Professional Nursing and State-Level Regulations
RE: Discussion - Week 5
Advance practice nurses have certification and training, entailing a master’s degree or even doctorate in nursing. APRPs include Nurse practitioners, Certified nurse midwives, Nurse Anesthetists, and Nurse Specialists (Vega, 2020) Professional Nursing and State-Level Regulations. The APRN regulations vary from one state to another. Milstead and Short (2019) outlined that APRN’s scope of practice varies for nurses having the same title in each state. This post compares the nurse practitioners in Maryland and those practicing in Michigan regarding nursing regulations.
In Maryland, regulatory bodies require NPs to collaborate with a physician for about eighteen months of practice. This implies that NPs partners and consults physician for first one year and four months (AMA, 2017). Besides, each new applicant is required to be certified as CRNP while naming their mentor for the certification application who must be certified by CRNP in Maryland. In Michigan, NPs are required to hold RN licenses and national certifications. NPs practice independently without supervision or collaboration with physicians.
In Michigan, NPs are not controlled and governed under the Nurse Practice Act; instead, they are regulated by Public Health Code. Nurse practitioners in this state prescribe non-schedule medicine independently without having to be supervised by physicians. However, they require physicians when they need to cosign the prescriptions schedule 2 to 5 drugs. Additionally, in Michigan, NPs are not allowed to sign employee’s compensation claims or death certificates. They take rounds in the hospital, make independent house call visits, order speech therapy or physical therapy without consulting or collaborating with physicians. They also diagnose and treats patients. Professional Nursing and State-Level Regulations
On the other hand, Nurse practitioners are regulated and governed by the Nurse Practice Act in Maryland, unlike Michigan. In Maryland, Nurse Practitioners are compulsorily required to be registered with PDMP, which stands for Prescription Drug Monitoring Program. After registration, they serve under their scope. Unlike in Michigan, NPs in Maryland prescribes schedule two to five drugs without collaborating with physicians, and they are allowed to sign a death certificate, especially when the deceased was under their care as their patients (Nurse Practitioner School).
Another example of APRN is certified Nurse-Midwives which have their regulations differing from one state to another. The nurse’s mid-wives in Maryland are permitted by regulation to practice independently without assistance or supervision from physicians. On the other hand, regulation in Michigan permits mid-wives to practice in partnership with doctors, especially when delivering care to patients Professional Nursing and State-Level Regulations.
All these regulations explained applies to APRN having the legal authority to practice fully based on their experience and scope of education. Therefore, these regulations are described as guidelines established to govern practice within a given discipline to protect their titles and protection for patients or the public. The APRNs obey these set regulations in every state of America by ensuring that all APRNs are licensed before practicing, and their license is up to date. APRN ensures that the need for continuing education training is met in each licensing year. Additionally, APRN adheres to the regulation set in each state by ensuring that there is safety as well as competence in practice.
To sum up, there are many similarities and differences between the nurse practitioners in Maryland and those practicing in Michigan regarding nursing regulations. Lastly, the selected rules apply to APRNs, especially those who have the legal authority to practices within the full scope of their experience and education, while providing an example of how APRNs obey the regulation.
