NUR 513 Topic 2 DQ 1: Identify at least three regulatory bodies or industry regulations that specify certification, licensure requirements, or scope of practice for your specialty
NUR 513 Topic 2 DQ 1: Identify at least three regulatory bodies or industry regulations that specify certification, licensure requirements, or scope of practice for your specialty
NUR 513 Topic 2 DQ 1: Identify at least three regulatory bodies or industry regulations that specify certification, licensure requirements, or scope of practice for your specialty
NUR 513 Topic 2 DQ 1
Identify at least three regulatory bodies or industry regulations that specify certification, licensure requirements, or scope of practice for your specialty. Discuss the way these bodies or regulations influence the educational requirements and experiences for your specialty. Advanced practice registered nurses must incorporate the APRN consensus model in their response.
Re: Topic 2 DQ 1
The federal government does play a role in the regulation process for APRNs in terms of Medicare and Medicaid reimbursement, but much of the regulatory responsibility has been shifted to the states (DeNisco & Baker, 2016). In general licensing and regulations are done on a state level, upheld by the Boards of Nursing (BONs) which vary from state to state (DeNisco & Baker, 2016). The BONs act as decision making bodies that define the nursing scope of practice, educational requirements, licensure, licensure requirements, certifications, and deliver disciplinary action (DeNisco & Baker, 2016). The Nurse Practice Acts (NPAs) are the defined state laws that outline the scope of practice for nurses and nursing specialties within each state that the BON enforces (DeNisco & Baker, 2016).
In the future I plan on pursing a career in Nursing Informatics. Informatics is a nontraditional advanced practice role so some of the certifications and licensure are not at regulated as the four traditional APRN roles. According to the Consensus Model for APRN regulation, informatics is not considered direct patient care and therefore does not require regulatory acknowledgement beyond a Registered Nursing license (APRN Consensus Work Group & National Council of State Boards of Nursing APRN Advisory Committee, 2008).
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There is an ANCC Informatics Nursing board certification that can be obtain. The eligibility to be certified requires active RN licensure from the BON, you must have at least a bachelor’s degree in nursing, a minimum of two years of practice as an RN, 30 hours of continuing education in Informatics withing 3 years, and you must meet practice hour requirements (ANCC, 2021). In my case, my practice hour requirements will be fulfilled by completing this graduate level program.
NUR 513 Topic 2 DQ 1: Identify at least three regulatory bodies or industry regulations that specify certification, licensure requirements, or scope of practice for your specialty References
American Nurses Credentialing Center (ANCC). (2021, February 8). Informatics nursing certification (RN-BC).https://www.nursingworld.org/our-certifications/informatics-nurse/
APRN Consensus Work Group & the National Council of State Boards of Nursing APRN Advisory Committee. (2008). Consensus model for APRN regulation: Licensure, accreditation, certification & education. APRN Joint Dialogue Group Report. https://www.ncsbn.org/Consensus_Model_for_APRN_Regulation_July_2008.pdf
DeNisco, S. M., & Barker, A. M. (2016). Advanced practice nursing: Essential knowledge for the profession (3rd ed.). Jones & Bartlett Learning. ISBN-13: 9781284072570
RESPOND HERE (150 WORDS, 2 REFERENCES)
Re: Topic 2 DQ 1
According to Denisco and Barker (2016) “Health professions regulation provides for ongoing monitoring and maintenance of an acceptable standard of practice for the professions, with the goal of protecting the interests of public welfare and safety. Regulation is needed as a mechanism to protect the public because of the complexity of the healthcare system”. Regulatory bodies include the Board of Nursing (BON) for each state. There are sixty BON’s and they are all members of the National Council of State Boards of Nursing (NCSBN).
Each states BON establishes licensing criteria, approved courses for nursing education, and licensure examination (Denisco & Barker, 2016). All nursing schools that are certified base their programs content on what is approved by the BON. When it comes to the nursing licensure exam, although each states BON sets the criteria for passing, it is the National League for Nursing (NLN) through its established State Board Test Pool Examination (SBPTE) that makes sure the licensing exam is standardized (Denisco & Barker, 2016).
National specialty nursing organizations play a role in the regulation of advanced practice registered nurses. They do so by developing practice standards and examinations. I am currently working toward a career in health care management. I am hopeful that I can complete my MBA and MSN in Leadership in Health Care Systems. A regulatory body that will be relevant to my chosen career field is the American Organization for Nursing Leadership (AONL). Through their credentialing center, the AONL offers certifications for nurses depending on their level of management; the Certified Nurse Manager and Leader (CNML) for managers, and Certified in Executive Nursing Practice (CENP) administrators (American Organization for Nursing Leadership, 2021).
Advanced practice registered nursing (APRN) was born out of the anticipated shortage of primary care providers following the birth of Medicare and Medicaid programs in the 1960s (Denisco & Barker, 2016). In an effort to make it easier for APRNs to practice across state lines, the NCSBN published the Consensus Model in 2008. “The Consensus Model provides guidance for states to adopt uniformity in the regulation of APRN roles, licensure, accreditation, certification and education (National Council of State Boards of Nursing, Inc., 2021).
Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: NUR 513 Topic 2 DQ 1 Identify at least three regulatory bodies or industry regulations that specify certification, licensure requirements, or scope of practice for your specialty
American Organization for Nursing Leadership (AONL) (2021). AONL Credentialing Center Certification Programs. Retrieved from https://www.aonl.org/initiatives/certification
Denisco, S.M. and Barker, A.M. (2016). Advanced Practice Nursing: Essential Knowledge for the Profession. Jones and Bartlett Learning. https://www.gcumedia.com/digital-resources/jones-and-bartlett/2016/advanced-practice-nursing_essential-knowledge-for-the-profession_3e.php
National Council of State Boards of Nursing, Inc. (2021). APRN Consensus Model: The Consensus Model for APRN Regulation, Licensure, Accreditation, Certification, and Education. Retrieved from https://www.ncsbn.org/aprn-consensus.htm
RESPOND TO KELLY HERE (150 WORDS, 2 REFERENCES)
Re: Topic 2 DQ 1
The regulatory bodies that work together to specify certification, licensure requirements, and scope of practice for Public health nursing include, the National Council of State Board of Nursing (NCSBN). The American Nurses Association (ANA), American Nurses Credentialing Center (ANCC) and the National Board of Public health examiners (NBPHE) (American Association of College of Nursing, 2021). In many cases, the major and legal requirement for Public health nursing practice is the registered nurse (RN) licensing.
Nurses with baccalaureate degree who are interested in receiving Advanced degree such as master’s degree or higher in public health nursing can seek additional voluntary certification through the American Nurses Credentialing Center (ANCC) to earn Advanced Public Health Nursing Board certified (PHN-BC) and the National Board of Public Health Examiners (NBPHE). Hence, they are awarded a Certified Public Health (CPH) certificate after the certification examination (Association of Public Health Nurses, 2019)
The National Council of State Board of Nursing (NCSBN) is a non-profit organization that ensures that competent care is rendered across the nation by licensed nurses. They do so by ensuring that the nurses entering the workforce have the necessary skills and knowledge to carry out safe patient care (National Council of State Board of Nursing, 2019). They developed the licensure examination for nurses known as NCLEX.
The American Nurses Association (ANA) empowers nurses to perform to the full extent of their expertise, for the benefit of public health. The review and revision of the scope and practice standard of public health nursing are facilitated by ANA to ensure that nursing responsibilities evolve at the same pace as the demands of public health (American Nurses Association, 2021). ANA also supports policy, advocacy, and education to build on individual nurse contributions to public in the areas of immunization, infection control, environmental health, and opioid crisis response (American Nurses Association, 2021).
NUR 513 Topic 2 DQ 1: Identify at least three regulatory bodies or industry regulations that specify certification, licensure requirements, or scope of practice for your specialty References
American Association of College of Nursing. (2021). Certification for Public Health Nursing. AACN. Retrieved March 4, 2021, from https://www.aacnnursing.org/Population-Health-Nursing/Certification-for-Public-Health-Nursing
American Nurses Association. (2021). Public Health Nursing. ANA. Retrieved 3 4, 2021, from https://www.nursingworld.org/practice-policy/workforce/public-health-nursing/
Association of Public Health Nurses. (2019). CPH Credential. APHN. Retrieved March 4, 2021, from https://www.phnurse.org/cph-credential
National Council of State Board of Nursing. 2019. History. Retrieved from https://www.ncsbn.org/history.htm
Week 2 Lecture:
Nursing in the 1970s
You would feel lost and confused if you were transported back in time to a hospital ward in the 1970s when the nurses who are now at the end of their careers were students. You would likely be out of your depth as a nurse from that era who suddenly found herself on duty in the present day.
Nursing students were part of the nursing staff allocation.
In 1975, I was accepted as a student nurse in an LPN program at a local hospital. We were given unlimited free meals, three student uniforms (green pin striped) a couple of matching caps, textbooks, and $100 a month as a nursing student. No tuition was charged. The program was a vocation program offered through Sumner county.
As students, we spent 8 hours a day Mon-Fri in class and after 3 months we spent 10 months working 8 hours a day Mon-Fri on the floors with our instructor rotating and we each had a preceptor on every floor that we worked and we also rotated through surgery.
IT WAS PROPER ETIQUETTE TO ALLOW SUPERIORS TO GO THROUGH A DOOR FIRST, AND YOU COULD OFTEN FIND A GROUP OF NURSING STUDENTS FORMING A “GUARD OF HONOR” AT A DOORWAY!
We were absolutely not allowed to use the elevators. We had to use the stairs and our classroom was on the 5th floor. It was a part of our discipline as nursing students. I did sneak a few times and used an elevator as I am sure every one of the students did as well. I was the only single student and got married the week after graduation.
The neatness of the nurse herself, as well as great respect towards licensed nurses was demanded.
We had visiting hours between 2 pm and 5 pm. No children and only two visitors at a time. Before visiting hours all the bed linens had to be straightened, with perfect hospital corners, the overbed tables had to be in a straight line at the bottom of the beds with all the wheels pointing in the same direction. Fortunately, most patients were understanding and endured the trussed-up state until the doors were opened for the visitors.
Our uniforms were the double-breasted type, cinched at the waist with a belt. We also had to learn how to fold and pin the caps into what looked like upside-down ice cream tubs and how to fasten them to our hair with clips so that they remained firmly perched in place all day.
The “mini” was in fashion then, and of course, we all tried to get away with wearing our dresses as short as possible without getting into trouble but the instructor would make sure that our dress was no shorter than the tip of our fingers when we held our arms down at our sides. We were allowed to wear a wedding ring, no engagement ring ☹ and only simple post earrings such as gold, silver, or pearl balls and they had to be tiny. No necklaces. No tattoos or be thrown out. White granny panties, and yes, they checked! White hose, no socks, and white clinic shoes with white shoe laces and they better be polished.
Nursing duties were allocated according to tasks rather than an assignment to particular patients. As the program progressed, the student could do more advanced procedures and tasks.
The food was not portioned packed, except for special diets. It was delivered in a large cart and the nurse in charge dished up for each patient. Other nurses would collect the plates, hand it out to the patients, and then assist those who needed feeding.
