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Practice committee flags APRN X‑ray ordering and ketamine‑clinic concerns; staff to survey other states and pilot FAQs/chatbot
Summary
Board practice staff reported growing practice inquiries, including an apparent conflict about APRN authority to order X‑rays and an anonymous complaint about ketamine clinics run by APRNs; the committee asked staff to gather other states' regulatory language and examples, and to explore FAQs or a chatbot to handle routine questions.
Linda Davies, a practice specialist, told the Kansas State Board of Nursing practice committee that staff continue to receive ‘practice calls’ that are increasingly complex and that only two staff members currently have allocated time to respond.
"So then when we receive them via email, there are only 2 staff that have any allocated time to address...and the staff also have other job duties, so it becomes kind of hairy to be able to keep up with these complex inquiries that sometimes require a little bit of research to respond," Davies said. She said staff can only point callers to the Nurse Practice Act for general counsel and cannot provide legal advice.
Davies identified two recurring concerns. First, she said KDAG statutes appear to prevent an APRN without an overseeing physician from ordering X‑rays, a rule that conflicts with full practice authority granted in other contexts. "A little bit of history of your KDAG statutes do not allow for an APRN without an overseeing physician to order X rays," she said. Second, staff received an anonymous complaint about a ketamine clinic run by APRNs and asked whether KSBN has regulatory authority or needs new rules to protect patients; Davies said there is currently no KSBN policy that specifically governs those clinics.
Committee members urged caution and further investigation. One member asked whether these practices are concentrated in urban or rural areas and whether specialized training (for example, ACLS) should be required when clinicians use potentially dangerous medications. Members recommended that staff survey other states for statutory or regulatory language and noted the National Council of State Boards of Nursing (NCSBN) has published recent material related to IV hydration.
Staff and members also discussed technology to reduce call volume: Mississippi and North Dakota board examples were mentioned and a possible chatbot or automated FAQ system was proposed for common practice questions hosted on kansas.gov.
The consent agenda that included the practice calls report was approved by voice vote. The committee asked staff to bring examples and proposed language to the December 2025 packet for further discussion.