References
American Medical Association. (2017). State law chart: Nurse practitioner practice authority. Retrieved from https://www.ama-assn.org/media/14391/download
Maryland Board of Nursing (n.d.) Nurse Practitioner-Scope and Standards of Practice. Retrieved from https://www.mbon.maryland.gov
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning. The Nurse Practitioner Association New York State. (n.d). About Us. Retrieved from https://apnnj.enpnetwork.com/page/30121-about-us
National Commission on Correctional Health Care (n.d.). Regulations, Standards, and Policies. Retrieved from https://www.ncchc.org/cnp-regulations#:~:text=in-the-profession-of
nursing-ensuring-safe-and-competent-practice. &text=Because-nursing-practice-has-aindividual-nursing-practice-is-necessary. Professional Nursing and State-Level Regulations
Nurse Practitioner Schools (n.d.). How Does Nurse Practitioner Authority Vary by State? Retrieved from https://www.nursepractitionerschools.com/faq/how-does-np-practice-authority-vary-by-state/
Practice Environment for Certified Nurse-Midwives. (2018). American College of Nurse-Midwives. Retrieved from, https://www.midwife.oeg/accnm/files/ccLibraryFiles/Filename/000000005600/ACNMStateFactSheets8-21-15.pdf
April 12). Role of an Advanced Practice Nurse. Retrieved from https://www.verywellhealth.com/what-is-an-advanced-practice-nurse-3146085Vega J., (2020,
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5 months ago
Jessica Ferrin
RE: Discussion - Week 5
5 months ago
Andrea Cholagh
RE: Discussion - Week 5
I currently reside in Ontario, Canada; the board of nursing regulations for my province would be the College of Nurses of Ontario (CNO) Professional Nursing and State-Level Regulations. With a current RN license here, and the desire to transfer my education as a APRN into Canada, it is important to know the regulations and scope of practice in my province for a nurse practitioner. I will be completing my practicums in Michigan and may possibly practice there, therefore I chose Michigan’s APRN board of nursing regulation known as Michigan Department of Licensing and Regulatory Affairs (LARA) to compare it with. Nursing regulatory bodies assure that safe and competent nursing care is provided by licensed nurses (NCSBN, n.d.). All states, and provinces have a unique Nurse Practice Act that describes a APRNs role, it is a nurses legal and professional responsibility to understand their legal scope of practice where they practice and follow it (Milstead & Short, 2019). Professional Nursing and State-Level Regulations Therefore, I should know the legal scope of practice, regulations, and practice standards where I may be practicing as a nurse practitioner including both in Ontario, Canada and Michigan, U.S.A.
According to CNO (n.d.), the definition of a NP’s scope of practice is the authorization to diagnose, order, and interpret diagnostic tests, as well as prescribe medications and other treatments to clients. Their practice includes health promotion and enables them to practice with diverse client populations in a variety of contexts and practice settings (CNO, n.d.) Professional Nursing and State-Level Regulations. LARA (n.d.) defines APRNs scope of practice by their specialty education training and national board certification. They further define it by the knowledge base of the APRN, the role they are in, and the client population within practice environment (LARA, n.d.). The functions/controlled acts APRN’s are authorized to perform listed under both CNO and LARA are very similar. These include performing physical examinations, health promotion, preventing illness and disability, managing health care during common acute and stable chronic illnesses, health counselling and guidance, admitting clients to hospitals/long term care facilities, consultation and collaboration with other health care providers, referrals to other health care providers or community resources, application of evidence-based practice, prescription of medications, ordering and interpreting lab tests and X-rays, client advocacy, and diagnosing a health/illness status and communicating that with the patient (LARA, n.d.).
While CNO lists the same functions as a NP, the College of Nurses of Ontario also allows a NP to set or cast a bone fracture or dislocation which was not listed it LARA’s functions (CNO, n.d.). Other differences noted between the two nursing regulatory bodies include which practice setting an APRN is authorized to work. As stated before, the Michigan Department of Licensing and Regulatory Affairs (LARA) states that a APRNs scope of practice is further defined by the knowledge base they have, their role they are in, and the client population within the practice environment (LARA, n.d.). While LARA limits an NPs practice environment based on their educational background, the College of Nurses of Ontario (CNO) state that they do not restrict the clinical areas or sectors in which a NP may work regardless of their specialty client population (CNO, n.d.) Professional Nursing and State-Level Regulations. Furthermore, in Michigan, LARA states that anything beyond their defined scope of practice must be performed under the supervision of a licensed physician (LARA, n.d.). Therefore, most APRNs work in collaboration with a Physician. Professional Nursing and State-Level Regulations In Ontario, CNO authorizes NPs to work independently and does not enforce them to perform anything with a Physician but to stay within their scope of practice and hold up to CNO practice standards (CNO, n.d.).
Each state has different regulations and scope of practices, so does each province in Canada when it comes to authorizing an NP’s full practice. Professional Nursing and State-Level Regulations CNO allows a NP to practice to their full extent of their experience and education. Michigan restricts full practice authority while they need a physician’s oversight to perform many tasks such as prescribing certain controlled substances, signing death certificates, and signing workers’ compensation claims (Staff Writers, 2021). A APRN can adhere to these regulations by completing the required education, examinations, and obtaining a APRN licence through their state/region’s regulatory bodies. Furthermore, a APRN can adhere to their state/regions regulations by understanding their state/regions scope of practice, only practicing within it, and continuously advancing their knowledge and experience Professional Nursing and State-Level Regulations.
