NURS 6050 Discussion: Professional Nursing and State-Level Regulations

Sample Answer for NURS 6050 Discussion: Professional Nursing and State-Level Regulations 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.

Resources

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.

WEEKLY RESOURCES

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.

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.

*Note: Throughout this program, your fellow students are referred to as colleagues.

A Sample Answer For the Assignment: NURS 6050 Discussion: Professional Nursing and State-Level Regulations

Title: NURS 6050 Discussion: Professional Nursing and State-Level Regulations

An Analysis of Advanced Practice Registered Nurse (APRN) Regulations in Massachusetts and New Jersey
State regulations about Advanced Practice Registered Nurses (APRNs) differ among jurisdictions.
Both states have similar prerequisites for attaining the designation of an Advanced Practice Registered Nurse (APRN). Both jurisdictions mandate that registered nurses possess an active license, have excellent moral character and standing, and hold an advanced academic degree in nursing with a focus on advanced pharmacology (Commonwealth of Massachusetts, 2014; State of New Jersey, 2015). While both states have requirements for pharmacology, the New Jersey Board of Nursing has more stringent academic restrictions. These regulations provide specific details regarding the minimum amount of course credits or continuing professional education hours that must be devoted to pharmacology (NursingLicensure.org, 2020).

Massachusetts, on the other hand, mandates that the subject must be covered in the advanced degree program and does not provide a specific number of hours required to meet the qualifications for the title (Commonwealth of Massachusetts, 2014). The academic rule is also interconnected with another state regulation for Advanced Practice Registered Nurses (APRNs). New Jersey has more stringent pharmacology standards because of their prescribing regulations. APRNs licensed in New Jersey can prescribe medications as long as they have a “collaboration” or agreement with a physician authorized in New Jersey (State of New Jersey, 2015). In Massachusetts, APRNs are allowed to have prescribing authority under the supervision of providers, but this does not include CNSs and CNMs (Commonwealth of Massachusetts, 2014). CNSs must possess knowledge of pharmacology due to their capacity to conduct intricate evaluations, provide consultation, educate fellow professionals, and make referrals to other healthcare teams. However, unlike their counterparts in New Jersey, they do not have the authority to prescribe medications (Commonwealth of Massachusetts, 2014; Nurse.org, 2020). In contrast, Certified Nurse Midwives (CNMs) are not obligated to have a supervising physician authorize prescriptions and have the autonomy to do so independently (Commonwealth of Massachusetts, 2014).

Given the collaborative nature of nursing, Advanced Practice Registered Nurses (APRNs) can comply with diverse requirements by relying on the assistance of their colleagues. As a clinical informatics specialist in Massachusetts, the supervision of project management will be carried out by an informatics director and an informatics physician to ensure patient safety. The demand for supervision was communicated to me through job postings for clinical specialist positions and my interactions with other specialists. Nevertheless, in New Jersey, Clinical Nurse Specialists (CNSs) may enjoy greater autonomy in prescription management within their professional endeavors as a result of state restrictions. As they must cooperate with a physician, they will be informed of this requirement while working. Nurses can consult their state’s nursing boards to ensure full compliance with these regulations.

A Sample Answer 2 For the Assignment: NURS 6050 Discussion: Professional Nursing and State-Level Regulations

Title: NURS 6050 Discussion: Professional Nursing and State-Level Regulations

Milstead and Short (2019) share that boards of nursing write rules with criteria that applicants must meet to be eligible to sit for licensure examinations and for issuing licenses.“ Applicants for licensure must pass an initial licensing examination, then comply with continuing education requirements or undergo competency assessment by the regulatory body that provides oversight for that profession (Milstead & Short, 2019).

The College of Nurses of Ontario (CNO) is the regulatory board of nursing in the province I live, that provides licensure and establishes education requirements for Advanced Practice Registered Nurses (APRN).  APRN’s bring a holistic as well as patient-centered and family-centered approaches to the prevention and management of complex health and behavioral issues addressed in various care settings across the life span (Bosse et al., 2017).

Within the category of APRN, are Nurse Practitioners (NP). NP’s provide primary, acute, and specialty health care across the lifespan through assessment, diagnosis, and treatment of illnesses and injuries (American Nurses Association).