Similarly, the patient’s medicines were not dispensed individually by the pharmacy. There was a cart with the full range of medications and from here, using a card system to which the individual patient’s prescriptions had been ordered, a senior nurse would hand out the medicines. Considering this system, it was surprising that very few medication errors occurred.
There were no computers and no electronic records. Everything was written by hand. The patient’s file was kept at the bedside. It contained the admission records, doctor’s notes, prescriptions, and diagnostic reports. There was also a vital signs chart on which the nurse responsible for taking the vital signs of all the patients had to chart them in graph format. Recoding vital signs required the use of a three-colored pen to reflect the three different shifts and was kept on the front of the chart for all to see.
The nursing care plans were introduced towards the late 1980s although this does not mean that there was no planning of nursing care. There was a metal flip folder, with a card for each patient from which the report was handed over to the next shift. Throughout the day any abnormal observations, changes in the patient’s condition, and treatment orders would be entered on this card. The nurse in charge would enter specific nursing instructions and handed over the card to the next charge nurse and individual nurses did not give report on their patients. The charge nurses planning of care was also reflected in the allocation of duties at the start of each shift.
Everything was written in pencil so it could be erased and updated as needed.
A major shift in hospital care has been the reduction in the length of patient stays due to advances in medicine and technology as well as the increased cost of hospital care. Patients remained in the hospital for at least one night even after very minimally invasive surgery. After surgery such as a hysterectomy, patients were on strict bed rest for at least two days and remained in the hospital for five days or, most often, until the sutures were removed. There were no pins and plates for treating fractures and a patient with a fractured femur was placed in traction and remained in the hospital for up to three months. (Consider the mix of the type of patients who most frequently end up with fractured femurs, their immobility while not being ill and young student nurses – made for some interesting times.)
“Beds and backs,” a routine done three times a day, fell into disuse mainly because of early mobilization and shorter patient stays. Usually, in teams of two, nurses went to each patient, in turn, seeing to patient comfort, making general observations, and taking action to prevent pressure sores. Bedridden patient’s backs, hips, heels, and elbows were rubbed and creases and crumbs removed from the linen. Pillows were plumped up, water jugs filled, and the general surrounding tidied.
Bedsores were frequently big enough to put your fist in and the bone was exposed. Pressure sores were treated with Maalox mixed with white sugar which was applied to the entire pressure sore inside and out and a heat lamp was shined on the pressure ulcer for 30 minutes 3-4 times a day. Patients with this level of pressure sores came in with them from nursing homes or occasionally from a patient’s home. If the pressure ulcer was on the patient coccyx, you could see the coccyx bone, just as you could see the hip bones, but when on the coccyx we had to tape one of the buttocks to the side rail for 30 minutes while the heat lamp was shining on the pressure ulcer in order to fully expose the coccyx area. There was no staging of pressure ulcers. Red areas or barely open areas were rubbed down and further than that there were huge pressure ulcers that were treated with the Maalox, sugar, and heat lamp.
Patient requests would be attended to, and anything unusual in the patient’s condition would be reported to the nurse in charge. There was less focus on infection control then, and you didn’t wash your hands between each patient! We had to clean patients stool and urine off of them with our bare hands. If we wore gloves, which weren’t around anyway except sterile gloves, the medical communities train of thought was that if we wore gloves the patients would think that we thought that they were dirty so we had anti-rooms in the halls about every four rooms apart and we went there to scrub up after cleaning up a patient and it was just soap and water. We did not know any different so it wasn’t a big deal to us. Now…..yuck!
Very little technology was in place to assist in monitoring patients. The temperature was taken with a mercury thermometer, you wore a pin watch for counting the patient’s pulse and respirations, and BP was measured with an aneroid sphygmomanometer. On general floors, most beds did not have an oxygen supply – you wheeled in a portable oxygen cylinder when a patient needed oxygen, there were no pulse oximeters.
IV fluids came in glass bottles and if you needed to control the speed of administration you either counted the drops per minute, or you stuck on a length of tape on which you marked the minutes or hours. There were no IV pumps or IV medications. The top of the IV bottle was flat and the patient would go to the restroom and put the IV bottle on the floor upside down on the flat end. By the time they got back to the bed a lot of their blood was in the IV bottle but it was just rehung and the blood was run back in with the fluids
The IV lines had just the roller clamps and very often patient with dementia or just bored would play with the roller clamp. It was not unheard of to go back to check on a patient IV and within 30 minutes 1000 ml had infused and the patient was having difficulty breathing. We just stopped the IV infusion for a while.
When starting an IV the needle remained in the patient’s arm. Every patient with an IV, which was just for hydration because there were no IV meds, had to have an arm board taped to their arm to keep the needle from bending or coming back out through the patient skin and blood pouring out all over.
Very few intensive care beds were available in the hospital. Most of the ICU’s were converted side rooms of specialist units, on each floor, with two to four beds. A cardiac monitor and a central venous pressure line were the only advanced equipment used in these units. The venous pressure line was inserted via the median basilic vein and very rarely anywhere else such as the intrajugular vein as is the most commonly used today. There were no ports of any kind.
Dialysis was available but was very complicated and lasted for 12 hours and there were no dialysis machines. The dialysis was peritoneal and therefore there were no dialysis shunts or ports. Patient died of septic infections due to lack of sterility with peritoneal dialysis although at that time no one knew what sepsis was. Mechanical dialysis was available by the late 70’s in big hospitals and by the early to mid-80’s in smaller hospitals.
There were no intermediate-high care units. Critically ill patients were mostly treated inside rooms on the floor where a form of patient allocation was used when one of the nurses on the staff complement of the unit was allocated to special one on one care.
The first big nursing strike was in 1972 when 97,000+ nurses went on strike due to pay. The second nursing strike due to pay occurred in 1974. After 1974 the average pay for a nurse went up by 30%.