References
College of Nurses of Ontario (CNO). (2021). Nurse Practitioner. Practice Standard. https://www.cno.org/globalassets/docs/prac/41038_strdrnec.pdf
Michigan Department of Licensing and Regulatory Affairs (LARA). (n.d.). Licensure/certification/scope of practice. https://cdn.ymaws.com/micnp.org/resource/resmgr/resources_&_links/micnp_licensure_certificatio.pdf
Milstead, J.A., & Short, N.M. (2019). Health policy and politics: A nurse’s guide (6th ed., pp. 54). Burlington, MA: Jones & Bartlett Learning.
National Council of State Boards of Nursing (NCSBN). (n.d.). https://www.ncsbn.org/index.htm
Staff Writers. (2021, August 4). Michigan nurse practitioners: The fight for full practice authority. Nurse Practitioner Schools. https://www.nursepractitionerschools.com/practice-authority/michigan/ Professional Nursing and State-Level Regulations
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5 months ago
Lucy Njogu
RE: Discussion - Week 5
5 months ago
Andrea Cholagh
Response
5 months ago
Ahou Karelle Koffi
RE: Discussion - Week 5
Hi Andrea, your post was informative, and I have learned a lot about what registered nurses' scope of practice in Canada entails Professional Nursing and State-Level Regulations. Every state has different rules, policies, and regulations regarding the scope of practices for nurses. I have noted various similarities between the scope of nursing practice in your state and my state. In all states, just like in Canada, the scope of practice in my state also allows nurses to practice to their full potential their knowledge, skills, and experiences. The scope of nursing practice entails the roles, responsibilities, as well as functions that registered nurses, are expected to perform (American Nurses Association, 2020besides, it also reflects the activities and roles that registered nurses undertake to address illnesses and promote health. Ideally, according to the scope of practice for registered nurses, nurses should ensure health protection, health promotion, health restoration, health maintenance, palliation, and rehabilitation. Professional Nursing and State-Level Regulations The nursing practice should be directed towards helping patients achieve optimal health outcomes.
References
American Nurses Association. (2020). Scope of practice. ANA. https://www.nursingworld.org/practice-policy/scope-of-practice/
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5 months ago
Andrea Cholagh
RE: Discussion - Week 5
Hello,
Thank you for the information on the American Nurses Association nursing activities! The scope of a nurse does need to be patient-focused in order to achieve the best health outcomes Professional Nursing and State-Level Regulations.
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5 months ago
Scott Lamprecht
RE: Discussion - Week 5
Healthcare is supposed to be about the patient n ot the money. That idea was lost many years ago!
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5 months ago
Lyndsey Cline
RE: Discussion - Week 5
The West Virginia Board of Nursing provide legal requirements for the registered professional nurse, and laws are put into place by the legislature. It is the nurses responsibility to be familiar with the scope of practice in the state they are employed in. There are laws put into place for the registered nurse and advanced practice registered nurse.
According to the WV APRN prescriptive authority privilege, the nurse must complete at least 45 pharmacology contact hours at an advanced pharmacology graduate level. The nurse must also show documentation of 15 graduate level pharmacology in clinical practice the past 2 years. In comparison, nurses in Kentucky must enter a collaborative agreement with a physician to be able to prescribe controlled substances Professional Nursing and State-Level Regulations.
Nurses are constantly provided education to help adhere to the different scopes and laws. We must be familiar with any changes to help guide others.
References
Kentucky Board of Nursing. (2021). https://kbn.ky.gov.
West Virginia Board of Nursing. (2021). https://wvrnboard.wv.gov.
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5 months ago
John Michael Natividad
RE: Discussion - Week 5
Great post-Lyndsey, according to West Virginia Law Code 30-7-1, relating to the limited prescriptive authority, an ARNP must at least practice 3 years under collaborative relationship with a physician and comply with the additional education requirement in pharmacology and clinical management of drug therapy. ARPN can only dispense without refills of Schedule III drugs for 30 days Professional Nursing and State-Level Regulations. In addition, ARNP who have been supervised by a physician for 3 years or more; are eligible to practice independently if they want to do so (Services, n.d.).
In addition to your research, according to the Kentucky Board of Pharmacy, ARNP can prescribe controlled substances: class II with 3 day supply, class III 30 days without refill, and class IV 6 month supply as of February 2021 (Kentucky Board of Pharmacy APRN and PA Prescribing, n.d.).