Within Ontario, CNO defines NP’s as “registered nurses who have met additional education, experience and exam requirements set by the College. They are authorized to diagnose, order and interpret diagnostic tests, and prescribe medication and other treatment” (College of Nurses of Ontario, 2020). CNO has outlined regulations for NP’s.  One regulation the board has outlined for NP’s is in regards to medication administration. Only NP’s who have successfully completed approved additional education are authorized to prescribe controlled substances.

There are also prescription regulations for NP’s in the state of New York. The board of nursing in New York states the “law authorizes nurse practitioners (NPs) to order, prescribe or dispense medications (including controlled substances) for the treatment of their patients. After completing New York State Education Department approved pharmacology coursework and being certified by the New York State Education Department to prescribe, most nurse practitioners must obtain additional government approvals and meet other criteria in order to prescribe medications” (New York State Education Department, 2019).

Both the boards of nursing in Ontario and New York require additional education requirements prior to NP’s being able to prescribe medications. Ontario will allow NP’s after obtaining licensure to prescribe medications, but not controlled substances. To be able to prescribe controlled substances additional education will be needed.The New York State requires all NP’s to have an additional pharmacology coursework prior to having the ability to prescribe any medications.

The New York State board also allows nurses to practice independently and not under the supervision of Physicians (New York State Education Department, 2019). CNO also consider NP’s as independent Practitioners who also do not need to work under the supervision of a Physician (College of Nurses of Ontario, 2020).

NURS 6050 Discussion Professional Nursing and State-Level Regulations
NURS 6050 Discussion Professional Nursing and State-Level Regulations

The Texas Board of Nursing (2018) differs from New York and Ontario where NP’s must practice under the supervision of a Physician.

Bosse et al. (2017) share that APRNs who are able to work to the full extent of their education and training have greater potential to identify creative approaches for solving problems within these systems, which will benefit nursing as a discipline, the larger health care community, and most importantly the community they serve.

APRNs such as NP’s adhere to the regulations of their regulatory body by maintaining their educational requirements and license requirements. As Bosse et al. (2017) mentioned it is important that NP’s are able to work to the full extent of their education and training. As mentioned above some states still have not allowed NPs to work independently, such as Texas. It would benefit the community served if NP’s in all states and provinces had the ability to practice independently.

References

American Nurses Association. (n.d.). ANA enterprse. Retrived December 29, 2020, from https://www.nursingworld.org/

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. https://doi-org.ezp.waldenulibrary.org/10.1016/j.outlook.2017.10.002

College of Nurses of Ontario. (2020). Nurse Practitioners. https://www.cno.org/en/learn-about-standards-guidelines/educational-tools/nurse-practitioners/

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning

New York State Education Department. (2019). Nursing Prescription Privileges. http://www.op.nysed.gov/prof/nurse/np-ppep.htm

Texas Board of Nursing. (2018). Advance Practice Registered Nurse.https://www.bon.texas.gov/applications_advanced_practice_registered_nurse.asp

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A Sample Answer 3 For the Assignment: NURS 6050 Discussion: Professional Nursing and State-Level Regulations

Title: NURS 6050 Discussion: Professional Nursing and State-Level Regulations

A video from Walden University (2018) featuring Joel Teitelbaum shares, “It is clear that politics is playing a vital role in the design at the outset and now the implementation of the ACA.” You mentioned that policymakers aren’t concerned by how the general population is affected but they care more about reelection. As this statement is partially true, I think research has shown that the general population votes are based on what the legislator is offering. The population is their voting pool and without them there would be no votes which leads to no re-election. I’m not sure that its common ground either, I think it’s all about popularity votes and how it directly affects the legislator. Elected officials generally want to make good policy. Many come to their respective legislative bodies because they want to make a difference and be part of good government. Many consider various things like: Do my constituents care about this issue? Is this good policy for the Nation and does this make sense? Is this press worthy (Ames, n.d.)? The representation of the specific legislators and what they support/represent will always be what sways votes. Taking each aspect into consideration and looking at the targeted population is what will keep legislators in office.

Grading Criteria

To access your rubric:

Week 5 Discussion Rubric

 

Post by Day 3 and Respond by Day 6 of Week 5

To participate in this Discussion:

Week 5 Discussion

Module 3: Regulation (Weeks 5-6)

Laureate Education (Producer). (2018). Regulation [Video file]. Baltimore, MD: Author.

