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.
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.
APA format and at least 3 references
Then respond to two peers in apa format and 2 references
The National Council of State Boards of Nursing (NCSBN) says that Advanced Practice Registered Nurses, or APRNs, are registered nurses who have a master’s or post-degree master’s and special credentials. They are very important to the U.S. healthcare system. (n.d.). APRNs can evaluate and diagnose patients, as well as order tests and give patients medicine when necessary. (n.d.). Unfortunately, state rules keep them from having full practice authority (FPA). This causes problems, like not being able to provide cost-effective, efficient care to people with lower incomes. (Bosse, et.al., 2017).
Experts say that there will be a shortage of primary care providers by 2025 because Nurse Practitioners don’t have full practice authority because of regulations. (Neff, et. al. 2018). Full practice authority restrictions and rules make it hard for an APRN to do everything they are allowed to do within their scope. The American Association of Nurse Practitioners said that FPA will mean that NPs will no longer have to work with doctors and will be able to practice on their own (2020). California is a restricted state, which means that NPs have to work under the supervision of a doctor. In Arizona, NPs can do their jobs without any restrictions, unlike in California. In AZ, NPs can have their own private practice, but in CA, they can’t yet. (AANP, 2022). The national certifications are another difference between NPs in California and Arizona. In order to get a state license in AZ, NPs must have an RN license, a graduate degree, and a national certification. In CA, they only need an RN license and a graduate degree. (AANP, 2022). For NPs in California to get FPA, a bill needs to be introduced and passed through the legislature. Luckily for CA practitioners, a similar bill is already in the works and has been signed. Governor Gavin Newsom sent a bill to the legislature that gives NPs full authority to practice. (Brusie, 2020). The bill goes into effect in January 2023, but until then, California will remain a restricted state.
Since each state has its own rules and regulations for Advanced Practice Registered Nurses (APRNs), it is very important for APRNs to know what those rules and regulations are. Regulation is important in health care because it lets people in charge of patient care and public safety keep an eye on the people who work in the field (Milstead & Short, 2019). The Board of Nursing (BON) and the Board of Medicine are the governing bodies in Virginia, where I live. On the other hand, there is only one governing body for nurse practitioners in Maryland. In the Commonwealth of Virginia, Nurse Practitioners (NPs) can’t work without a license from both the Board of Nursing and the Board of Medicine (Virginia’s Legislative Information System, 2022). These groups that make rules are very important to keeping people safe. Virginia and Maryland are the two states I’d like to talk about in this talk.
The way regulations are set up in Virginia, where I live, makes it hard for APRNs to work. According to the American Academy of Nurse Practitioners (AANP, n.d.), Virginia’s practice and licensing laws prevent NPs from working on their own. In order to care for patients, they need to be supervised by a doctor. For NPs to be able to work on their own until July 2022, they only need two years of full-time clinical experience under a practice agreement with a doctor, which is equal to 1,800 hours per year (Virginia Department of Health Professions Board of Nursing, 2022a). But after that, they need the same amount of clinical experience as if they had worked full time for five years. Also, NPs can write prescriptions for Schedule II-VI drugs under the supervision of doctors (Virginia Department of Health Professions Board of Nursing, 2022b). If NPs meet the requirements set by the BON and the Board of Medicine, they can work with a doctor to write prescriptions.
State practice and licensing laws in Maryland give NPs full freedom to assess, diagnose, and treat complex medical conditions at any time without a doctor’s supervision. And the state’s BON license gives them full power to write prescriptions (AANP, 2022). According to the National Conference of State Legislatures (NCSL, 2022), NPs can prescribe controlled substances from Schedule II to Schedule V and are considered primary care providers by state law.
Neff et al. (2018) say that increasing the number of Nurse Practitioners could help reduce the lack of primary care in rural and underserved areas. In Virginia, NPs have to wait five years before they can work on their own. This won’t help with the growing shortage of primary care providers, especially in rural areas. Understanding the rules and regulations of each state is important for APRNs who want to work within their scope of practice. The lack of doctors and nurses in the United States can be fixed by NPs. Being accountable and responsible to state regulations as a healthcare provider helps improve access to healthcare and protect legal matters. The full practice authority of APRNs in Virginia needs new legislation that NPs have the authority to practice independently at any time to improve healthcare access.