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RE: Discussion - Week 5
Nursing boards are important as they serve as the “gate keepers” of the nursing world. I remember when I graduated nursing school and feeling intimidated about the nursing board because it sounds very official, and it is. Boards of nursing (BON) exist to ensure nurses are providing safe and care to a specific standard, and are also serve as a regulatory committee. Each state has their own board, with their own regulations, but each board serves the same purpose. I recently moved from Maine to Arizona. When I made the move, I knew that each state was a part of the nursing compact, which was helpful for me to begin work and also apply for a license in the new state. In my opinion, I feel that all states should abide by the same guidelines, and allow APRNS the autonomy that the are educated and as a result they are entitled to exhibit. This would make it easier for nurses to provide care across multiple state lines, with the same rules in each state, and would likely change the way boards of nursing operate.
That being said, Arizona and Maine have very similar expectations of registered nurses. One of the big differences for RN’s is that in Arizona, it is mandatory that you provide you finger prints to the BON, something I did not have to provide in Maine. I think this is in part due to population of the whole state of Maine being less than the greater Phoenix metro area, and Maine having less nurses to regulate. Additionally, Maine is a very old state and may not be suited to require finger prints for nurses in that state, however this may develop in the future.
As an APRN in Maine, you must practice with a supervisory licensed physician or nurse practitioner during the first 24 months of your employment. As a future APRN, I find comfort in knowing that as I grow my autonomy, I am still not alone and will have a mentor, even after my 24 months expires. As an APRN in Maine, once you become a NP, you receive prescribing authority from the BON. As a practitioner you can choose weather or not you prescribe, but the BON requires you to complete 15 CEU’s in pharmacology every 2 years and submit this to the board.
Now living in Arizona, I find that there are a lot of similarities between Arizona and Maine, however there are also a few more “hoops to jump through.” As mentioned, in Maine you are granted prescribing authority when they become licensed. In Arizona, there are more steps to being allowed to prescribe such as submitting a verified application, providing your name address, etc., population of focus, NP certificate number and business address, and must submit 45 contact hours withing 3 years preceding the application with a focus in pharmacology or clinical management of drug therapy. Arizona clearly lays out what steps you need to follow, however, these are not steps the BON of Maine requires.
Advanced Practice Registered Nurse (APRN) FAQs. (n.d.). Retrieved March 21, 2020, from https://www.maine.gov/boardofnursing/licensing/adv...
Arizona State Board of Nursing. (n.d.). Retrieved March 20, 2020, from https://www.azbn.gov/search-site? search_api_fulltext=aprn
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
RE: Discussion - Week 5
The term APRN stands for Advanced Practice Registered Nurse and knowledge regarding the policies and regulations is vital in understanding the difference in practice from state to state. The ability of nurse practitioners to work to the full extent of their training and education is an issue which affects nurse practitioners nationwide. The American Association of Nurse Practitioners (AANP, 2017) defines three practice authority statuses nationwide which are full practice, reduced practice, and restricted practice. Many states remain resistant to the idea of allowing Advanced Practice Registered Nurses (APRN) more autonomy due to different regulations and legislative barriers to expanding their scope of practice privileges.
In this discussion I will compare the state of New Jersey, my state to a random state of Arizona and analyze the difference in nursing regulations between those states. New Jersey requires a ‘joint protocol” with a collaborating physician. New Jersey is a reduced practice where the state practice and licensure law reduces the ability of nurse practitioners to engage in at least one element of NP practice. State law requires a regulated collaborative agreement with an outside health discipline in order for the NP to provide patient care or limits the setting or scope of one or more elements of NP practice (NCSBN, 2019). In other words, an APRN in NJ requires a physician when prescribing medications and the NP must complete education in pharmacology related to controlled substances (Scope of practice, 2020).
In the state of Arizona it has full authority with DEA registration which means the state of Arizona is a state practice and licensure law that provides for all nurse practitioners to evaluate patients, diagnose, order and interpret diagnostic tests, initiate and manage treatments including prescribe medications under the exclusive licensure authority of the state Board of Nursing (NCSBN, 2019). Arizona mandates fingerprints to the Board Of Nursing (BON) where other states may not. The purpose of the BON is to regulate practice for the safety of every citizen.
Lastly, APRNS need to adhere to the state they practice in regards to their policies and regulations. State law requires career-long supervision, delegation or team management by another health provider for the NP to provide patient care (aanp.org, n.d.) Prior to this discussion, I was not aware that many states differ in the Nurse Practice Acts. Thankfully due to this assignment I am aware that certain states either have full, reduced, or restricted practices where the NP must follow. In my opinion, I believe all states should abide by the same guidelines to allow autonomy to the APRNs who have completed their education.This action would allow nurses statewide to provide high quality of care using the same rules that other states use.
Aanp.org. (n.d.) State Practice Environment. Retrieved March 17, 2020, from https://www.aanp.org/advocacy/state/state-practice-environment
National Council of State Boards of Nursing (NCSBN). (2019). Retrieved from https://www.ncsbn.org/index.htm
New Jersey Scope of Practice Policy - State Profile. (2020). Retrieved 25 March 2020, from http://scopeofpracticepolicy.org/states/nj/
Why Join AANP? (n.d.). Retrieved October 29, 2017, from American Association of Nurse Practitioners website: https://www.aanp.org/membership/why-join