Learning Objectives
Students will:

Compare state/regional board of nursing regulations
Compare boards of nursing and professional nurse associations
Analyze members of boards of nursing
Analyze state regulations for healthcare

Due By
Assignment
Week 5, Days 1–2
Read/Watch/Listen to the Learning Resources.
Compose your initial Discussion post.
Week 5, Day 3
Post your initial Discussion post.
Begin to compose your Assignment.
Week 5, Days 4-5
Review peer Discussion posts.
Compose your peer Discussion responses.
Continue to compose your Assignment.
Week 5, Day 6
Post at least two peer Discussion responses on two different days (and not the same day as the initial post).
Week 5, Day 7
Wrap up Discussion.
Week 6, Days 1-6
Continue to compose your Assignment.
Week 6, Day 7
Deadline to submit your Assignment.

Learning Resources

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)

American Nurses Association. (n.d.). ANA enterprise. Retrieved September 20, 2018, from http://www.nursingworld.org

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.

Halm, M. A. (2018). Evaluating the impact of EBP education: Development of a modified Fresno test for acute care nursing. Worldviews on Evidence-Based Nursing, 15(4), 272–280. doi:10.1111/wvn.12291

National Council of State Boards of Nursing (NCSBN). (n.d.). Retrieved September 20, 2018, from https://www.ncsbn.org/index.htm

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

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.

Required Media

Laureate Education (Producer). (2018). The Regulatory Process [Video file]. Baltimore, MD: Author.

Laureate Education (Producer). (2018). Healthcare economics and financing [Video file]. Baltimore, MD: Author.

Laureate Education (Producer). (2018). Quality improvement and safety [Video file]. Baltimore, MD: Author.
Discussion: Professional Nursing and State-Level Regulations

To access your rubric:

Week 5 Discussion Rubric

Post by Day 3 and Respond by Day 6 of Week 5

To participate in this Discussion:

Week 5 Discussion

A Sample Answer 4 For the Assignment: NURS 6050 Discussion: Professional Nursing and State-Level Regulations

Title: NURS 6050 Discussion: Professional Nursing and State-Level Regulations

My husband and I have recently moved from Colorado to North Carolina, and I was disheartened to find out that we had moved from a state that allows APRNs to practice unrestricted to a more rigidly restricted state. In Colorado, newly graduated nurse practitioners must complete an 1800-hour preceptorship with a physician, and they have to be able to meet and collaborate weekly. Following this preceptorship, the nurse practitioner and physician will then enter into a 1800 hours mentorship and has to be outlined with a plan for continued collaboration. (Nurse Practitioner Scope of Practice: Colorado | Thriveap, 2013)

In North Carolina, APRNs must enter into a collaborative practice agreement with a physician. This agreement will outline the exact drugs and devices the APRN will be allowed to prescribe. Within the first six months, the APRN and physician will meet each month to discuss the agreement’s revisions or quality improvement measures. Once the first six months are complete, the APRN and physician will review the collaborative practice agreement annually. The burden seems to fall on the APRN to pay for a collaborative practice agreement with the physician, and a financial contract for the physician’s services must be drawn up. (North Carolina Scope of Practice Policy – State Profile, 2020)

In February 2019, legislators in North Carolina introduced the SAVE act with the hopes of removing outdated restrictions on APRNs and give them full practice authority. The act had a lot of support, and the North Carolina Nurses Association was hopeful that it would be passed by the end of 2020, but when COVID, the act was placed on the backburner.(Legislative Update 6/26/2020, 2020) It is still eligible to be brought up and voted on anytime this year, but with elections coming up in November, it seems like it will have to be refiled for next year. I hope that amid this pandemic, legislators will realize that allowing APRNs to practice fully could save money and, more importantly, save lives.

I have found that the VA has nurse practitioner residency programs in most states for FNPs and PMHNPs, and there is one here in Durham, North Carolina. These programs are for one year, and they are paid internships. In 2016, the VA announced that it would recognize full practice authority for NPs, clinical nurse specialists, and nurse-midwives despite certain state restrictions.  (Livanos, 2016)

 References

Legislative update 6/26/2020. (2020, June 26). North Carolina Nurses Association. https://ncnurses.org/advocacy/legislative/legislative-update-6-26-2020/

Livanos, N. (2016). Increasing avenues to care: Department of veterans affairs makes move to grant aprns full practice authority. Journal of Nursing Regulation, 7(3), 58–62. https://doi.org/10.1016/s2155-8256(16)32322-5

