NURS 6050 Discussion Week 5 Professional Nursing and State-Level Regulations

Sample Answer for NURS 6050 Discussion Week 5 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.

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.

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

Title: NURS 6050 Discussion Week 5 Professional Nursing and State-Level Regulations

The nursing specialty I chose is psychiatric mental health. I had some difficulties making this decision. I struggled a lot in nursing school with psychiatric outcomes. I felt like with mental illness; you could never really treat the problem. Psychiatric medication takes time to reach a therapeutic level. Most medications take 30 days or more to get a therapeutic grade. One clinical rotation was not enough time to follow a patient from an acute episode to discharge. When I left my psychiatric clinical rotation, I felt defeated, like I did not truly help anyone. I immediately decided that I would not become a psychiatric nurse. I finished nursing school with my mindset on becoming an obstetric nurse. However, most hospitals in the TN area require one year of prior experience to work on the OB floor. I had no experience. My first job as a nurse was in geriatric psychiatry. I thought I would hate it. I learned so much and grew to love mental health nursing. Psychiatric nursing is often a revolving door. I got to see my patients get better, but unfortunately, I got to know many of them often. I had to realize that mental health is fluid; there are ebbs and flows. There are good, bad, and worse days. Once I accepted mental health nursing is an ongoing process, I felt like it became my calling.

American Psychiatric Nurses Association (APNA) is a professional organization affiliated with psychiatric-mental health nursing. It is pretty simple to become a member. You create an account with your demographics and email. Then select a membership type; regular, Full-time nursing student, retired nurse, international nurse, affiliate (non-RN), or full-time military on active duty. Pay dues and present documentation for memberships other than regular. Full time active duty members will have to provide proof of active duty status and call a specific number for membership discount.

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.

Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message.

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

A Sample Answer 2 For the Assignment: NURS 6050 Discussion Week 5 Professional Nursing and State-Level Regulations

Title: NURS 6050 Discussion Week 5 Professional Nursing and State-Level Regulations

For a person to be considered a professional, they must meet the minimum requirements of that profession and follow the regulations that govern the profession. Regulation of Advanced Practice Registered Nurses (APRN) varies from state to state. The scope of practice also differs from state to state. There are some differences in regulations between the state of Michigan and Maryland. The Public Health Code regulates APRNs in Michigan. They can independently prescribe non-scheduled medications but require a doctor to cosign for the prescription of schedule 2-5 medications (Michigan Board of Nursing, 2021). APRNs cannot sign a death certificate but can participate in ward rounds, perform house call visits without a collaborating doctor (Michigan Board of Nursing, 2021). The Nurse Practice Act governs APRNs in Maryland. They can sign a death certificate. They have to register with the Prescription Drug Monitoring Program to be allowed to prescribe schedule 2-5 drugs (Maryland Board of Nursing, 2021). In Michigan, certified nurse-midwives must partner with physicians to offer care to patients, while in Maryland, they are allowed to practice independently without entering into a physician collaboration.

APRNs have the skills, education, and clinical knowledge to offer specialized care to their patients. Complying with these regulations will allow them to identify and beware of their practice areas and the boundaries of their operations. The regulation stipulates the necessary certifications required for an individual to practice. An example is all APRNs must obtain certification from the Maryland Board of Nursing before being allowed to practice. Nurses can adhere to these regulations by finishing the mandatory course hours to become APRNs. They can also ensure that their license is updated, participate in continuous education programs to ensure they are up to date with new nursing knowledge

References

Maryland Board of Nursing. (2021). Pages – Advanced practice registered nursing. https://mbon.maryland.gov/Pages/advanced-practice-index.aspx

Michigan Board of Nursing. (2021). Michigan board of nursing. SOM – State of Michigan. https://www.michigan.gov/lara/0,4601,7-154-89334_72600_72603_27529_27542_91265-59003–,00.html

A Sample Answer 3 For the Assignment: NURS 6050 Discussion Week 5 Professional Nursing and State-Level Regulations

Title: NURS 6050 Discussion Week 5 Professional Nursing and State-Level Regulations

This discussion makes it very apparent why it is important for the APRN to be aware of the scope of practice of the state in which they are practicing. It is evident that the nurses in Maryland have more freedoms than the nurses of Michigan.