Other interesting tidbits:
· Nurses lived and died by the Kardex, a folded card-stock roadmap to all things for the patient, completed in pencil and continuously crossed out or erased and updated during every shift
· MAR’s were hand-written every day on the night shift and would last for 24 hours. The nurse initialed when a med was given. Black Ink 7 am-3 pm, Green Ink for 3 pm-11 pm and Red Ink for 11 pm- 7 am. Military time was not used.
· Universal precautions didn’t exist.
· HIV, C-diff, VRE, and MRSA did not exist.
· Electrophysiology studies were done at the bedside to discover and treat arrhythmias.
· A patient suffering an MI stayed in the hospital for a minimum of 2 weeks and was not allowed to do anything including taking a shower or drinking anything either cold or hot.
· All patients were given a backrub at bedtime by their nurse.
· There were no outpatient surgeries. Most surgical patients stayed as an inpatient for 7-10 days.
· GI bleeds were managed by inserting tubes with balloons (attached to football helmets) to tamponade varices.
· Warm-water-heated metal bedpans were used for patient comfort.
· Central venous pressure was measured with water manometers.
· Nurses used the second hand of a wristwatch to calculate I.V. drip rates.
· White oxford lace-up shoes were the norm for nurses.
· Only operating-room (OR) staff and physicians wore scrubs.
· Nurses wore all white, cap, either pantsuit or dress and must wear white granny panties. Colored underwear or bikini underwear would show through the white uniform and you would be sent home!
· . One pair of post earrings, one wedding band, no stones, and no tattoos
· Hair longer than shoulder length had to be up and under the nursing cap.
· Vital signs recording required a three-colored pen to reflect the three different shifts.
· Nurses mixed antibiotics without pharmacist assistance and were not available until the late 1970s.
· Nurses became proficient in I.V. sticks by practicing on one another.
· Patients were weighed manually.
· Requisitions were completed on typewriters.
· Public health meant well-baby check-ups at the new mother’s home.
· Grandma died at home.
· Patients heading for the OR had their body hair shaved with hand razors.
· Most surgery patients were admitted to the hospital the night before.
· Nursing caps were still mandatory.
· The nurse carried the doctor’s charts and walked behind the doctor as he made rounds.
· Dr’s. did not have beepers or cell phones. Nurses were scared of doctors and drew straws when one had to be called.
· There were no ultrasound, CT, or MRI machines. Most surgeries were listed as exploratory because the surgeon had no idea what was going on inside the patient.
· No pulse oximetry
· No accucheck machines, urine had to be tested for sugar QID and insulin was given according to which of four colors the urine changed to after a clinitest tablet was added to the urine.
· No fetal monitors existed; the baby was deemed ok when it was born alive
· No dinemapps
· No ventilators
· The Physician’s Desk Reference and the U.S. Pharmacopeia were chained to the desk, were the common drug references.
· Nurses carried trays with cups of pills and med cards.
· Cancer was a definite death sentence.
· Staff and patients smoked in the hospitals
· Nurses and doctors smoked at the nurse’s station
· There was no HIPAA. Nurses knew everyone’s business and many did tell friends and even just acquaintances their patients’ private medical information.
Nursing yesterday, today and tomorrow
Nursing has changed dramatically over the past 4-5 decades and will probably change as much or more over the next forty-five years, and this is why continuing education has become so important. While developments in society, medicine, and technology will change the landscape, it could never replace the essence of nursing – caring for other human beings at a time of need.
BTW- After graduation my rate of pay was $3.25 an hour and that was a good wage. Minimum wage was .90 an hour. My brand-new car was $2,999.99. Advertised as still being under $3,000. However, for me it was free. My parents promised me a brand-new car, of my choice, if I finished LPN school. I did not realize until the second day of class that I was in nursing school. I thought I was in school to be a CNA. Obviously at that time I had no interest in education! Oh, how times changed! (For the better)!
I hope things are going well during our first few weeks of class! I would like you to take a minute and think about the goals you have for this class. When we have specific and targeted goals, we are better able to determine when and how meet our objectives. Please respond to this topic with:
- A prioritized list of 3 to 5 goals for your personal learning for this course.
- Include a brief description of how you see yourself accomplishing your goals.
- Let me know what I can do to help you achieve your outlined goals.
While this is not a graded or required activity, I find that it is helpful to outline what you want to personally gain from a course. Also, your responses will count towards your participation, as long as they are substantive in nature (at least 100 words long).
Thanks
I have many goals for this course and graduate school in general. My biggest goal is to fully engage and to absorb as much information as possible. I have limited knowledge on the information in this class, but I am hoping that I will have a great understanding by the end of this class. To keep myself accountable, I want to be actively working on schoolwork at least 5 days per week, whether this is doing assigned reading, discussion posts, or other assignments. There is a lot of information to learn in this class, and I want to get the absolute most out of it.
My next biggest goal is to take the time to read my classmates discussion posts, even if I am not replying to them. Everyone within this class has a unique background within nursing, and it is always great to learn from a different perspective. My fellow classmates have a very diverse background of knowledge and expertise, and I am very excited to learn from their work experiences.
My final goal is to try my absolute hardest to get straight A’s. I am aware that getting an A in every class is not the most important thing, but I am easily motivated by grades. I have always been a student who is disappointed to get anything less than an A, but this is obviously a much harder program, and I am working 50+ hours per week, so it could definitely be a challenge. I am excited and nervous to see what the remainder of this class and program will bring.
My goals for this class are as follows:
Make a consorted effort to respond to the weekly DQ and other weekly assignment whether its a graded or non graded responses with in the specific time allotted. For I know if I were to submit a late assignment I would probably loose points, every points are important to me.