North carolina scope of practice policy – state profile. (2020). Scope of Practice Policy. http://dev.scopeofpracticepolicy.org/states/nc/

Nurse practitioner scope of practice: Colorado | thriveap. (2013, November 19). ThriveAP. https://thriveap.com/blog/nurse-practitioner-scope-practice-colorado

A Sample Answer 5 For the Assignment: NURS 6050 Discussion: Professional Nursing and State-Level Regulations

Title: NURS 6050 Discussion: Professional Nursing and State-Level Regulations

I enjoyed reading your post. It’s so interesting how different states have such drastically different rules for advanced practice nurses. One would think that during a pandemic, it would be obvious that the need for advanced practice nurses is great, however, it does seem to have put a hold on a lot of things. According to the North Carolina Nurses Association, they remained very confident, naming this act as one of the highest priorities for the 2020 legislative session (NCNA, 2020).  I do agree with you, however, that there may be a hold up due to the presidential election season. Hopefully, though, those in healthcare can continue to advocate for the dire need of advanced practice nurses being able to operate to their full capacity. You mentioned the VA NP residency programs, are you interested in working for the VA? Just curious as to how those programs are. It might be a good option to try; it seems as though it is a great way to incorporate NP’S in utilizing their full practice authority.

One of my good friends that I met along my travel nursing experiences recently moved to Colorado specifically because NP’s are able to work independently. Her goal is to open her own practice and with Colorado’s laws for NP’s, it would allow her, essentially, to be her own medical director. It seems as though, as of 2010, NP’s in Colorado are not required to practice under the supervision of an MD, although, when it comes to prescribing medications there are some limitations early on in their career as an advanced practice nurse (ThriveAP, 2013).

After reading and researching through different state mandates, it’ll be interesting to see what will happen with regards to the independence of NP’s in the coming years. I do hope that North Carolina is finally able to pass the SAVE act!

 References:

Nurse Practitioner Scope of Practice: Colorado. (2020, July 22). Retrieved October 02, 2020, from https://thriveap.com/blog/nurse-practitioner-scope-practice-colorado

SAVE Act. (n.d.). Retrieved October 02, 2020, from https://ncnurses.org/advocacy/legislative/save-act/

A Sample Answer 6 For the Assignment: NURS 6050 Discussion: Professional Nursing and State-Level Regulations

Title: NURS 6050 Discussion: Professional Nursing and State-Level Regulations

APRNs in Missouri must adhere to strict supervision laws. A regulation Missouri APRNs are to follow is that an APRN and their collaborating physician are still required to work within a specific geographic proximity, even after the first initial thirty days (Sommer et al., n.d.). An APRN must be within a 30-mile radius in a non-Health professional shortage area (non-HPSA) or a 50-mile radius in a HPSA of their collaborating physician to practice legally (ThriveAPb, 2013). An APRN can only practice outside of those 30 miles if they are utilizing telehealthcare but must obtain consent from patients before telehealth services are initiated. Although APRNs must have a practice agreement in place with a physician, they are not required to meet. Another regulation APRNs in Missouri are to follow are that they are not allowed to sign death certificates or declare someone deceased.  Like Missouri, Illinois APRNs have practice agreement sent in place with a collaborating physician, but how they differ is that Illinois APRNs must meet monthly with their collaborating physician (ThriveAPa, 2013). Illinois APRNs also cannot sign death certificates or pronounce someone deceased.  

To adhere to these regulations, APRNs must find a collaborating physician and have a collaborative practice agreement set in place. Collaborative practice agreements is a written agreement that must establish guidelines for consultation and referral to collaborating physician or health facility, agreement of protocols and standing orders, must be signed and dated by both APRN and collaborating physician before the APRN can start practicing, there must be a subsequent notice of termination and must identify the process for review and management of abnormal test results, the scope of practice, physician’s number of collaborative practice arrangement limitations, distance from a physician (30 non-HPSA or 50 HPSA miles),  other physician designated to collaborative practice arrangement, physician two-week provisions, process and documentation of review, prescription pad requirements, controlled substance limitations, dispensing logs and 72-hour dispensing boundaries, diagnosis and initiation of treatment, self-limited or well-defined problem parameters, population-based public health services, review and revision of collaborative practice arrangements as needed, and physician accountability for delegated medical acts  (Missouri Division of Professional Registration, n.d.). Having a professional and respected relationship with your collaborated physicians will help APRNs adhere to their regulations. 

