NURS 6050 Discussion Professional Nursing and State-Level Regulations SAMPLE
Sample Answer for NURS 6050 Discussion Professional Nursing and State-Level Regulations SAMPLE Included After Question
Boards of Nursing (BONs) exist in all 50 states, the District of Columbia, American Samoa, Guam, the Northern Mariana Islands, and the Virgin Islands. Similar entities may also exist for different regions. The mission of BONs is the protection of the public through the regulation of nursing practice. BONs put into practice state/region regulations for nurses that, among other things, lay out the requirements for licensure and define the scope of nursing practice in that state/region.
It can be a valuable exercise to compare regulations among various state/regional boards of nursing. Doing so can help share insights that could be useful should there be future changes in a state/region. In addition, nurses may find the need to be licensed in multiple states or regions.
To Prepare:
- Review the Resources and reflect on the mission of state/regional boards of nursing as the protection of the public through the regulation of nursing practice.
- Consider how key regulations may impact nursing practice.
- Review key regulations for nursing practice of your state’s/region’s board of nursing and those of at least one other state/region and select at least two APRN regulations to focus on for this Discussion.NURS 6050 week 5 Discussion: Professional Nursing and State-Level Regulations.
By Day 3 of Week 5
Post a comparison of at least two APRN board of nursing regulations in your state/region with those of at least one other state/region. Describe how they may differ. Be specific and provide examples. Then, explain how the regulations you selected may apply to Advanced Practice Registered Nurses (APRNs) who have legal authority to practice within the full scope of their education and experience. Provide at least one example of how APRNs may adhere to the two regulations you selected.
By Day 6 of Week 5
Respond to at least two of your colleagues* on two different days and explain how the regulatory environment and the regulations selected by your colleague differ from your state/region. Be specific and provide examples NURS 6050 week 5 Discussion: Professional Nursing and State-Level Regulations.
A Sample Answer For the Assignment: NURS 6050 Discussion Professional Nursing and State-Level Regulations SAMPLE
Title: NURS 6050 Discussion Professional Nursing and State-Level Regulations SAMPLE
Nursing is a highly structured profession. Many states have a Board of Nursing which helps organize, inform, educate, and publicize the nursing profession. Nursing is a profession that is regulated due to the risks involved in caring for and saving the lives of others. Regulatory bodies such as the NCSBN are specifically involved in licensure to encourage competent practice and public safety (National Council of State Boards of Nursing, n.d.). An APRN’S scope of practice is determined by the BON at the state level and it is the duty of the nurse to be mindful of the regulations that direct their practice based on the state they are practicing in. In this post, I will compare nursing regulations between the state of the Virgin Islands in which I graduated and the State of Georgia in which I am licensed.
APRN Nursing Regulations
In Georgia, the Georgia Board of Nursing as well as the Georgia Composite Medical Board have the authority to define rules and limitations to the practice of the APRN. APRN’s have limited access to practicing independently in the State of Georgia. State regulations in Georgia dictate that an APRN needs physician supervision to diagnose and treat patients. Georgia’s state board of Nursing also limits diagnostic testing that APRN’S can do such as ordering MRI’s or CT scans without physician authorization. APRN’s are also not allowed to prescribe schedule II medications, only physicians due to the risk of abuse and addiction. (Stephens, 2015). The lack of acknowledgment and full use of an APRN’s scope of practice has contributed to the decrease in patient access to healthcare. By utilizing an APRN’s full scope of practice and education, health care costs can be lowered (Stephens, 2015).
In comparison, the Virgin Islands is not a Nursing Licensure Compact Jurisdiction. Interested persons must apply to the Virgin Islands Board of Nursing (CGFNS International, n.d.). Like Georgia, a collaborative physician relationship must be established under Act 6736. A written agreement specifies procedures performed on patients requiring physician attendance. Regarding prescriptive authority, they may prescribe certain drugs, procedures, and IV-V schedule-controlled drugs. However, a physician must occasionally review orders (U.S. Virgin Islands Scope of Practice Policy: State Profile).
Adhering to Regulations
APRN’s can adhere to state regulations by visiting their respective state board website and familiarize themselves not only with the application process but the renewal process as well. It is important to be aware of the regulating board and changes that may be made. For prescriptive regulations APRN’s should ensure and be familiar with policies specific to the prescribed controlled drugs.
