Professional Nursing and State-Level Regulations Discussion Essay
Board of Nursing (BON) are government agencies in every state in the US responsible for overseeing all nurses’ activities (Cassiani et al., 2020). They are the organizations in charge of regulating nursing practice in each of the fifty states of the US, and each board of nursing is a member of the National Council of State Boards of Nursing (NCSBN). Each BON’s role is to regulate all nurses’ activities in the particular state using clearly defined standards and practice regulations. However, the version of practice standards differs in every state. Some states permitting advanced practice nurses (APNs) full practice authority in primary settings while others only allow APNs full practice authority under a professional’s supervision Professional Nursing and State-Level Regulations Discussion Essay.
Comparison of Two APRN Board of Nursing Regulations
The activities of nurses are regulated in Arizona by the Arizona State Board of Nursing, which is the state’s licensing and regulatory body in charge of setting standards and scope of practice for nurses in Arizona (Cassiani et al., 2020). Some of the practice regulations put in place by this organization are similar to the regulations in other states in ensuring nurses provide patients with quality medical care. For instance, the regulations guiding a nurse’s requirements to qualify as an APRN are similar in Arizona and New Jersey. To practice as an APRN in both states, a nurse must hold a bachelor’s degree in nursing and acquire certification as a registered nurse from the state’s licensing organ. They must advance their role from an accredited master’s program that met the state’s advanced clinical education standards and passed the national APRN board certification exam. In addition to the graduate degree or master’s program, the person must be licensed as a qualified nurse by the Arizona State Board of Nursing Professional Nursing and State-Level Regulations Discussion Essay.
Despite sharing many standard nursing practice regulations, the two states differ regarding authorization of full practice authority. Nurse practitioners in Arizona are permitted full practice authority (Bosse et al., 2017)) by the state board of nursing, unlike in New Jersey, where the state board of nursing prohibits the same category of nurses from carrying out some roles unless under the direct supervision of a physician. For example, nurse practitioners in Arizona practice independently in the primary setting. They can prescribe medications to patients and treat basic mild and severe illnesses without signing any supervision contracts with a physician. On the other hand, nurse practitioners in New Jersey are not authorized to prescribe medications independently but under the supervision of a physician with whom they have to sign a practice contract Professional Nursing and State-Level Regulations Discussion Essay.
Application of the Regulations to APRN
Regulations are critical in every area of nursing discipline and any other professional field. Rules ensure only qualified people practice in their different professional roles (Peterson and Morris, 2019). In the nursing domain, regulations guiding the nursing practice are enforced by various professional organizations like ANA and several state-based organizations like ABON. In Arizona, such regulations enforced by the ABON include full practice authority to nurse practitioners. This regulation applies to the APRNs role by enabling the nurse to fully utilize her skills in her position without relying on any physician supervision, thus improving the quality of care provided. Professional independence allows the NP to improve healthcare accessibility at an affordable cost, especially in underserved rural areas (Peterson and Morris, 2019). Career advancement also endows the nurse with the needed competency to fully discharge her role with confidence and make meaningful, informed medical decisions concerning her patients. For example, APRNs with full practice authority adhere to practice regulations by ensuring they consult with other healthcare providers and transfer patients outside their scope of practice to physicians.
Bosse, J., Simmonds, K., Hanson, C., Pulcini, J., Dunphy, L., Vanhook, P., & Poghosyan, L. (2017). Position statement: Full practice authority for advanced practice registered nurses is necessary to transform primary care. Nursing Outlook, 65(6), 761-765.
Cassiani, S. H. D. B., Lecorps, K., Cañaveral, L. K. R., da Silva, F. A. M., & Fitzgerald, J. (2020). Regulation of nursing practice in the Region of the Americas. Revista Panamericana de Salud Pública, 44.
Peterson, K. S., & Morris, B. C. (2019). Creating synergy between academia and practice: the Arizona State University and Mayo Clinic Arizona model. Journal of Professional Nursing, 35(4), 305-313 Professional Nursing and State-Level Regulations Discussion Essay.
I agree that the Board of Nursing (BON) in each state varies tremendously, which can be very confusing. There should be standardization to the regulations and practice of advanced practice nurses (APN). Presently there are only 21 states that allow APNs to practice independently without physician oversight (Cabbabe, 2016).
One of the barriers that the BON faces is pushback from physicians. Dr. Gary Pigman, an emergency room physician and lawmaker for Florida, states he presented 18 bills on the topic related to APNs becoming primary care providers dating back to 2014 (Jordan, 2019). Many physicians are opposed to the idea and argue that the care provided by APNs is not as comparable to those provided by a physician, even though research has proven this is a false claim. In actuality, physicians are afraid that the increase of APNs as primary care providers and exclusion of physicians from the healthcare team would become a danger to their practice becoming extent (Jordan, 2019).
An APN’s ability to practice independently without physician oversight should not be restricted to state government. Hopefully, with increased lobbying, it will reach the federal level. Therefore, giving all APNs in every state a standardized level as a primary provider Professional Nursing and State-Level Regulations Discussion Essay.
