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. 

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. 




In the United States, different states have APRN boards that are tasked with developing unique regulations to govern how nurse practitioners operate within clinical settings (Yang et al., 2021). Broadly, the regulations set by these boards fall under three broad categories full practice, reduced or restricted. This analysis compares the Practices of APRNS in the state of Maryland where I live, and to another state, North Carolina where practice restrictions differ. In Maryland, Nurse Practitioners have the authority to independently prescribe medications, diagnose conditions, and administer treatments, their counterparts in North Carolina do the same but under the keen supervision of physicians (McMichael & Markowitz, 2023). To demonstrate this by example, a Nurse practitioner in Maryland would be able to autonomously manage chronic conditions like diabetes. Quite the opposite, a  Nurse Practitioner in North Carolina would require the oversight and close supervision of a physician to engage in activities such as making adjustments to insulin regimens.

Needless to say, these regulations by APRN boards impact nursing practice in several ways. According to McMichael & Markowitz (2023), in states where nurses have full practice authority for example in Maryland, these healthcare professionals are free to exercise their legal right of practicing autonomously. In their report on this, Alexander and Schnell (2019) wrote that in full practice states, these professionals are authorized to engage independently in activities such as prescribing medications, diagnosing medical conditions, and providing treatments. The benefit this authority has is allowing APRNs to optimize their skills. More importantly, this full practice authority demonstrates a commitment to recognizing the full scope of nursing practice expertise. Suffice it to say, that nurse practitioners must adhere to these stipulated regulations and a practical way in which they can do this is by ensuring that they fully understand the specific requirements that these regulations have. Secondly, they must appreciate the differences between different states, especially those planning to move from one state to another. These two approaches are necessary to ensure that these practitioners abide by the set practice regulations.


Alexander, D., & Schnell, M. (2019). Just what the nurse practitioner ordered: Independent prescriptive authority and population mental health. Journal of Health Economics66, 145-162.

McMichael, B. J., & Markowitz, S. (2023). Toward a uniform classification of nurse practitioner scope of practice laws. Medical Care Research and Review80(4), 444-454.

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

Yang, B. K., Johantgen, M. E., Trinkoff, A. M., Idzik, S. R., Wince, J., & Tomlinson, C. (2021). State nurse practitioner practice regulations and US health care delivery outcomes: a systematic review. Medical Care Research and Review78(3), 183-196.



Regulations in the healthcare system are created to provide protection for the public and each state has different laws and regulations to follow (Milstead & Short, 2019). Advanced Registered Nurse Practitioner has been evolving for the past few years to provide the needs to the public. The scope of work is somehow different from being a registered nurse and it varies in every state. APRN are trained and educated to provide comprehensive care to the public with evidence-based practice that is high quality (Boehning & Punsalan, 2023).

In Texas, APRNs must only perform their practice scope of work that is within the Board authorized professional standards that are aligned to Nursing Practice Act, Board rules, and other regulations in Texas that are applicable to their scope of practice. The Texas Nurse Association (TNA) supports full practice. However, it does not allow full authority and only allows practice under the supervision of a physician where they made a contract with. Physicians are required to review the charts and sign a form to allow APRN to prescribe. APRN can order Physical therapy (PT), sign disabled person placard forms, sign Physician Orders for Life Sustaining Treatment (POLST) and sign other similar documentations. They are not allowed to sign a death certificate without being under primary care provider. Prescribing medications are allowed especially the schedule II drugs but must follow and maintain the protocol with the physician (Weisen, 2023).

In contrast to Illinois, full practice authority has been granted and was effective on June 14, 2019, for those who completed their education and training. It allows the APRNs to fully practice without the supervision of a physician. To obtain the full practice authority, they must apply to the Illinois Department of Financial and Professional Regulation (IDFPR) and notarized that they have completed at least 250 hours of continuing education or 4000 hours of clinical training after getting their national certification. The other advantages are there is no limitation when prescribing, administering, and dispensing drugs if APRN has licensed under the Illinois Controlled Substance Act. They can prescribe schedule II to through IV controlled substances without the physician’s approval. However, they need the collaboration of physician if they were to prescribed benzodiazepine and narcotic drugs. If APRN does not want to file for full authority to practice, then he/she must complete 45 hours of continuing education in pharmacology to obtain the authority to prescribe schedule II. There is a collaborative practice agreement between the APRN and physician to let the APRN prescribe schedule II, III, IV, and V. You are only allowed to prescribe 30 days supplies for uncontrolled substances.

To obey the regulations and rules, APRNs must be aware of our scope of practice and the limitations to avoid malpractice and it varies in every state and must apply these to show the adherence to the policy, regulations, and rules to provide public safety and appropriate healthcare needs. Learning is never ending, and it evolves as days go by. This indicates that even with the title of being Advanced Practice Registered nurse must continue to educate and train to acquire a new set of knowledge and skills to provide high quality of care and promote safety to the public. As APRNs, we can join different organizations to develop our growth as professionals and connecting with other APRNs because they can provide suggestions on choosing the right continuing education you need. One of the organizations that can help APRNs attain highest quality of education are Nurse Practitioner Associates for Continuing Education (NPACE) and the American Association of Nurse Practitioners (AANP). In addition to this, we can get certification. According to American Board of Nursing Specialties, being certified demonstrate your competence level and expertise and boost your confidence in decision making.



APRNs Granted “Full Practice Authority” In Illinois. (2020, November 24).

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Boehning, A. P., & Punsalan, L. D. (2023, March 1). Advanced Practice Nurse Roles. PubMed; StatPearls Publishing.

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Full Practice Authority for aprns | 1 FULL PRACTICE AUTHORITY FOR APRNS. (n.d.).

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Nurse Practitioner Scope of Practice: Illinois | ThriveAP. (n.d.).

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The Benefits of Advanced Nursing Certifications & List of Certification Boards. (n.d.). Purdue Global.

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‌ Wiesen, K. (2023). Nurse Practitioner Scope Of Practice By State – 2023.

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Dr. Falci thank you for your question  

I almost left out a great piont. In my opinion, Pennsylvanians still need to make a lot of progress when it comes to nurse practitioner laws. Although they are acknowledged as primary care professionals under state law in Pennsylvania, nurse practitioners  must have formal collaboration agreements with a qualified physician that enables an NP to diagnose medical issues, create and implement treatment programs, order and carry out diagnostic tests, and provide other health care services. (Pa. Code Section 49.21.251).  

While the legal scope of practice for nurse practitioners, commonly known as advanced practice registered nurses, was expanded in West Virginia in 2016 along with 21 other states (APRNs).  

This significant change in West Virginia law has resulted from the legislature’s decision to let a nurse practitioner who has collaborated with a physician in a formal, supervised setting for at least three (3) years be eligible to practice independently.. This noteworthy development broadens the range of APRN practice and offers competent APRNs the chance to establish independent nurse practitioner practices in WV. (W. Va. Code § 30-7-1 et seq.) 

 One thing I most clarified, Although  West Virginia is part of the multiple license states. APRN licenses are not part of the compact and do not cross state lines. You may work as an RN in West Virginia, but to work as an APRN you will need to obtain a West Virginia APRN license. One can do so by contacting  [email protected] for more information. 


AANP National Nurse Practitioner Database, 2022 

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

Jones & Bartlett Learni 

Nursing scope of practice: American Nurses Association. ANA. (2022). Retrieved 

July 1, 2022, from 

Kandrack, R., Barnes, H., & Martsolf, G. R. (2021). Nurse practitioner scope 

of practice regulations and nurse practitioner supply. Medical Care 

Research and Review, 78(3), 208. 217.