Profession Nursing and State Level Restrictions
Profession Nursing and State Level Restrictions
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. Profession Nursing and State Level Restrictions
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. Profession Nursing and State Level Restrictions
To Prepare for Profession Nursing and State Level Restrictions
- 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 XXX
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. Profession Nursing and State Level Restrictions
STUDENT #1 S.L
Mississippi has set additional requirements for advanced practice nurses who prescribe controlled substances. The APRN must be able to document education and training in pharmacology. An APRN can meet the education requirement through pharmacology coursework that was integrated into the advance practice program (Mississippi State Board of Nursing,2020). The Missouri state which I reside in Board can instead accept a recent three semester hour advance pharmacology course Offred by an accredited school or 45 hours of recent continuing education. Profession Nursing and State Level Restrictions
The students must have 300 hours of preceptorship. Preceptors is to include training with medications, drugs, and therapies devices. Eventually, the advanced practitioner will enter into a collaborative agreement with a physician who has an unrestricted DEA number and who is engaged in similar practice. An advanced practice nurse cannot apply for prescriptive authority until he or she has 1000 hours of experienced (Missouri Secretary of State: Code of State Regulation, 2020, p. 7). Profession Nursing and State Level Restrictions
State practice and licensure law reduces the ability of nurse practitioners to engage in at least one element of NP practice. The Association of Nurse Practitioners (2019) State requires a regulated collaborative agreement with an outside health discipline in order for the NP to provide patient care in Mississippi. Nurse practitioner practice is further limited in Missouri as state law requires that any patient evaluated and treated by an NP that does not have a self-limited or well-defined condition be reevaluated by a physician within two weeks.
References
American Association of Nurse Practitioners. (2019). Scope of practice for nurse practitioners. Retrieved
September 27, 2020, from https://www.aanp.org/advocacy/advocacy-resource/position-statements/scope-of-practice-for-nurse-practitioners
Mississippi State Board of Nursing. (2020) Controlled Substance. Retrieved from
https://www.msbn.ms.gov/licensure/advanced-practice-registed-nurse
Missouri secretary of state: Code of state regulations [PDF]. (2020). Missouri Division of Professional
Registration. Retrieved September 29, 2020,
from https://www.sos.mo.gov/cmsimages/adrules/csr/current/20csr/20c2200-4.pdf
STUDENT # 2 A.E
The Florida Board of Nursing assumes an important capacity in clinical considerations, rules, and maintenance of protocols for the effective practice of NPs. Florida is one of those states that are very restrictive in NPs practices under state guidelines and laws. Per laws and mandates that govern the practice of NPs, Florida requires that nurse practitioners are supervised by physicians; while the supervising physician does not need to be available in person, he/she must be available by phone for consultation (Nurse Practitioner Scope of Practice: Florida, 2013). With an increase in the disproportion of retiring physicians to the percentage of medical students, it is unfortunate that Florida is now realizing that we need more NPs to fill the gap in providing primary care. Profession Nursing and State Level Restrictions
While state laws managing NPs in Florida may be among the toughest in the country, according to recent policy changes dating back to July 2020, advanced NPs who have accumulated at least 3,000 hours of experience under physician supervision will have the right to independently operate primary care practices in Florida without an attending doctor (The pulse of nursing, 2020). At the same time, the passage of this bill is like having a foot in the door, it gives a level of the liberation of practice to some practitioners and excludes similar discipline like a CRNAs. Profession Nursing and State Level Restrictions