Learn as much as possible from this and subsequent classes so when I finish with school and become a nurse leader with a higher degree I can be effective and bring about change on the unit where I work and the patient population I serve.
Pass all my classes with decent grades for me grade is very important it is reflective of application dedication to the course of study.
Read all my classmates posts for iI know I will definitely come away with some new information which iI can incorporate in my daily practice.
I can achieve my goals by a few simple alteration in my time. I am prepared to cut back on the over time I generally work, focus on reading the outlined chapters and other material that might be helpful, spending less time on my phone looking at nothing of importance and lastly probable taking less road trips
One of my goals in this class is to make a good effort to make discussion posts weekly and respond to my classmate’s posts. I will try to be active in the online environment.
My second goal, though this is my first time doing online schooling, I will do my best to grasp every knowledge I can so that I can be successful in my field. Since I started in the ICU, I have been telling myself no matter how long I work in this unit, I will be like a “sponge” where I gather and understand everything I needed to learn.
Lastly, my goal is to get good grades in this subject. I will do my best to read, write and learn what I can.
Nursing Regulatory Bodies
Every country has nursing regulatory bodies that control the nursing profession. Nursing regulatory bodies are always formed to enhance healthcare practices through establishing standards and overseeing nurses’ individual practices. Through the regulatory and professional organizations, nursing professionals are able to promote professional developments, determine practice standards, and advance nursing practice to ensure quality treatment outcomes. Nursing regulatory bodies often support quality practice environments through the identification of different attributes of safe nursing practices. These bodies also ensure public safety by establishing entry-to-practice competencies and the required practice standards.
The three major nursing regulators in the field of health informatics include the National Council of State Boards of Nursing (NCSBN), the American Nurses Association (ANA), and the Alliance of Nursing Informatics. These regulatory bodies often engage in specifying certifications, licensure requirements, and the scope of practice for the nursing informatics specialty (Rutherford-Hemming et al., 2016). National Council of State Boards (NCSBN) protects public healthcare delivery by ensuring that licensed nurses provide safe and competent nursing services. The organization is always involved in the provision of certifications and licenses to only qualified nurses capable of delivering quality care to the patients.
American Nurses Association (ANA) is always involved in the regulatory activities in ensuring the delivery of quality care to the patients. For individuals with qualifications in nursing informatics, ANA often provides certifications that ensure quality healthcare practices (Camicia et al., 2018). Finally, the Alliance of Nursing Informatics advances nursing informatics education, leadership, policy, and research through the nursing informatics organization’s unified voice. The organization ensures that there are qualified, certified, and licensed nursing informaticists capable of managing current issues that involve the application of technology in the healthcare processes (Sensmeier, 2019).
NUR 513 Topic 2 DQ 1: Identify at least three regulatory bodies or industry regulations that specify certification, licensure requirements, or scope of practice for your specialty References
Camicia, M., Chamberlain, B., Finnie, R. R., Nalle, M., Lindeke, L. L., Lorenz, L., … & McMenamin, P. (2018). The value of nursing care coordination: A white paper of the American Nurses Association. Nursing Outlook, 61(6), 490-501. https://www.nursingoutlook.org/article/S0029-6554(13)00188-7/abstract
Rutherford-Hemming, T., Lioce, L., Jeffries, P. R., & Sittner, B. (2016). After the national council of state boards of nursing simulation study—Recommendations and next steps. Clinical Simulation in Nursing, 12(1), 2-7. https://S1876139915000900
Sensmeier, J. (2019). The Value and Impact of the Alliance for Nursing Informatics Emerging Leaders Program. CIN: Computers, Informatics, Nursing, 37(12), 612-614. https://journals.lww.com/cinjournal/Citation/2019/12000/The_Value_and_Impact_of_the_Alliance_for_Nursing.2.aspx
All fifty states have individual boards of nursing which collectively comprise the National Council of State Boards of Nursing. The board of nursing protects the health and safety of the public by regulating nursing practice and defining the standards for safe nursing care. In California the Nurse Practice Act (NPA) describe the scope of practice and responsibilities for the registered nurse within the state.
The California Board of Registered Nursing provides information and guidelines for the registered nurse. The scope of the advanced practice nurses continues to change and so does the information and guidelines of practice. The California Board of Registered nurses defines the scope of practice, education, and certification of advanced practice nursing. For example, a Nurse Practitioner “is a registered nurse who possesses additional preparation and skills in physical diagnosis, psycho-social assessment, and management of health-illness needs in primary health care, who has been prepared in a program that conforms to Board standards as specified in California Code of Regulations, CCR, 1484 Standards of Education” (CA.gov, p. 1). In California Nurse Practitioners can prescribe medications and work independently which is a difference in practice compared to other states within the United States.
As stated earlier, the scope of advanced practice nursing continues to change and in turn the board of registered nursing and NPA continues to update. It is important as a nurse that we continue to strive to educate ourselves and keep up to date in changes in legislation and nursing practice.
CA.Gov, (N.D.). California board of registered nursing: General information: Nurse practitioner practice. https://www.rn.ca.gov/pdfs/regulations/npr-b-23.pdf
Thank you for the information about the New York state nurse practice act. There are some common elements that are shared among most state nurse practice acts. However, one thing I have noticed in the area I live is that though advanced degrees are highly encouraged, it is almost a larger expectation that advanced nurses become certified. The type of certification is not necessarily determined, but you obtain a certification. The organization I work for has told all nurse leaders they must be certified within six months or find another position within the hospital, non-leadership.
As we all know, nursing and advanced nursing schools are hard. However, each school is somewhat different, yet everyone must pass the national licensure exam. Becoming a certified nurse validates your expert knowledge and skills in a specific area (AACN, n.d.). I chose to become a certified critical care registered nurse (CCRN) because of my vast experience in the critical care areas. I encourage all of you to consider elevating your nursing level at some point for certification, as it speaks volumes to your employer (or potential employer) about how knowledgeable you are.