NURS 6050 Discussion Professional Nursing and State-Level Regulations SAMPLE ReferencesCGFNS International. (n.d.). U.S. Virgin Islands Licensure & Registration Info. Retrieved from CGFNS: https://www.cgfns.org/licensure/us-virgin-islands/
National Council of State Boards of Nursing. (n.d.). Nursing Regulation. Retrieved from NCSBN: https://www.ncsbn.org/boards.htm
Stephens, B. (2015, January). Perspectives on Advanced Practice. Retrieved from Gerogia Watch: https://www.georgiawatch.org/wp-content/uploads/2015/01/APRN01072015WEB.pdf
U.S. Virgin Islands Scope of Practice Policy: State Profile. (n.d.). Retrieved December 2020, from Scope of Practive Policy: http://scopeofpracticepolicy.org/states/vi/
RE: Discussion – Week 5 Main Post
Advanced practice registered nurses practice is distinct state by state and the APRN scope of practice and regulative criteria vary from nurses with same qualifications and titles in each state (Milstead & Short, 2019). In comparing APRNs in Texas and New Mexico, there are differences in regulations based on the respective nursing boards and the scope of practice authority. In Texas, the APRN board of nursing regulations mandates nurse practitioners to restricted practice. The NPs can only engage in one element of practice and should be on career-long supervision of a physician. APRNs should also have registered nurse license, graduate degree and have national certification. The Texas Board of Nursing also mandates APRNs to meet the Nurse Practice Act and all its requirements (Texas Board of Nursing, 2021). In New Mexico, Nurse practitioners are under the Nurse Practice Act and must register with the Prescription Monitoring Unit. The APRNs have full practice authority and can prescribe drugs and controlled substances. The APRNs are also regulated by the state Board of Nursing and should have national certification and graduate degree qualification (NMNPC, 2020). The implication is that certified family nurse practitioners (FNPs) as a specialty in APRN may also have variations based on states. In Texas, family nurse practitioners must have supervising physicians to provide patient care. However, in New Mexico FNPs are allowed to practice independently to the full extent of their training and education.
The regulations impact APRNs who have legal authority to practice to the full level of their education and experience as they set guidelines for those practicing with the profession to protect their titles and the public (Laureate Education, 2018). APRNs comply with the regulations by ensuring that they update their licenses, meet the requirements for continuing education and training and enhancing patient safety and competence in their nursing practice.
A Sample Answer For the Assignment:
Title:
NURS 6050 Discussion Professional Nursing and State-Level Regulations SAMPLE References
Laureate Education (Producer). (2018). The Regulatory Process [Video file]. Baltimore, MD:
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Author.
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.).
Burlington, MA: Jones & Bartlett Learning.
New Mexico Nurse Practitioner Council (2020). Practice Regulations.
Texas Board of Nursing. (2021) Practice-APRN Scope of Practice.
Hello, great post on the state of Kentucky. The state of Kentucky is in the reduced state category. Reduced practice means that state practice and licensure laws reduce the capacity of APRN practice in at least one aspect. In addition, the APRN must maintain a regulated collaborative agreement with another health provider. In Kentucky, APRNs must maintain a practice agreement with a provider to prescribe controlled medication (American Association of Nurse Practitioners, n.d.). Additionally, the Kentucky practice agreement states that the APRN may prescribe drugs independently after four years of practicing under the collaborative agreement (Brown et al., 2021).
To get licensed as an APRN in Kentucky, one has to follow a specific process and meet certain criteria. This information is available on Kentucky’s state board website at aanp.org
Links to an external site.. One must apply through the Kentucky Board of Nursing with the following proof; a complete application, a federal and state criminal background check, an official transcript of advanced practice education with degree and date posted, national certification with current proof, along with reports of any criminal convictions (Brown et al., 2021). The KBN (Kentucky Board of Nursing) defines the scope of APRN practice as the boundaries that provide the legal authority and regulate professional practice (Brown et al., 2021).
Just like in Kentucky, the state of Texas restricts the abilities of the APRN to restricted practice that requires direct supervision of a physician for all scope of practice (nursejournal.org, 2022). Texas state APRNs have a limited amount of prescriptive power. A protocol or agreement with a doctor must be obtained by an APRN (Texas Board of Nursing, 2018). Courses on pathophysiology, pharmacology, assessment, and diagnosis and treatment of issues specific to the specialty are required for prescriptive authority (Texas Board of Nursing, 2018). APRNs must submit a separate application for controlled substance registration with the state Department of Public Safety in order to prescribe them (Texas Board of Nursing, 2018). The ability to have a full scope of practice without the direct supervision of a Physician would increase access and as you stated would likely decrease the amount of pressure on the APRN (Texas Board of Nursing, 2018). Thank you!
Thank you very much for your post and for taking the time to explain the different terms associated with APRNs and the responsibilities of regulators – including protecting the patient, protecting ARNPs, and clarifying the scope of practice of APRNs to ensure that they are fully operating within the parameters set forth by the legislature as authorized by the board of nursing in their respective states of practice. As a well-trained APRN, understanding the scope of practice is crucial in ensuring patient safety and achieving the best outcomes regardless of the state of practice. While researching the APRN requirement and restrictions in Virginia, I also realized that APRNs must collaborate with physicians in consultation and collaboration. As such, an electronic practice or written agreement is required in most cases (with few exceptions) to prove that an APRN is working with at least one patient care team physician. It is also new to me that in Virginia, APRNs must have a joint license from the Board of Nursing and Medicine – which prescribe the rules governing the licensure of APRNs and similar advanced degrees (law.lis.virginia.gov, n.d.).