APRNs who have full practice authority allow APRNs the full ability to utilize knowledge, skills, and judgment to practice to the full extent of their education and training (American Nurses Association, n.d.). APRNs allowed to full practice authority have advantages such as reduction in health care costs, expansion of care to rural or underserved areas, and efficient and effective care as they do not have to wait for directions from their collaborating physician (Bradley University, n.d.). APRNs who are allowed full authority practice would function as a primary care physician. They would be allowed to make decisions as a physician and practice to their full extent. They would be unaffected by the regulations I selected; they would be allowed to make these decisions without breaking the law.  

 References 

American Nurses Association. (n.d.). Advanced Practice Registration Nurses (APRN). https://www.nursingworld.org/practice-policy/aprn/ 

Bradley University. (n.d.). What is Full Practice Authority for Nurse Practitioners? https://onlinedegrees.bradley.edu/nursing/msn-fnp/resources/understanding-regulations-what-is-full-practice-authority/#:~:text=According%20to%20the%20American%20Association%20of%20Nurse%20Practitioners,nursing%20board%20%28a%20definition%20last%20updated%20in%202015%29. 

Missouri Division of Professional Registration. (n.d.). Nursing & Collaborative Practice. https://pr.mo.gov/nursing-advanced-practice-nursing-collaborative.asp 

ThriveAP. (2013). Nurse Practitioner Scope of Practice: Illinois. https://thriveap.com/blog/nurse-practitioner-scope-practice-illinois 

ThriveAP. (2013). Nurse Practitioner Scope of Practice: Missouri. https://thriveap.com/blog/nurse-practitioner-scope-practice-missouri  

Sommer, C., Franklin, D., Kelly, H., Neely, J., Peters, J., and Smith, C. (n.d.). Current Practice of Advanced Practice Registered Nurses. https://house.mo.gov/Billtracking/bills171/commit/rpt1510/Scope%20of%20Practice%20Report.pdf#:~:text=To%20be%20recognized%20as%20an%20APRN%20in%20Missouri,obtained%20in%20the%20advanced%20practice%20nursing%20education%20program. 

A Sample Answer 7 For the Assignment: NURS 6050 Discussion: Professional Nursing and State-Level Regulations

Title: NURS 6050 Discussion: Professional Nursing and State-Level Regulations

The state boards of nursing protect the public through controlling the nursing practice. The regulations indicate the level of education and scope of practice required to provide safe and cost-effective care. They vary from one state to another but aim to make sure nurses’ access growing evidence to provide effective care. There are important differences relating to education and renewal of licenses in Maryland and Idaho’s Boards of Nursing.

As mentioned, Maryland and Idaho’s Boards of Nursing have different regulations relating to education and renewal of licenses. In Maryland, the Board of Nursing approves licenses for APRNs upon obtaining a master’s degree or higher in an approved nurse practitioner program (NCSBN, 2020). On the other hand, in Idaho, an APRN only provide evidence of a graduate or post-graduate nursing program degree. Moreover, the nursing license is renewed after a specific period. In the state of Maryland, the renewal of licenses is done annually, and APRNs must provide active national certification and transcripts of refresher courses undertaken during the period of practice (NCSBN, 2020). In Idaho, APRN licenses are renewed after two years, and APRNs must undergo a 10-hour course on pharmacology (NCSBN, 2020). The education and training impart knowledge and skills to support nurses to practice at the advanced level.

Graduate or post-graduate degree, refresher courses, and continuous education required for renewal of APRN license apply to APRN’s scope of practice. Education and license renewal requirements support the provision of safe and cost-effective care by the APRNs (Nursing Licensure, 2020). According to Bosse et al. (2017), continuous education and refresher courses allow nurses to access a growing body of evidence essential in the execution of APRN roles. Per Halm (2018), attaining a graduate or post-graduate degree program and engaging in continuous nursing education helps APRNs to utilize their knowledge and skills to the full extent of their training. Importantly, APRNs must adhere to the education and licensure stipulations. For example, a nurse needs to hold RN and APRN credentials concurrently because RN licensure is a precondition to APRN. The two licensure credentials facilitate a nurse’s licensing process.