Reference
American Association of Critical-Care Nurses [AACN] (n.d.). Certification benefits patients, employers and nurses. https://www.aacn.org/certification/value-of-certification-resource-center/nurse-certification-benefits-patients-employers-and-nurses#:~:text=By%20becoming%20certified%2C%20nurses%20validate,licensure%20measures%20entry%2Dlevel%20competence.
REPLY
you mentioned some good points about the National Council of State Boards of Nursing (NCSBN) working to standardize, guide and encourage collaboration among the nursing regulatory bodies across the country. I agree that this allows nurses to learn from one another and move the profession of nursing forward by sharing knowledge and working together. Another way that NCSBN is advancing the nursing profession is by offering products that not only connect regulatory leaders, but also focus on growing and developing those leaders. (NCSBN, n.d) I was so impressed and encouraged to learn that an organization like NCSBN exists.
You and I are working to become a master’s degree trained nurse educator and public health nurse, respectively. Although nurse educators and public health nurses are not currently included in the list of four approved APRN roles, that may soon change (DeNisco & Baker, 2019). I feel that the NCSBN and the collaboration that goes on there may play a large part in developing regulations and nursing licensure examinations to facilitate that change.
References:
DeNisco, S. M., & Barker, A. M. (Eds.). (2019). Advanced practice nursing: Essential knowledge for the profession (4th ed.) Jones & Bartlett Learning. ISBN-13: 9781284176124
In the healthcare field, as nurses, we need to follow many rules to provide safe care to the patient. There are many requirements that the state of California has for nurses to get a nursing license. The California Nurse Practice Act (NPA) in California sets the scope of practice for Registered Nurse and their responsibilities. The Board of Registered Nursing (BRN) “set statutes and regulations that govern nursing practice and education in California” (California Board of Registered Nursing, 2022). The BRN requires nurses to apply for the license in California, complete an associate or bachelor’s degree, and pass the NCLEX-RN exam. For the Advance Practioner Registered Nurse (APRN), the nurse must have an active RN license, a master’s in nursing, and pass the exam for the certification. Also, the APRN must obtain a furnishing certificate to prescribe. The APRN in California can prescribe medications, medical devices, and control medication within the field of practice and cannot perform surgery (California Board of Registered Nursing, 2022). Registered Nurses (RNs) in California do not need to be supervised if they adhere to their scope of practice. All the regulations help keep nurses updated with the education to provide patient safety. Nurses in California must adhere to the rules that are in place by the BRN to provide patient care safely.
California Board of Registered Nursing. (2015). California Board of Registered Nursing
Retrieved August 12, 2022, from General Practice Information:
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I agree with your statement that as nurses, we must follow the rules established by regulatory bodies to ensure patient safety. As a nurse working in hospice, the majority of our patients reside in their homes and are cared for in this setting. When the COVID-19 pandemic occurred, our nursing practice vastly changed based on the Centers for Disease Control and Prevention (CDC) guidelines. Prior to the pandemic, hospice admissions were done by a nurse and social worker who went into patient homes and spent up to several hours inside these homes talking to patients and families and completing assessments and paperwork.
Once we started admitting COVID-19 positive patients in their homes and the CDC recommended contact and droplet precautions for these patients, we had to redesign the way we admitted patients. In the interest of protecting our staff, patients, and families, we started conducting admission meetings via conference call, followed by a short visit to the home where staff maintained contact and droplet precautions the entire time. The current issue we are facing is that for immunocompromised patients, which is all of our hospice patients, isolation and use of contact and droplet precautions should be maintained for at least 20 days, per current CDC guidelines (Centers for Disease Control and Prevention, 2022).
As the CDC updates their guidelines and now only recommends isolation of 5 days for the general public, we are encountering many patients and families who do not understand or want to follow the CDC guidelines for immunocompromised patients. This is requiring our staff to take more time educating and reeducating families on the importance of maintaining precautions as long as the CDC currently recommends. As professional nurses, we understand that guidelines are updated over time as more research is conducted and thus changing guidelines are evidence of knowledge gained, not mistakes made. Unfortunately, the patients and families we encounter do not always view changes in guidelines this way, therefore making it challenging to maintain CDC recommended guidelines for all types of infectious diseases in the home setting.
Reference
Centers for Disease Control and Prevention. (2022). Ending Isolation. https://www.cdc.gov/coronavirus/2019-ncov/hcp/duration-isolation.html
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Thank you for you insight in hospice care and how COVID-19 changed not only how you interacted with those patients but also how it affected your guidelines of practice. I can relate to the changes of guidelines and also how this impacted not only patients but their families. The hospital setting also had to make multiple changes to maintain the Center of Disease Control (CDC) guidelines of care. The importance of educating not only yourself as a healthcare provider but also educating the patients and families cannot be stressed enough.
The changes within the hospital setting continues to fluctuate with new evidence and updates on how to provide the best care to our patients. Initially when COVID-19 began to outbreak our hospital, per the CDC recommendations, removed visitation to protect the patients, families, and healthcare workers. This change was not well received by a significant number of patients and their families. With the decrease in social interaction and physical touch I noted just how much of a negative impact this had on the patient, and I found myself playing a bigger role to these patients then I ever could have imagined. Nursing school and nursing prior emphasized holistic nursing, but with the pandemic the severe importance of holistic nursing became more apparent to me. Policies within the hospital adjusted for the safety and care of our patients.