Reference
Services, B. C. (n.d.). Nurse Practitioner Independent Practice in WV OK for Some APRNS | Blog. Jenkins Fenstermaker, PLLC. https://www.jenkinsfenstermaker.com/blog/nurse-practitioner-independent-practice-in-wv-ok-for-some-aprns
Kentucky Board of Pharmacy APRN and PA Prescribing. (n.d.). Pharmacy.ky.gov. https://pharmacy.ky.gov/Pages/APRN-and-PA-Prescribing.aspx
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5 months ago
Idowu Oshokoya
RE: Discussion - Week 5- Initial
The duties of the Boards of nursing are to ensure evaluation of all applicants for nurse licensure, to grant new or renew nurse licenses, and to place punishable actions for any professional misconduct or criminal convictions. The main goal is to protect the public through regulation of nursing practice (NCSBN, 2021). Professional Nursing and State-Level Regulations It is a fact that the scope of practice or guidelines for Advance nurse practitioners are vary by state and it depends on each regulation that governed their nursing practice (Milstead & Short, 2019).
Some States granted a full practice to Nurse Practitioners which means they can diagnose, prescribe and treat patient without any physician oversight. Also, they can establish their own independent primary care facility. On the other hand, some States does restrict Nurse Practitioners from operating in full practice; It means all nurse practitioners needs physician oversight to prescribe, diagnose, and treat patients Professional Nursing and State-Level Regulations.
The two board of nursing regulation that I would like to compare is the State of Illinois board of nursing and Michigan State board of nursing. June 14, 2019, Advanced Practice Registered Nurses in the state of Illinois are granted full practice upon completion of education, trainings, exams, and certification. According to the Illinois General assembly (2021), “An advanced practice registered nurse certified as a nurse midwife, clinical nurse specialist, or nurse practitioner who files with the Department a notarized attestation of completion of at least 250 hours of continuing education or training and at least 4,000 hours of clinical experience after first attaining national certification shall not require a written collaborative agreement, The scope of practice of an advanced practice registered nurse with full practice authority includes:
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(2) practicing without a written collaborative |
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According to the State of Illinois Department of Financial & Professional Regulation, a written collaboration agreement is no longer required to fully practice as a primary care provider (IDFPR, 2021). Nurse Practitioners may prescribe prescription drugs and Schedules III-V controlled substances. Schedule II controlled substances may be prescribed if certain requirements and outlined in the rules are met Professional Nursing and State-Level Regulations.
In Michigan State, the policy stated that an Advance Nurse Practitioners cannot fully practice as a primary care provider.
According to Michigan National Conference of State Legislature, “NPs may be delegated tasks and functions by a physician and must fall within the NP’s scope of practice. An NP may prescribe nonscheduled drugs without the delegation of a physician. The NP may prescribe Schedules II-V controlled substances if delegated by a physician”( Mich. Comp. Laws § 333.16215-17211a).
References
Idfpr.com. (2021). State of Illinois | Department of Financial &
Professional Regulation. Retrieved from: https://www.idfpr.com/profs/nursing.asp
Illinois General Assembly. (2021). Illinois Compiled Statutes -Advance
Nurse Practitioner
https://www.ilga.gov/legislation/ilcs/documents/022500650K65-43.htm
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: a
nurse's guide. Jones & Bartlett Learning.
National Conference of State Legislature, Michigan. (2021). Scope of
practice-Nurse Practitioners. Retrieved from
https://scopeofpracticepolicy.org/states/mi/
National Council of State Boards of Nursing. (2021). Nursing
Regulation. Retrieved from:
https://www.ncsbn.org/boards.htm
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5 months ago
Cyrin Natividad
RE: Discussion - Week 5- Initial
Hi Idowu,
Interesting post! I currently hold my RN licenses in Pennsylvania and Illinois but now practicing in PA. It's incredible to know that a nurse practitioner licensed as an advanced practice registered nurse in Illinois may practice without a written collaborative agreement if they are certified as a nurse practitioner (Illinois General Assembly, n.d) Professional Nursing and State-Level Regulations. In addition, Illinois NP can Utilize local anesthetic but do not perform operative procedures, manage the administration and dispensing of over-the-counter, legend, and schedule II through V controlled substances (Hidmand, 2019). Thank you for sharing your research, and best of luck, Idowu!