The license requirements vary from one state to another. Apart from the required educational qualification, different states require additional training to help APRNs address changes in the ever-changing healthcare sector. The education and renewal of license provisions help nurses with a growing body of evidence to competently provide care to patients

 References

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.

Halm, M. (2018). Evaluating the impact of EBP education: Development of a modified Fresno test for acute care nursing. Worldviews on Evidence-Based Nursing, 15(4), 272–280.

NCSBN. (2020). Board of Nursing professional licensure requirements. National Council of State Boards of Nursing. https://www.ncsbn.org/14730.htm.

Nursing Licensure. (2020). Nurse Practitioner license requirements: Change is in the air. Nursing Licensure. https://www.nursinglicensure.org/articles/nurse-practitioner-license.html

 

A Sample Answer 8 For the Assignment: NURS 6050 Discussion: Professional Nursing and State-Level Regulations

Title: NURS 6050 Discussion: Professional Nursing and State-Level Regulations

In the United States, there are many rules and regulations for all APRNs; every state has a Board of Nursing (BON) that determines the regulations. The BON is responsible for clearly outlining all the rules and regulations that APRNs must follow and what is within their scope of practice. Regulations are essential because they are meant to keep the community safe. (Milstead & Short, 2019, chap 4, p. 59-60). Under New Jersey law, APRNs can prescribe medications and procedures under a collaborating physician with whom they work. APRNs have independent autonomy compared to Alaska and do not need a physician (States et al. Practice Authority for Nurse Practitioners, 2023). For example, in NJ, an APRN would need to collaborate with the physician when prescribing medications such as antibiotics for an infection and ordering tests.

There would be information about the prescribing APRN and the collaborating physician on the scripts written (New et al. of Nursing, 2022, pp. 51–52). Compared to APRNs in Alaska, they can practice independently and have their own prescriptions without collaborating with another professional. Another regulation with medications is that in Alaska, APRNs are not restricted to the medications they can prescribe, whereas in NJ, they are. “NPs in New Jersey have reduced prescriptive authority for Schedule II drugs, but they can prescribe certain drugs after completion of a pharmacology course” (McGhee, n.d.). I also think that in the future, there will be a big push to get more states to allow APRNs to practice without restrictions. I think there is a shortage of APRNs, and allowing APRNs to practice independently can change that and positively impact communities.

 

References:

McGhee, M. K. (n.d.). 2023 State by state Scope of practice: Nurse practitioner. https://hire.vivian.com/blog/2022-state-by-state-scope-of-practice-nurse-practitioner

Milstead, J. & Short, N. (2019). Health Policy and Politics: A Nurse’s Guide (6th ed.). Jones & Bartlett Learning.

New Jersey Board of Nursing. (2022, July 18). New Jersey Administrative Code. NJ Consumer Affairs. Retrieved December 26, 2023, from https://www.njconsumeraffairs.gov/regulations/Chapter-37-New-Jersey-Board-of-Nursing.pdf

Links to an external site.

States with Full Practice Authority for Nurse Practitioners. (2023, August 30). Maryville University. Retrieved December 26, 2023, from https://nursing.maryville.edu/blog/states-granting-np-full-practice-authority.html

A Sample Answer 9 For the Assignment: NURS 6050 Discussion: Professional Nursing and State-Level Regulations

Title: NURS 6050 Discussion: Professional Nursing and State-Level Regulations

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.

 References

Laureate Education (Producer). (2018). The Regulatory Process [Video file]. Baltimore, MD:

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.

https://www.nmnpc.org/page/PracticeRegs

Texas Board of Nursing. (2021) Practice-APRN Scope of Practice.

https://www.bon.texas.gov/practice_scope_of_practice_aprn.asp

Name: NURS_6050_Module03_Week05_Discussion_Rubric

 Grading Rubric Guidelines

Performance Category 10 9 8 4 0
Scholarliness

Demonstrates achievement of scholarly inquiry for professional and academic decisions.