Cabbabe, S. (2016, Nov – Dec). Should Nurse Practitioners Be Allowed to Practice Independently? Missouri Medicine, 113(6), 436-437. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6139780/
Jordan, G. (2019, December 13). WFSU Public Media. Retrieved from Florida Doctor Groups Push Back Against Giving Advanced Nurses Their Independence: https://news.wfsu.org/state-news/2019-12-13/florida-doctor-groups-push-back-against-giving-advanced-nurses-their-independence Professional Nursing and State-Level Regulations Discussion Essay
Discussion: Professional Nursing and State-Level Regulations
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.
- 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..
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 Professional Nursing and State-Level Regulations Discussion Essay.
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.
Advanced Practice Registered Nurses (APRNs) have regulations they must follow once they are licensed practitioners. According to NCSBN, Nursing Regulatory Bodies (NRBs) are jurisdictional governmental agencies in the 50 states, the District of Columbia and four US territories that are responsible for the regulation of nursing practice (n.d). One regulation the state of South Carolina has is that APRNs require an approved written protocol with a collaborating physician (Staff Writers, 2020). One state that has a regulation that differs from South Carolina is Oregon. The regulation for prescribing authority in this state is that APRNs have full prescriptive authority (Staff Writers, 2020). Regulations differ state to state, therefore it is important for APRNs to be familiar with the regulations if they decide to work in a different state. Another regulation that differ in these two states is the requirements for continuing education. According to NCSBN, in South Carolina, APRNs require 20 hours of which 2 much consist of controlled substance. Oregon continuing education requirements consists of APRNs having 45 hours in which 15 are pharmatherapeutic content (n.d). Some states are considered compact which eliminates having regulations being different in all 50 states individually.
In states such as South Carolina, APRNs struggle with practicing to their full potential because of what is considered being within their scope of practice. For example, the regulation of prescribing authority explained above limits what the APRN can prescribe to a person without the approval of a MD first. Whereas in states such as Oregon, the APRN can prescribe without consulting a MD or having an approval first. According to Neff et. al, in states with restrictive NP practice, NPs are geographically collocated with supervising MDs, restricted NP practice limits their ability to provide care in areas that lack access to primary health-care providers, and NPs are not practicing to their full scope of practice (2018). APRNs in some states are further along in autonomy and practicing to their full ability. Someday all 50 states may align with regulations, which will make things simpler rofessional Nursing and State-Level Regulations Discussion Essay.
National Council of State Boards of Nursing (NCSBN). (n.d). Retrieved March 29, 2021, from https.//www/ncsbn.org/index.htm
Neff, D.F, Yoon, S.H., Steiner, R.L., Bumbach, M.D., Everhrt, D., & Harman J.S. (2018). The impact of nurse practitioner regulations on population access to care. Nursing Outlook, 66(4), 379-385. doi: 10.1016/j.outlook.208.03.001
Staff Writers. (2020, October). How does nurse practitioner authority vary by state?. https://www.nursepractitionerschools.com/faq/how-does-np-practice-authority-vary-by-state/
Advanced Practice Registered Nurses (APRNs) have been a great asset for communities, especially rural ones. As a Registered Nurse (RN) in the state of Michigan I can relate to your state, South Carolina, where it can be difficult for APRNs to practice to their full potential due to state board of nursing (BON) difference across all states (Milstead & Short, 2019) Professional Nursing and State-Level Regulations Discussion Essay. Michigan is comparable to South Carolina for we also require an overseeing Physician to delegate the prescription of certain medications, we require a Physician to delegate the prescription of scheduled II-V controlled substances (NCSLSOP, n.d.). With limitations as such, rural areas that have difficulties to hire physicians will continue to struggle because APRNS cannot work there without a delegating/overseeing Physician, which is really unfortunate in my opinion.
Regarding the continuing education (CE) hours, Michigan is also different. According to NursingCE (n.d.) Michigan APRNS are required to complete 25 hours between each licensure renewal. Similarly, we must complete certain number of hours to particular topics. While Michigan’s BON requires at least 2 hours in pain and symptom management and a one-time human trafficking CE (NursingCE, n.d.). Something to consider and to watch out for in some states such as Michigan is a limited amount of CE credits that can be completed in a day. So, do not binge all of the CE credits required for licensure renewal in one day.
Thank you for sharing information about your state, I am glad to see that my state is not the only one that has some ‘stricter’ rules and regulations compared to others like Oregon as you stated Professional Nursing and State-Level Regulations Discussion Essay.
Milstead, J. A., & Short, N.M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones Bartlett Learning.
NCSLSOP. (n.d.). Nurse Practitioners. Scope of practice policy. Retrieved March 30, 2021, from https://scopeofpracticepolicy.org/practitioners/nurse-practitioners/?fbclid=IwAR0xWHuSPdq8iCfp0dAnEfL-tXd6M0vdq6MY9_Aunw54FsUC5fcXW_a1g3A
NursingCE. (n.d.). Requirements specific to Nurse Practitioners in Michigan. NursingCE by ati. Retrieved March 31, 2021 from https://www.nursingce.com/ceu-requirements/michigan/np#requirements Professional Nursing and State-Level Regulations Discussion Essay.