References:
Illinois General Assembly (n.d). https://www.ilga.gov/commission/jcar/admincode/068/068013000D04650R.html
June Rick L. Hindmand,2019. Illinois Creates New Independent Practice License For Nurses. https://mcdonaldhopkins.com/Insights/June-2019/Illinois-creates-new-independent-practice-license
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5 months ago
Jessica Ferrin
RE: Discussion - Week 5
Laureate Education (2018) discusses that “state boards of nursing provide the means to obtain, maintain, and perhaps lose a license”. The South Carolina Board of Nursing recognizes four advanced practice registered nurses (APRN) roles including Nurse Practitioner (NursingLicensure.org, n.d.). Nursing regulations vary from state to state for NP’s. This post will discuss the regulations in my home state of South Carolina, and the regulations in Texas.
In most cases in South Carolina, graduates of an APRN program are required to achieve certification within one year of successful completion (NursingLicensure.org, n.d.). South Carolina belongs to the nurse licensure compact (NLC) allowing them to practice in any other compact state after obtaining a multistate License (NursingLicensure.org, n.d.). Nurses who work in compact states are required to obtain a multistate licensure through their own board of nursing (NursingLicensure.org, n.d.). In South Carolina, APRNs are required to either maintain national certification, or complete 30 contact hours every two years. In order to prescribe medications in South Carolina, the APRN must complete a total of 20 of the required 30 contact hours in pharmaceuticals related to their specialty in addition to two hours in control substance prescribing (NetCE, n.d.).
The Texas Board of Nursing provides licensure to nurses who reside in Texas. APRNs in Texas must complete 20 contact hours of continuing education or obtain, maintain, or renew their national nursing certification every two years (Texas Board of Nursing, 2019). Prescriptive authority is achieved by completing an additional five contact hours in pharmaceuticals every two years (Texas Board of Nursing, 2019) Professional Nursing and State-Level Regulations.
Both South Carolina and Texas APRNs have a restricted practice environment (American Association of Nurse Practitioners, 2021). What this means is that APRNs must work under the direction of a physician at all times in order to provide patient care. Both regulatory agencies are the Board of Nursing with required hours of continuing education. Both states have similar requirements for licensure with 20 required contact hours. However, South Carolina requires an additional two hours for controlled substance prescribing and Texas requires an additional 5 years (NursingLicensure.org, n.d.). Many states allow APRNs full practice environments permitting them to evaluate, diagnose, and initiate treatment including prescribing medications and controlled substances (American Association of Nurse Practitioners, 2021). I believe APRNs should be allowed this autonomy with a certain amount of contact hour requirements either yearly or bi-yearly.
References
American Association of Nurse Practitioners. (2021, August 4). State Advocacy. Retrieved from State Practice Environment: https://www.aanp.org/advocacy/state/state-practice-environment
Laureate Education (Producer). (2018). Regulation [Video file]. Baltimore, MD: Author.
NetCE. (n.d.). South Carolina Advanced Practice Registered Nurses CE Requirements, Accreditations & Approvals. Retrieved from https://www.netce.com/ce-requirements/nurse-practitioner/sc/
NursingLicensure.org. (n.d.). Advanced Practice Registered Nurse License Requirements in South Carolina. Retrieved from https://www.nursinglicensure.org/np-state/south-carolina-nurse-practitioner/
Texas Board of Nursing. (2019, February ). Education - Continuing Competency Requirements. Retrieved from https://www.bon.texas.gov/education_continuing_education.asp#E
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5 months ago
Angela Sullivan
RE: Discussion - Week 5
5 months ago
Lucy Njogu
RE: Discussion - Week 5
5 months ago
Annisha Mcgowan
RE: Discussion - Week 5
Hi Jessica, your post was informative. Advanced practice registered nurses (APRNs) are registered nurses who hold licensure from the Texas Board of Nursing to practice as advanced practice registered nurses based on completion of an advanced educational program acceptable to the Board (Texas Board of Nursing, n.d.). I am from Texas, and you gave me insight on prescriptive authority here. I do know that Texas is a restrictive practice state which restricts advanced practice register nurses (APRN) to practice fully without the supervision of a physician. The supervision is career long for an APRN. I agree with you that South Carolina and Texas are similar with requirements. I see South Carolina has a prescriptive authority in place. An APRN may perform medical acts via telemedicine pursuant to a practice agreement (South Carolina code of laws, n.d.).
References
Practice - Texas Board of Nursing Position statements. Texas Board of Nursing - Practice - Nursing Practice. (n.d.). Retrieved October 3, 2021, from https://www.bon.texas.gov/practice_bon_position_statements_content.asp#15.14.