Prior to the pandemic intubating a patient on med-surg floor was unheard of unless a patient coded. Unfortunately, intubating the wide awake and scared patient became frequent occurrence on my floor as we admitted higher acute COVID patients. I had to learn quickly about intubation and educate myself thoroughly so I could provide the best care for my patients. As critical care bed availability decreased the higher acute our patients became. I remember at the beginning the CDC guidelines kept changing as more and more evidence began to be found. The type of isolation and personal protective equipment would continuously change based on the CDC guidelines, and as the pandemic progressed we all learned so much. I believe the pandemic forever changed nursing practice and truly emphasized the importance of continuing education and evidence based practice.
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The Virginia Nurse Practice Act contains laws that govern nursing in the state of Virginia (Virginia State Board of Nursing, 2022). It defines what constitutes nursing practice in the state and establishes The Virginia State Board of Nursing. The Virginia Department of Health Professions, and specifically, The Virginia Board of Nursing is a regulatory body that that operates under the Virginia General Assembly’s legislative authority via The Virginia Nurse Practice Act (Virginia State Board of Nursing, 2022). The Virginia State Board of Nursing sets minimum standards for, and approves, educational programs that prepare people for licensure, certification or registration under the definition of nursing. Additionally, the board can investigate illegal nursing practices, and form regulations regarding delegation among many other things required as set for the in the Nurse Practice Act (Virginia State Board of Nursing, 2022).
The Virginia Nurse Practice Act also gives The Virginia Board of Nursing the authority to enter into the Nurse Licensure Compact (NLC). The NLC is regulated by The National Council of State Boards of Nursing (NCSBN). The NLC system supports the consensus model by providing a multistate agreement on advanced practice nursing education, roles, licensure, and accreditation. In my nursing practice the influence of these regulatory bodies is demonstrated by having multistate privileges to practice as an RN and eventually as an APRN (National Council of State Boards of Nursing, 2022). This was especially important during COVID-19 to allow nurses to move between states in order to provide consistent quality care to patients. In my future role as an APRN with a focus on healthcare quality and patient safety, these regulatory bodies set the standard for safe, quality nursing both in the state of Virginia and in all participating compact states ((National Council of State Boards of Nursing, 2022).
References
Virginia State Board of Nursing. (2022, July 1). Retrieved from Virginia State Board of Nursing: http://www.dhp.virginia.gov/Boards/Nursing/PractitionerResources/LawsRegulations/index.html
National Council of State Boards of Nursing. (2022, August 12). Retrieved from National Council of State Boards of Nursing http://www.ncsbn.org: https://www.ncsbn.org/about-nursing-regulatory-bodies.htm
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your post just brought into sharp focus something I had not considered throughout the entire period of the pandemic. You mentioned the usefulness of having a compact state license that helped people to travel across the nation to provide nursing care. I was not able to do this because of my peculiar situation so I had not come across the possibility of answering a question on my ability to travel around with my license. I really enjoyed having other nurses traveling and coming to help us in the facility I work in without thinking about a possible hinderance of not holding a compact state license. I strongly believe, and now have become an advocate, that the lessons learnt from the COVID-19 pandemic should make us all think differently and the noncompact states must do away with whatever encumbrances to help make their nurses available to help everywhere in times like the pandemic presented.
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Thank you for your post it was very well written. I agree that the Nurse Licensure Compact is very important for nurses to be able to move between states and provide consistent quality care. I initially came from Texas, which was also part of the Nurse Licensure Compact, but now living in California my state does not participate in this. I completed my nursing school in Texas which gave me the opportunity to learn the rules and regulations that govern the nursing profession in Texas. Although I was considered a nurse and had my nursing license I could not work in California until I applied and received my California nursing license. Some of the rules and regulations that were imbedded into my nursing education were not quite the same when I came to California. One difference I noted immediately was that California had a state mandated nurse-to-patient ratio. In Texas the Board of Nursing didn’t have strict authority over staffing ratios, but the Texas Nursing Practice Acts did have standards of nursing practice that would protect the nurse and patient from unsafe staffing ratios. The hospitals in Texas have staffing committees and staffing policies to protect both the nurse and the patient. I am impressed with both California and Texas regarding the nursing profession. Both states have pros and cons and I find it so interesting to evaluate the differences.
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agree with your point of view regarding the “Nurse Licensure Compact” that can help other states that need nurses, especially during the pandemic. Still, currently, there is a shortage of nurses in our facility. It is a big help when nurses from other states can help with patient care. The patient ratio changed; I remember that during COVID, we were over ratio because there were not enough staff. In my opinion, more states should endure the licensure compact. According to the Nacional Council of State Board of Nursing (NCSBN), on August 12, 2020, let advance practice registered nurse (APRN) “hold on multistate license” to work in the compact state but first the states “must pass the model legislation” (NCSBN, 2020). I hope one day the state of California can be part of the Licensure Compact to be able to work in other states.
APRN Compact. NCSBN. (2020, August 12). Retrieved August 13, 2022, from https://www.ncsbn.org/aprn-compact.htm
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I wanted to add to your and Rosa’s discussions about the Nurse Licensure Compact (NLC). When I was looking on the National Council of State Boards of Nursing (NCSBN) website, I found that in addition to the NLC, there is the beginning of an APRN compact. So far only Delaware, Utah, and North Dakota have enacted legislation to be apart of the APRN compact (National Counsel of State Boards of Nursing [NCSBN], 2022). However, a total of seven states have to pass legislation and join the compact in order for the APRN compact to go into effect (NCSBN, 2022). There are two states with pending legislation, but APRNs and others are encouraged to reach out to their state legislatures to help create and pass proposals to join (NCSBN, 2022). Just like with the NLC, there are many benefits of having an APRN compact. For example, it increases access to care from APRNs across state lines, it allows APRNs to practice to the full extent of their license, and enhances the response of APRNs during times of need/disaster (NCSBN, 2022). Unfortunately, I was not able to find any current proposed legislation to join to APRN compact in my state of Arizona. I hope that soon more states will realize the need for this change and the APRN compact will go into effect.