Additionally, another APRN board of nursing regulation in the state of Florida is NPs practicing in Florida may sign for handicap parking permits, but they may not sign death certificates (Nurse Practitioner Scope of Practice: Florida, 2013). Experienced APRNs should be able to sign death certificated as they are highly trained and skilled professionals. Although our neighboring state of Georgia has similar restrictions on NPs practice, interestingly, unlike Florida, an NP may prescribe Schedules III-V controlled substances if the NP is authorized to prescribe and has submitted the written protocol with the supervising physician (Scope of practice policy, n.d.). Profession Nursing and State Level Restrictions
Advanced Practice Registered Nurses (APRNs) who have the legal authority to practice within the full scope of their education and experience will be able to work alongside an MD whenever possible to provide care to patients in areas that otherwise lacked health access. Full practice authority does not make the MDs less available to patients but rather allows more territory access of health coverage by NPs. APRNs may adhere to the two regulations by understanding the laws that govern the practice and using them as guidelines, so they are compliant in their practice. Profession Nursing and State Level Restrictions
Although the regulations governing APRNs’ practices differ from state to state, ultimately the laws and policies are adapted for the safety and immediate medical needs of the patients through a developed interdisciplinary relationship amongst NPs and MDs. Profession Nursing and State Level Restrictions
References
AANP. (n.d.). State practice environment. American Association of Nurse Practitioners. Retrieved September 29, 2020, from https://www.aanp.org/advocacy/state/state-practice-environment
Nurse Practitioner Scope of Practice: Florida. (2013, October 9). Thriveap.Com. https://thriveap.com/blog/nurse-practitioner-scope-practice-florida
The pulse of nursing. (2020, March 24). Florida Nurse Practitioners Gain Full Practice Authority. DailyNurse.Com. https://dailynurse.com/florida-grants-advanced-nps-full-practice-authority/
Scope of practice policy. (n.d.). Georgia Scope of Practice Policy: State Profile. Dev.Scopeofpracticepolicy.Org. Retrieved September 30, 2020, from http://dev.scopeofpracticepolicy.org/states/ga/
Learning Resources for Profession Nursing and State Level Restrictions
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.
- Chapter 4, “Government Response: Regulation” (pp. 57–84)
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. doi:10.1016/j.outlook.2017.10.002
Note: You will access this article from the Walden Library databases.
Neff, D. F., Yoon, S. H., Steiner, R. L., 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. doi:10.1016/j.outlook.2018.03.001
Note: You will access this article from the Walden Library databases.
Peterson, C., Adams, S. A., & DeMuro, P. R. (2015). mHealth: Don’t forget all the stakeholders in the business case. Medicine 2.0, 4(2), e4. doi:10.2196/med20.4349
Note: You will access this article from the Walden Library databases.
Rubric Detail for Grading RESPONDS
Select Grid View or List View to change the rubric’s layout.
Name: NURS_6050_Module03_Week05_Discussion_Rubric
| First Response | 17 (17%) – 18 (18%)
Response exhibits synthesis, critical thinking, and application to practice settings.
Communication is professional and respectful to colleagues.
Responses to faculty questions are fully answered, if posed.
Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.
Demonstrates synthesis and understanding of learning objectives.
Response is effectively written in standard, edited English. |
. | or no credible sources are cited. | 0 (0%) – 12 (12%)
Response may not be on topic and lacks depth.
Responses posted in the discussion lack effective professional communication.
Responses to faculty questions are missing.
No credible sources are cited. |
||
|
Second Response |
16 (16%) – 17 (17%)
Response exhibits synthesis, critical thinking, and application to practice settings.
Communication is professional and respectful to colleagues.
Responses to faculty questions are fully answered, if posed.
Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.
Demonstrates synthesis and understanding of learning objectives.
Response is effectively written in standard, edited English. |
. | 12 (12%) – 13 (13%)
Response is on topic and may have some depth.
are cited. |
0 (0%) – 11 (11%)
Response may not be on topic and lacks depth.
Responses posted in the discussion lack effective professional communication.
Responses to faculty questions are missing.
No credible sources are cited. |
||
| . | 0 (0%) – 0 (0%) | 0 (0%) – 0 (0%)
Does not meet requirements for participation by posting on 3 different days. |
||||
| Total Points: 100 | ||||||