South Carolina Code of Laws Unannotated. Code of laws - title 40 - chapter 33 - nurses. (n.d.). Retrieved October 3, 2021, from https://www.scstatehouse.gov/code/t40c033.php.
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5 months ago
Misty Williams
RE: Discussion - Week 5
Board of Nursing Regulations in Illinois and Colorado
In the United States there are three types of licensure descriptions that impact the scope of practice of Advanced Practice Registered Nurse’s based on the state that they practice in. There are states that practice under “Full Practice, Reduced Practice, and Restricted Practice” (State Practice Environment, 2021). To operate under Restricted practice or Reduced practice limits the ability to provide care in areas that lack access to primary health-care providers (Neff et al., 2018).
The states that I chose to use for comparison on two APRN board of nursing regulations are Illinois and Colorado. I chose these states because I am a resident in the state of Illinois, but I am interested in relocating to Colorado at some point in my career. I felt like this is the perfect opportunity to research how the regulations apply to Advanced Practice Registered Nurses (APRNs) and which states allow them the legal authority to practice within the full scope of their education and experience.
In Illinois, a Nurse Practitioner practices under “Reduced Practice” authority. Prescriptive authority must be outlined in a collaborative agreement. According to the NCLS, A written collaboration agreement is required and must describe the relationship between the APRN and the supervising physician (State practice environment, 2021). This document outlines the categories of care, treatment and procedures, and prescriptive authorities that may be provided. For example, an APRN has the authority to prescribe prescription drugs and Schedules III-V controlled substances. However, Schedule II controlled substances prescriptions must be delegated by the supervising physician (Illinois, n.d.)
Colorado operates under a “Full Practice” authority. This means that APRNS can diagnose, treat and prescribe independently and without the management and monitoring of a physician after completing a period of supervision at the start of their career. A Nurse Practitioner in Colorado has the legal authority to operate and manage a clinic without the supervision and management of a physician (Colorado, n.d.). This would not be permitted in the state of Illinois or other states that adhere to the restricted or reduced practice laws.
References
Colorado. (n.d.). American Association of Nurse Practitioners. https://www.aanp.org/advocacy/colorado
Examining scope of practice for health care workers. (n.d.). Legislative News, Studies and Analysis | National Conference of State Legislatures. https://www.ncsl.org/research/health/examining-scope-of-practice-for-health-care-workers.aspx
Illinois. (n.d.). Scope of Practice Policy. https://scopeofpracticepolicy.org/states/il/
Neff, D. F., Yoon, S. H., Steiner, R. L., Bejleri, I., Bumbach, M. D., Everhart, D., & Harman, J. S. (2018). The impact of nurse practitioner regulations on population access to care. Nursing Outlook, 66(4), 379-385. https://doi.org/10.1016/j.outlook.2018.03.001
State practice environment. (2021, January 1). American Association of Nurse Practitioners. https://www.aanp.org/advocacy/state/state-practice-environment
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5 months ago
Annisha Mcgowan
RE: Discussion - Week 5
5 months ago
Shelley Lalush
RE: Discussion - Week 5
5 months ago
KAREN MARUYAMA
Reply to Main Post: Discussion - Week 5
5 months ago
KAREN MARUYAMA
RE: Reply to Main Post: Discussion - Week 5
5 months ago
Misty Williams
RE: Reply to Main Post: Discussion - Week 5
Hi Karen.
Professional Nursing and State-Level Regulations Thank you so much for your response. You are correct! I honestly had no idea. I appreciate knowing that not only does Illinois allow full practice authority but also that I need to be aware that information can sometimes be outdated even on reputable websites. According to an article written in Healthcare Weekly the number of nurse practitioners in Illinois has almost tripled and is expected to continually increase (Matshazi, 2020). It is also reassuring to find out that if I stay in Illinois that I would be able to have full practice authority based on the information you provided from Track Bill.
References
Matshazi, N. (2020, February 16). Illinois nurse practitioners nearly triple, but skepticism remains. Healthcare Weekly. https://healthcareweekly.com/illinois-nurse-practitioners/
Sb105 | Illinois 2021-2022 | Aprn full practice authority | Trackbill. (2021, July 9). Legislative Tracking Software | TrackBill. https://trackbill.com/bill/illinois-senate-bill-105-aprn-full-practice-authority/2014972/
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5 months ago
Angela Sullivan
RE: Discussion - Week 5
Thank you for your post. I'm hoping to relocate one day to Arizona, which is also a full practice state. Adopting full practice authority (FPA) for NPs provides patients with full and direct access to all the services that NPs are equipped to provide. FPA improves access to care, streamlines care and makes care delivery more efficient, decreases costs, and protects patient choice for provider (Issues at a glance, 2021).
