DIRECTOR, AND TIM
BEAR ENBOOM AND D.P.I. EDUCATION
CONSULTANT.
THANK YOU BOTH FOR BEING HERE.
>> THANK YOU.
>> FIRST TO YOU, ABIGAIL.
THE RECENT D.P.I. DATA RELEASE
DOESN'T NAME INDIVIDUAL SCHOOLS
THAT ARE USING SECLUSION AND
RESTRAINT.
AS A PARENT, COULD I FIND OUT IF
MY CHILD'S SCHOOL WAS USING
THESE TECHNIQUES?
AND IF NOT, WHY NOT?
>> IT'S A GREAT QUESTION.
THE FIRST THING TO KEEP IN MIND
ABOUT THIS IS WE'VE BEEN
COLLECTING THIS DATA FOR THREE
YEARS AND THE LAW REQUIRES TO US
COLLECT IT AND WE DECIDE TO PUT
IT INTO A REPORT AND MAKE THAT
PUBLIC.
THERE ARE DOWNLOAD FILES ON OUR
WEBSITE THAT GO INTO MORE DETAIL
THAN THE REPORT DOES.
>> AND SO --
>> AND I BELIEVE TIM HAS SPOKEN
TO OTHERS ABOUT HOW WE ARE ABLE
TO SHOW THAT INFORMATION AT A
MORE GRANULAR LEVEL.
>> AND SO AS A PARENT, I COULD
SEEK THAT OUT?
>> YES.
>> TIM, WE KNOW THAT SECLUSION
AND RESTRAINT IS TO BE USED AS A
LAST RESORT, ACCORDING TO
D.P.I., AND ONLY IN CASES OF
IMMINENT DANGER.
BUT WHY IS IT AT ALL?
>> WELL, FOR A COUPLE OF
REASONS.
IF THERE IS IMMINENT DANGER OF
PHYSICAL HARM TO THE STUDENT OR
THE STUDENT'S CLASSMATES OR
ANYONE, THAT IT SOMETIMES,
UNFORTUNATELY, IS NECESSARY.
SO ONE WAY TO THINK ABOUT IT,
WHY USE IT AT ALL, IS THAT IN
THOSE MOMENTS, YOU MIGHT NEED TO
USE PHYSICAL RESTRAINT AND THAT
BALANCING TEST.
SO THE QUESTION IS, IS THE RISK
OF NOT DOING A SECLUSION OR NOT
DOING A RESTRAINT GOING TO CAUSE
MORE HARM THAN DOING A PHYSICAL
RESTRAINT.
SO, FOR EXAMPLE, A STUDENT ABOUT
TO DART INTO HEAVY TRAFFIC.
NOT RESTRAINING THAT STUDENT
FROM DOING THAT COULD CAUSE MUCH
MORE HARM THAN ACTUALLY
RESTRAINING THE STUDENT.
STUDENTS BEING IN A VIOLENT
PHYSICAL FISTFIGHT, NOT
PHYSICALLY RESTRAINING A STUDENT
WOULD CAUSE MORE HARM THAN
ENGAGING IN PHYSICAL RESTRAINT
SO WHY DO IT, THE ANSWER IS TO
PREVENT FURTHER HARM OR PREVENT
THESE INTENSE, TRAUMATIC,
DANGEROUS SITUATIONS FROM
ESCALATING AND GETTING EVEN
WORSE.
>> ABIGAIL, WHY DO SOME SCHOOLS
USE IT AND OTHERS DON'T?
I MEAN, CAN D.P.I. LEARN FROM
SCHOOLS THAT DON'T ENGAGE IN
SECLUSION AND RESTRAINT ABOUT
WHAT THEY DO INSTEAD?
>> THERE ARE A LOT OF SCHOOLS.
THE MAJORITY OF OUR SCHOOLS,
ACTUALLY, ARE NOT USING THIS AS
A LAST RESORT BECAUSE WE DON'T
HAVE TO GET TO THAT POINT AND
THERE ARE LESSONS THAT WE ARE
LEARNING ABOUT THE STRUCTURES
AND SYSTEMS THAT WE NEED TO PUT
INTO SCHOOLS TO MAKE SURE THAT
THEY ARE TRAUMA-INFORMED AND
ABLE TO NEVER REACH THIS LAST
RESORT.
AND ALSO WE'VE LEARNED SO MUCH
ABOUT THE STAFFING THAT'S NEEDED
IN THAT SPACE AND IT'S ONE OF
THE REASONS WE'VE BEEN TALKING
SO MUCH ABOUT TRYING TO MAKE
SURE WE HAVE THE MENTAL HEALTH
SUPPORTS WE NEED FOR OUR
STUDENTS IN OUR SCHOOLS.