I enjoyed learning about the states that you discussed. I’m in Virginia, and the difference is APRN’s in my state can sign death certificates. I see that you mention in Michigan APRN’s cannot sign deaf certificates. I also see that in Michigan, APRN’s can prescribe medications independently, in Virginia you must work under a licensed physician in order to prescribe. Unfortunately, you cannot work independently.

Reference 

13, F. J., & 12, ray M. (2020, March 24). Nurse practitioner scope of practice: Virginia. thriveap. Retrieved December 27, 2021, from https://thriveap.com/blog/nurse-practitioner-scope-practice-virginia

A Sample Answer 4 For the Assignment: NURS 6050 Discussion Week 5 Professional Nursing and State-Level Regulations

Title: NURS 6050 Discussion Week 5 Professional Nursing and State-Level Regulations

It was great reading your discussion post this evening. I wanted to share with you, that the week 5 discussion board is very practical and as a result, I have learned that Advanced Practice Registered Nurses (APRN) varies state-to-state. I did not know this and made the assumption that every state was the same in regard to the scope of practice.

Like as you stated Michigan governing body that regulates their scope of practice is headed by the Michigan Public Health Code. In North Carolina, there is a Board of Nursing separate from the North Carolina Public Health Code. Like in (Milstead, 2019) Idaho became the first state to legally recognize the diagnosis and treatment as part of the scope of nurse practitioners. APRN (nurse practitioner) regulation in Idaho was accomplished through a joint agreement between the state boards of nursing and medicine. The Idaho model set a precedent for other states to include some form of joint nursing and medical board oversight for APRN regulation”.

Thus without this weeks’ readings, I would not be aware of the variety of regulations that affect each APRN scope of practice, in various states. This brings me to ask this question, do you think there should be a national board of APRN?

Again, it was very informative reading your post this evening.

References

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

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

Title: NURS 6050 Discussion Week 5 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 6 For the Assignment: NURS 6050 Discussion Week 5 Professional Nursing and State-Level Regulations

Title: NURS 6050 Discussion Week 5 Professional Nursing and State-Level Regulations

I also wonder why each state has different regulations on how APRNs practice after getting board certified by the state. It would be easier to have universal rules and regulations for all APRNs to follow while practicing. I enjoyed reading your discussion post; it is educational and to the point on the rules put in place by the board of nursing in Maryland and Michigan. I would personally prefer practicing in Maryland as there is more freedom to practice independently.

I concur with the concept that the state laws and regulations between Michigan and Maryland differ in several capacities. In Michigan, under the Public Act 499, An APRN that is registered under the Michigan health professional licensure is permitted to prescribe a non-scheduled prescription drug and a controlled substance. The APRN is expected to prescribe in schedules of 2 to 5 as a delegated act of a supervising physician. Notably, APRNs are also permitted to conduct the ordering, receipt, and dispensing of complimentary starter dose drugs under specified conditions. On the other hand, in Maryland, APRNs are permitted to practice independently

without or with limited supervision of the physician. Furthermore, the measure also allows the APRN to prescribe medication and controlled substances without having an attestation agreement with a physician (Rubenfire, 2015). Succinctly, an APRN might directly dispense a controlled dangerous substance listed in Schedules III, IV, or V. In this manner, the prescription drug must be established under the Federal Food, Drug, and Cosmetic Act, or state law.

References

Rubenfire, A. (2015). Maryland allows nurse practitioners to practice independently of a physician. Modern Healthcare. Retrieved from https://www.modernhealthcare.com/article/20150514/NEWS/150519928/maryland-allows-nurse-practitioners-to-practice-independently-of-a-physician

Sheehan, A., Jones, A., McNerlin, C., Iseler, J., & Dove-Medows, E. (2021). How advanced practice registered nurse practice barriers impact health care access in Michigan. Journal of the American Association of Nurse Practitioners, 33(9), 739-745. https://doi.org/10.1097/jxx.0000000000000443 

Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: NURS 6050 Discussion Week 5 Professional Nursing and State-Level Regulations

A Sample Answer 7 For the Assignment: NURS 6050 Discussion Week 5 Professional Nursing and State-Level Regulations

Title: NURS 6050 Discussion Week 5 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

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.

Also Check Out:  NURS 6050 Discussion Week 1 Presidential Agendas