Issues at a glance: Full Practice Authority. American Association of Nurse Practitioners. (2021, August). Retrieved October 2, 2021, from https://www.aanp.org/advocacy/advocacy-resource/policy-briefs/issues-full-practice-brief.
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5 months ago
Michael Collins
RE: Discussion - Week 5
5 months ago
Sophie Enjema Ndumbe
RE: Discussion - Week 5
Hi Misty,
I enjoyed reading your post Professional Nursing and State-Level Regulations. The board of nursing regulations differ from state to state. All Advanced practice registered nurses must practice according to their state regulations. Fraser & Melillo (2018) states “many state laws restrict the scope of practice (SOP) of APRNs, thus preventing APRNs from performing necessary care” (p.23). The practice authority given by the state board of nursing to practice make it easy for an individual to chose where they would like to practice after getting their certification.
In a full practice state the APRNs assess patients, diagnose diseases, interpret labs, prescribe medications, initiate treatments without any supervision from a physician (American Association of Nurse Practitioners, 2021). Some individuals might like to go to a state where they can have full authority to practice, so that they can use their skills, knowledge and experienced which they have gained throughout their education to care for patients. For an APRN to practice in a state which has reduced practice authority, it difficult for the APRNs because they must depend so much on the physicians. They cannot really perform anything until it gets approved by their supervisor (physician).
References
American Association of nurse Practitioners (2021). State practice environment. https://www.aanp.org/advocacy/state/state-practice-environment
Fraser, M. A., & Melillo, C. (2018). Expanding the scope of practice of APRNs: A systematic review of the cost analyses used. Nursing Economic$, 36(1), 23–28.
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5 months ago
Annisha Mcgowan
RE: Discussion - Week 5
Regulation of the U.S. healthcare delivery system and of healthcare providers exists to protect the interests of public safety, but regulatory structures are extraordinarily complex (Milstead & Short, 2019). Every state board of nursing have their own regulation regarding nursing practice. Rules and regulations are put in place to protect the public from harm and danger.
Texas Board of Nursing Regulations
The Texas State Board of Nursing certifies advance practice registered nurses. The advanced practice nurse provides a broad range of health services, the scope of which shall be based upon educational preparation, continued advanced practice experience and the accepted scope of professional practice of the particular specialty area (Texas board of nursing, n.d.).
Texas is a restrictive state which requires supervision by a physician, but APRN has full prescriptive authority unlike some other states. Being that Texas is a restrictive state there are many APRN that have their own primary care clinics here.
Louisiana Board of Nursing Regulations
Louisiana State Board of Nursing certifies advance practice registered nurses. Louisiana is a reduce practice state. State practice and licensure laws reduce the ability of NPs to engage in at least one element of NP practice. State law requires a career-long regulated collaborative agreement with another health provider for the NP to provide patient care, or it limits the setting of one or more elements of NP practice (AANP, n.d.). In Louisiana a bill was recently passed for NP to practice on there own without a collaborative physician. Physicians were upset stating that NP do not have the required education it takes to fully diagnose and treat a patient Professional Nursing and State-Level Regulations. This has been an ongoing battle because NP go to school for 4 years to become a registered nurse and an additional 2-3 years becoming a NP. The bipartisan bill was introduced during covid due to the lack of providers that was available. The governor wants to extend the bill permanently.
References
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.
Texas Board of Nursing - Advanced Practice Information. (2013) Retrieved from https://www.bon.texas.gov/
State practice environment. American Association of Nurse Practitioners. (n.d.) https://www.aanp.org/advocacy/state/state-practice-environment.
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5 months ago
KAREN MARUYAMA
Response to Main Post: Discussion - Week 5
Hi there Annisha! Thank you for the compare-contrast between Texas and Louisiana APRNs and their scopes of practice in these respective states.