I'LL JUST REITERATE WHAT TIM
JUST SAID AS WELL, THAT BECAUSE
THIS IS LAST RESORT, EVERYTHING
YOU DO LONG BEFORE IS SO, SO
IMPORTANT.
AND ALSO WHAT YOU DO AFTER.
WE'VE ALSO BEEN LEARNING SO MUCH
ABOUT WHAT HAPPENS AFTER.
WHAT ARE THESE CONVERSATIONS AND
HOW CAN WE LEARN GOING FORWARD.
>> TIM, WHAT DOES THE D.P.I. DO
WITH THIS DATA?
>> THE LAW DOESN'T SAY WE HAVE
TO PUBLISH THE DATA OR DOESN'T
DIRECT US TO DO ANYTHING WITH
IT, SO WHEN THIS ALL WENT INTO
EFFECT, WE HAVE A WORKGROUP, A
TEAM THAT WORKS ON HOW DO WE
WANT TO ADDRESS WHAT WE REFER TO
AS SORT OF OUTLIER SCHOOL
DISTRICTS -- OR SCHOOLS, EXCUSE
ME, SCHOOLS THAT HAVE A HIGHER
NUMBER OF SECLUSION RESTRAINT SO
WHEN WE GET THOSE IN RESPONSE,
WHEN WE REVIEW THE FAT THAT WE
GET EACH YEAR -- GET THE DATA
THAT WE GET EACHIER, WE CONTACT
THE SCHOOLS THAT HAVE HIGHER
NUMBERS AND WORK WITH THEM TO
IDENTIFY THE ROOT CAUSE OF
WHAT'S CAUSING THOSE HIGHER
NUMBERS AND PROVIDE COACHING,
TECHNICAL ASSISTANCE, TRAINING
TO HELP REDUCE THOSE NUMBERS.
>> TO THAT END, ABIGAIL, IN A
PERFECT WORLD, WHAT KIND OF
STAFFING AND TRAINING RESOURCES
WOULD BE NEEDED IN SCHOOLS SO
THAT SECLUSION AND RESTRAINT
WERE NOT NECESSARY IN A MAJOR
KIND OF WAY?
>> THIS IS THE GOOD NEWS.
WE KNOW WHAT CAN WORK.
WE KNOW THAT THE TRAUMA-INFORMED
WORK THAT WE'VE BEEN DOING AT
D.P.I. TO TRY AND GET THOSE
KINDS OF SYSTEMS AND SUPPORTS
INTO SCHOOLS, WE KNOW THAT MAKES
A DIFFERENCE.
WE KNOW THAT HAVING STUDENT
SERVICES STAFF, LIKE SCHOOL
SOCIAL WORKERS, LIKE SCHOOL
PSYCHOLOGISTS, LIKE TIM IN OUR
SCHOOLS MAKES SUCH A HUGE
DIFFERENCE AND PROFESSIONAL
DEVELOPMENT FOR REALLY EVERY,
EVERY ASPECT OF THE SCHOOL,
EVERY SCHOOL STAFF FROM SCHOOL
NUTRITION ALL THE WAY TO
ADMINISTRATORS.
I WAS A SPECIAL EDUCATION
ASSISTANT AND ALSO A GENERAL
CLASSROOM TEACHER AND ALL OF
THOSE REELS NEED THAT
PROFESSIONAL DEVELOPMENT AND WE
KNOW THAT WORKS AND THAT IS WHY
WE NEED TO MAKE SURE WE GET THE
FUNDING TO SUPPORT THAT WORK.
>> ABSOLUTELY.
ALL RIGHT.
WE WANT TO THANK YOU, ABIGAIL
SWETZ AND TIM PEERENBOOM FOR
JOINING US ON THIS.
THANK YOU.
>> THANK YOU.
>> FOR MORE ON THIS AND OTHER
ISSUES FACING WISCONSIN, VISIT
OUR WEBSITE AT PBS WISCONSIN
DOT-ORG AND THEN CLICK ON THE
NEWS TAB.
NEXT WEEK, WE BEGIN A SERIES ON
ABORTION, BEGINNING WITH STORIES
OF WOMEN WHO HAVE HAD ONE.
THAT'S OUR PROGRAMME FOR
TONIGHT.
I'M FREDERICA FREYBERG.
HAVE A GOOD WEEKEND.
>> FUNDING FOR "HERE & NOW" IS PROVIDED BY THE FOCUS FUND FOR JOURNALISM AND FRIENDS OF PBS
WISCONSIN.