  • Provides relevant evidence of scholarly inquiry clearly stating how the evidence informed or changed professional or academic decisions
  • Evaluates literature resources to develop a comprehensive analysis or synthesis.
  • Uses valid, relevant, and reliable outside sources to contribute to the threaded discussion
  • Provides relevant evidence of scholarly inquiry but does not clearly state how the evidence informed or changed professional or academic decisions.
  • Evaluates information from source(s) to develop a coherent analysis or synthesis.
  • Uses some valid, relevant, reliable outside sources to contribute to the threaded discussion.
  • Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions.
  • Information is taken from source(s) with some interpretation/evaluation, but not enough to develop a coherent analysis or synthesis.
  • Little valid, relevant, or reliable outside sources are used to contribute to the threaded discussion.
  • Demonstrates little or no understanding of the topic.
  • Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions.
  • Information is taken from source(s) without any interpretation/evaluation.
  • The posting uses information that is not valid, relevant, or reliable
  • No evidence of the use of scholarly inquiry to inform or change professional or academic decisions.
  • Information is not valid, relevant, or reliable
Performance Category  10 9 8 4 0
Application of Course Knowledge –

Demonstrate the ability to analyze, synthesize, and/or apply principles and concepts learned in the course lesson and outside readings and relate them to real-life professional situations

  • Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources;
  • Applies concepts to personal experience in the professional setting and or relevant application to real life.
  • Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources.
  • Applies concepts to personal experience in their professional setting and or relevant application to real life
  • Interactions with classmates are relevant to the discussion topic but do not make direct reference to lesson content
  • Posts are generally on topic but do not build knowledge by incorporating concepts and principles from the lesson.
  • Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life
  • Does not demonstrate a solid understanding of the principles and concepts presented in the lesson
  • Posts do not adequately address the question posed either by the discussion prompt or the instructor’s launch post.
  • Posts are superficial and do not reflect an understanding of the lesson content
  • Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life
  • Posts are not related to the topics provided by the discussion prompt or by the instructor; attempts by the instructor to redirect the student are ignored
  • No discussion of lesson concepts to personal experience in the professional setting and or relevant application to real life
Performance Category  5 4 3 2 0
Interactive Dialogue

Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days.

(5 points possible per graded thread)

  • Exceeds minimum post requirements
  • Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts three or more times in each graded thread, over three separate days.
  • Replies to a post posed by faculty and to a peer
  • Summarizes what was learned from the lesson, readings, and other student posts for the week.
  • Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days
  • Replies to a question posed by a peer

Summarizes what was learned from the lesson, readings, and other student posts for the week.

  • Meets expectations of 2 posts on 2 different days.
  • The main post is not made by the Wednesday deadline
  • Does not reply to a question posed by a peer or faculty
  • Has only one post for the week
  • Discussion posts contain few, if any, new ideas or applications; often are a rehashing or summary of other students’ comments
  • Does not post to the thread
  • No connections are made to the topic
  Minus 1 Point Minus 2 Point Minus 3 Point Minus 4 Point Minus 5 Point
Grammar, Syntax, APA

Note: if there are only a few errors in these criteria, please note this for the student in as an area for improvement. If the student does not make the needed corrections in upcoming weeks, then points should be deducted.

Points deducted for improper grammar, syntax and APA style of writing.

The source of information is the APA Manual 6th Edition

  • 2-3 errors in APA format.
  • Written responses have 2-3 grammatical, spelling, and punctuation errors.
  • Writing style is generally clear, focused, and facilitates communication.
  • 4-5 errors in APA format.
  • Writing responses have 4-5 grammatical, spelling and punctuation errors.
  • Writing style is somewhat focused.
  • 6-7 errors in APA format.
  • Writing responses have 6-7 grammatical, spelling and punctuation errors.
  • Writing style is slightly focused making discussion difficult to understand.
  • 8-10 errors in APA format.
  • Writing responses have 8-10 grammatical, spelling and punctuation errors.
  • Writing style is not focused, making discussion difficult to understand.
  • Post contains greater than 10 errors in APA format.
  • Written responses have more than 10 grammatical, spelling and punctuation errors.
  • Writing style does not facilitate communication.
  • The student continues to make repeated mistakes in any of the above areas after written correction by the instructor
0 points lost       -5 points lost
Total Participation Requirements

per discussion thread

The student answers the threaded discussion question or topic on one day and posts a second response on another day. The student does not meet the minimum requirement of two postings on two different days
Early Participation Requirement

per discussion thread

The student must provide a substantive answer to the graded discussion question(s) or topic(s), posted by the course instructor (not a response to a peer), by Wednesday, 11:59 p.m. MT of each week. The student does not meet the requirement of a substantive response to the stated question or topic by Wednesday at 11:59 pm MT.