I was astonished to find that APRNs in Texas can amount to costs of 60K annually when it comes to contracting a physician to perform supervisory chart reviews, a required element of the state of Texas for an APRN to be able to prescribe. (Texas Nurses Association, 2020-2021). This is a lucrative barrier to working as an APRN in Texas. To add to this frustration, the contracted physician is not required to see the patient in this regard. (Texas Nurses Association, 2020-2021). The Texas Nurses Association (2020-2021) further states that there are very few states in addition to Texas that require physician supervisory oversee of APRNs. In addition, The Texas Nurses Association (2020-2021) states that “Twenty percent of Texans lack access to a primary care provider”. Allowing APRN practice to transition from a restrictive to the full scope of practice would allow improved patient access to primary care, it would in effect lower the associated costs of seeing a physician and it would help to alleviate the stress on providers with the Covid-19 Pandemic. (Texas Nurses Association, 2020-2021).
Woodruff (2021) describes a newly enacted house bill 495 in Louisiana that allows APRNs full practice authority. APRNs in Louisiana were with the same estimated costs as Texas, for physician required collaboration annually. “Many nurses say this is a costly and unnecessary requirement that the legislation would remove”. (Woodruff, 2021). An amendment to the bill was enacted to require APRNs have a required number of hours with a licensed physician prior to practicing autonomously. “It also created a new board to provide oversight to nurse practitioners operating without collaborative agreements with doctors”. (Woodruff, 2021). Apparently, both APRNs and physicians were not satisfied with the state of the bill and its amendments, as there is still opposition with the details (as you have detailed in your discussion Annisha), but it is a definite starting point, as efforts to pass the bill failed four times over a period of twelve years. (Woodruff, 2021).
Reference
Texas Nurses Association. (2020-2021). Full practice authority for aprns. Retrieved October 1, 2021, from,
https://cdn.ymaws.com/www.texasnurses.org/resource/resmgr/docs/gac/2021/aprn_full_practice_authority.pdf
Woodruff, E. (2021, May 6). Louisiana house oks bill to let nurse practitioners works without doctors. Retrieved
October 1, 2021, from, https://www.nola.com/news/healthcare_hospitals/article_a0ad6d96-adef-11eb-8754-8f2c38023856.html
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5 months ago
KAREN MARUYAMA
RE: Response to Main Post: Discussion - Week 5
In addition, comparing nurse practitioner states of authority in Texas, Louisiana, Florida, and Hawaii; Texas is the only restrictive state that has not converted nurse practitioner practice authority to a full state of practice.
American Association of Nurse Practitioners. (n.d.). State practice environment. Retrieved September 26,
2021, from, https://www.aanp.org/advocacy/state/state-practice-environment
Howard, Chase. (2020, July 3). Florida aprn independent practice update. Florida Healthcare Law Firm.
Retrieved September 30, 2021, from, https://www.floridahealthcarelawfirm.com/aprnindependentpractice/
Texas Nurses Association. (2020-2021). Full practice authority for aprns. Retrieved October 1, 2021, from,
https://cdn.ymaws.com/www.texasnurses.org/resource/resmgr/docs/gac/2021/aprn_full_practice_authority.pdf
Woodruff, E. (2021, May 6). Louisiana house oks bill to let nurse practitioners works without doctors. Retrieved October 1, 2021, from,
https://www.nola.com/news/healthcare_hospitals/article_a0ad6d96-adef-11eb-8754-8f2c38023856.html
REPLY QUOTE EMAIL AUTHOR
5 months ago
Angela Sullivan
RE: Discussion - Week 5
Thank you for your post. I never knew this was going on in Louisiana, I guess because I'm not from there and I don't know anyone from there. I did read up on the proposal and the views of physicians and APRNs. "Dr. Roland Waguespack III is concerned removing the requirement would reduce quality of care. He said, “Independent practice of medicine by non-physicians is dangerous and puts patients at risk" (Norwood, 2021). Then there is an APRN stating that it's a misuse of the terms oversight and supervision, as the APRNs would still need to collaborate with a physician if care falls out of their specific area of practice. Professional Nursing and State-Level Regulations I can see the physicians may think that they went to school and residency longer than nurses and maybe they feel that if APRNs have too much freedom, physicians won't be needed as much to save money within the health care system. I can see that just from working in health care. It seems to be cut throat at times, especially with the extent some organizations go through to cut costs.
Norwood, N. (2021, May 19). Nurse practitioner Bill approved in Senate Committee. https://www.fox8live.com. Retrieved October 2, 2021, from https://www.fox8live.com/2021/05/19/nurse-practitioner-bill-approved-senate-committee/ Professional Nursing and State-Level Regulations.