Reference
National Council of State Boards of Nursing [NCSBN]. (2022). About the compact. APRN Compact. https://www.aprncompact.com/about.htm
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Nursing regulatory bodies (NRBs) are governmental agencies present in all 50 states, regulating the nursing practice. NRBs are designed to protect the public’s health by overseeing and ensuring the safe practice of nursing (National Council of State Boards of Nursing, 2022). The NRB outlines the safe standard of nursing, while also issuing licenses. Once a license is issued, the NRBs monitor its compliance and act against those who are not upholding safe practices (National Council of State Boards of Nursing, 2022). Two examples of regulatory bodies are the National Council of State Boards of Nursing and the American Nurses Association.
Each state within the United States has its own nurse practice act, which is enforced by the NRB. The nurse practice act is similar to the NRB but is more specific to the state. It describes qualifications for licensure, nursing titles allowed to be used, the scope of practice, and actions that will happen if the nurse does not follow the nursing law (National Council of State Boards of Nursing, 2022). According to the Arizona State Board of Nursing, a nurse practitioner (NP) must be certified by the board and complete an approved nurse practitioner education program. The scope of practice of an NP expands beyond a traditional registered nurse license. It includes assessing, synthesizing, and analyzing data while making independent decisions to help the patient. The NP is allowed to diagnose and prescribe pharmacological and non-pharmacological treatments (Arizona State Board of Nursing, 2018). Unlike a physician assistant, an NP does not need a physician’s authorization to treat patients.
Advanced practice registered nurses (APRNs) are blossoming in U.S healthcare, with more and more registered nurses stepping into the roles of either a nurse midwife, clinical nurse specialist, nurse practitioner, or nurse anesthetist. The APRN consensus model provides the structure for states to adopt uniformity in the regulation of these different roles, licensure, accreditation, certification, and education (LACE). According to the model, “APRNs are educated in one of the four roles and at least one of six foci: family/individual across the lifespan, adult-gerontology, pediatrics, neonatal, women’s health/gender-related or psych/mental health” (National Council of State Boards of Nursing, 2022). The educational program must be accredited, with a board-based education, including three separate graduate-level courses in advanced physiology/pathophysiology, health assessment, and pharmacology, plus clinical experiences. Once an individual is educated, they will go through the process of certification, where if they pass, will be licensed and able to practice (National Council of State Boards of Nursing, 2022).
References:
Arizona State Board of Nursing. (2018). Arizona State Board of Nursing. About | Arizona State Board of Nursing. Retrieved August 12, 2022, from https://www.azbn.gov/scope-of-practice/about
National Council of State Boards of Nursing. (2022). APRN Consensus model. NCSBN. Retrieved August 12, 2022, from https://www.ncsbn.org/aprn-consensus.htm
National Council of State Boards of Nursing. (2022). Guiding philosophy. NCSBN. Retrieved August 12, 2022, from https://www.ncsbn.org/1325.htm
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Its interesting to know that Arizona State Board of Nursing comes under the 15 states/jurisdictions whose Nurse Practitioners are regulated completely by their Board of Nursing and they have an independent scope of practice and prescriptive authority without Physician collaborations. the state of affairs with the Affordable Care act has been very unpredictable with the current trends in Healthcare regulation, insurance coverage and costs & changes to Medicare & Medicaid services. Its now more than ever, the need for all states to re convene to make health regulations standard for the Advance Practice Registered nurse following the APRN consensus model, to allow for affordable quality healthcare to the public.
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your post was great. America has many avenues to keep our healthcare as safe as possible. We have to meet educational requirements in many different ways, to obtain our license and later to keep them. In South Carolina nurses are required to do continuing education courses to reinstate our license. All these regulatory bodies are thorough in their attempt to hold us to standards for the safety of everyone. The Nurse Practice Act typically does many things such as define nursing and the boundaries of the scope of practice, determines grounds for disciplinary action, establishes educational program standards and much more. These rules and guidelines from all the regulatory bodies create a large safety net for us, which enables us to practice with confidence from start to finish.
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In California, the Board of Registered Nursing (BRN) certified advanced practice nurses, which include nurse practitioners (NP), nurse-midwives, clinical nurse specialists, and nurse anesthetists (California Board of Registered Nursing, 2022). The nurse must have an active Registered nurse license to apply for APRN. Also, here in California, the NP must have another “furnishing number “that will allow to prescribe controlled substances for patients. For APRNs, there is an extensive education to get their license, but at the same, they are better prepared to care for the different populations and comorbidities that the community has by providing better health care assistance for patients. The APRN has provided much help to healthcare, especially now with the shortage of physicians. Although the BRN requires more education and certifications to get the license to better understand our role and responsibilities as nurses.
California Board of Registered Nursing. (2022, August 12). California Board of Registered Nursing
Retrieved from Advanced Practice and Certification: /www.rn.ca.gov/forms/pubs
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I also live in Arizona and have found some really great information on our State Board. The Arizona State Board of Nursing has a plethora of information as they regulate licensure requirements, specify certification, and scope of practice for your specialty. Within the Arizona State Board of Nursing is the Advanced Practice Advisory Committee who provides recommendations to the Board on issues involving advanced practice (Arizona State Board of Nursing, 2018). Some of the goals of this committee are to clarify regulatory sufficiency of the four Advanced Practice roles and develop recommendations for change related to Advanced Practice (Arizona State Board of Nursing, 2018). For example, Certified Registered Nurse Anesthetists in Arizona have their scope of practice laid out on Arizona State Board of Nursing and the Arizona State Legislature. CRNA’s in Arizona are able to
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