Unlike Virginia, APRNS in Washington State (WA) has more autonomy and freedom and can practice fully and independently without looking for a collaborating physician. In addition, Washington does not have any joint licensure requirement by the Board of Nursing and Medicinewhichis is a requirement in Virginia. WA Board of Nursing (Nursing Care Quality Assurance Commission (NCQAC)) is a state regulatory authority responsible for protecting public health and safety. NCQAC ensures that the competency and quality of different healthcare professions within WA are current and compliant with the laws. This body also investigates accusations, takes disciplinary actions against licensed individuals if necessary, and could revoke an individual’s license in severe cases of gross infringements on patients’ rights and privacy and certain unprofessional behaviors unexpected of individuals held with very high ethical expectations and standards (NCQAC, n.d.).
References
Continuing competency. Nursing Care Quality Assurance Commission. (n.d.-a). https://nursing.wa.gov/licensing/maintain-license/continuing-competency
Title 54.1. professions and occupations. § 54.1-2957. Licensure and practice of nurse practitioners. (n.d.). https://law.lis.virginia.gov/vacode/title54.1/chapter29/section54.1-2957/
The APRN Regulatory Environment between New Jersey and California
In California, NP practice is governed by the State Nurse Practice Act. The Board of Registered Nursing has promulgated regulations that require the NP to work under standardized procedures for authorization to perform overlapping medical functions (CCR § 1485). Currently, NPs are in restricted practice in California. This regulation requires that NPs work under collaboration with a physician and adhere to standardized procedures developed through collaboration among administrators and health professionals, including physicians and surgeons. California NPs must obtain additional certification from the BRN to “furnish” (prescribe or order) drugs or devices under standardized procedures developed with the supervising physician and surgeon. As collaborators, physicians take legal responsibility for the NP’s practice and are expected to determine the appropriate level of supervision, communicate regularly with the NP, and oversee the NP’s practice and quality of care.
Whereas in New Jersey, NPs are in reduced practice. Certification by the New Jersey Board of Nursing is required to be an Advance Practice Nurse in New Jersey (N.J.A.C. 13:37-7.1 (a)). Any nurse who wishes to practice as a nurse practitioner/clinical nurse specialist, or present, call or represent himself or herself as a nurse practitioner/clinical nurse specialist must be certified by the Board. Each applicant for certification shall be required to successfully pass the highest-level practice examination in the area of specialization approved by the Board. Written verification that the applicant has successfully passed the exam is to be submitted directly by the national certifying agency to the Board.
An A.P.N. in New Jersey has prescriptive authority and is required to have a joint protocol with a collaborating physician who is licensed in New Jersey, prior to prescribing any medication or medical device. Joint Protocol means an agreement or contract between an advanced practice nurse and a collaborating physician which conforms to the standards established by the Director of the Division of Consumer Affairs.
New Jersey and California differs in scope of practice however both states’ nurse leaders are advocating for increase consumer access to health care by eliminating barriers such as removal of the joint agreement between an APN and a physician. This agreement restricts an APN’s ability to practice to the full extent of their education and licensure, known as full practice authority.
The signing of AB 890 (Wood) in September 2020 opened the pathway for nurse practitioners (NPs) in California to treat patients without physician supervision. This change has the potential to improve access to health care for millions of state residents, particularly those most impacted by health care provider shortages.NPs will be authorized to practice to the fullest extent of their education and training following a transition-to-practice (TTP) period of no less than three full-time equivalent years or 4,600 hours in specified settings. Additionally, NPs will be authorized to practice to the fullest extent of their education and training following an additional three years of practice beyond the TTP in all other settings.California’s Board of Registered Nursing (BRN) is in the process of promulgating regulations that will further specify details of the TTP period. This regulatory process is a critical next step on the path to the implementation of AB 890.
References
R. P. Newhouse et al., “Advanced Practice Nurse Outcomes 1990-2008: A Systematic Review,” Nursing Economics 29, no. 5 (Sept.–Oct. 2011): 230–50.
J. Stanik-Hutt et al., “The Quality and Effectiveness of Care Provided by Nurse Practitioners,” Journal for Nurse Practitioners 9, no. 8 (2013): 492–500.
C. M. Everett, P. Morgan, and G. L. Jackson, “Primary Care Physician Assistant and Advance Practice Nurses Roles: Patient Healthcare Utilization, Unmet Need, and Satisfaction,” Healthcare (Amsterdam) 4, no. 4 (Dec. 2016): 327–33, doi:10.1016/j.hjdsi.2016.03.005.
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