NURS 6050 Professional Nursing and State-Level Regulations

Walden University NURS 6050 Professional Nursing and State-Level Regulations – Step-By-Step Guide

This guide will demonstrate how to complete the Walden University NURS 6050 Professional Nursing and State-Level Regulations assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for NURS 6050 Professional Nursing and State-Level Regulations

Whether one passes or fails an academic assignment such as the Walden University NURS 6050 Professional Nursing and State-Level Regulations depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for NURS 6050 Professional Nursing and State-Level Regulations

The introduction for the Walden University NURS 6050 Professional Nursing and State-Level Regulations is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for NURS 6050 Professional Nursing and State-Level Regulations

After the introduction, move into the main part of the NURS 6050 Professional Nursing and State-Level Regulations assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for NURS 6050 Professional Nursing and State-Level Regulations

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for NURS 6050 Professional Nursing and State-Level Regulations

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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

 Each state has its own board of nursing that mandates regulations Advanced Practice Registered Nurses (APRN) practicing in the state must abide by. Regulations, also known as rules, provide details that allow for the practical implementation of a law (Milstead & Short, 2019). These regulations are in place to ensure the same standard of care is been provided statewide. I will compare APRN board of nursing regulations in the state I live in, Texas, against Arizona.

            Full practice, reduced practice, and restricted practice are the three forms of practice an APRN can engage in based on the state they are practicing in. Arizona is a full-practice state meaning that APRNs can practice independently to the full extent of their education and licenses (Wiesen, 2023). Oppositely, Texas is a restricted practice state. This means that a physician must supervise APRNs throughout their career, and APRNs may be restricted in other aspects of practice (Wiesen, 2023). Each state deems it necessary to establish these guidelines for APRNs in their state. In addition, in Arizona, NPs can prescribe medications independently, including Schedule II medications (Wiesen, 2023). Schedule II drugs are considered to have a high potential for abuse, such as Dilaudid, Adderall, and Oxycodone (Drugs, n.d.). As a result, extra precaution is taken when prescribing these medications. In Texas, APRNs can prescribe Schedule II drugs as long as they have prescriptive authority in combination with a physician and follow the guidelines (Wiesen, 2023). Furthermore, the authority to prescribe scheduled II drugs in Texas applies to APRNs who are part of a hospital facility-based practice or part of the care team for a hospice patient under a qualified hospice provider (TBON n.d.). In Arizona, APRNs can pronounce death and sign death certificates independently, while in Texas, pronouncing of death occurs in certain circumstances, and death certificates can only be signed by an APRN under a practice agreement with a physician (Wiesen, 2023). According to the Texas Board of Nursing (TBON), an APRN cannot pronounce death if artificial means of life support were used prior to the death (n.d.). These rules and many more affect how APRNs practice in different states. These regulations are in place to provide ongoing maintenance of acceptable standards of practice (Milstead & Short, 2019).

            APRNs in Texas may find it limiting to rely on physicians to be able to provide certain care.  However, regulations in health care are in place to protect public safety (Milstead & Short, 2019).  Consequently, APRNs must adhere to the states’ regulations in which they practice. This can be done by ensuring their APRN licenses are connected to the state they practice in. Oftentimes, regulations are changed or updated. Therefore, APRNs need to stay current with their state-approved practice regulations.

The healthcare team must work collaboratively to accomplish high-quality care and positive outcomes. Each role in the healthcare team has a specific scope of practice and is based on their educational preparation and triaging, allowing them to contribute to primary care (Bosse et al., 2017). APRNs will focus on bringing a holistic, patient-centered, and family-centered approach to prevent and manage complex health and behavioral issues (Bosse et al., 2017). 

           Some examples of APRNs are nurse practitioners (NP) and certified nurse-midwife (CNM). Nurse practitioners provide comprehensive care services to address physical and mental health needs. While CNMs offer services focusing on primary sexual and reproductive health services and postpartum care, childbirth, and care of newborns (Bosse et al., 2017). 

           Healthcare professionals must practice within their scope of practice, or consequences could follow. Living in Pennsylvania, in 2004, Governor Rendell introduced the proposed legislation known as Prescription of Pennsylvania (Rx4PA), which sought to increase access to health care, control spiraling state healthcare costs, and improve quality (Carthon et al., 2016)—allowing for APRNs to order medical equipment, signing disability forms, and prescriptive authorities (Carthon et al., 2016). Pennsylvanians were 11% more likely to use the emergency room than all other Americans (Carthon et al., 2016). 

           State to state regulations varies regarding the prescriptive authority. Revealing in 2017 Florida legislature expanded APRN prescribing controlled substances, such as opioids and stimulants, reported earlier that Florida physicians were dispensing oxycodone five times more than the national average (Reynolds, Reynolds, & Craig-Rodriguez, 2021). Comparing to Pennsylvania, the Governor allowed APRNs to prescribe medications in 2004. Florida was the last state to rant controlled substances prescriptive authority (Reynolds, Reynolds, & Craig-Rodriguez, 2021). 

           In 1985, The Medical Practice Act imposed strict requirements on CNMs to legally practice in Pennsylvania (Levinson, 2018). Pennsylvania legislators made unsuccessful attempts in the early 1990s to legalize non-nurse midwifery practice. Pennsylvania has a high home birth rate, and non-nurse midwives attend (Levinson, 2018). Their attempts were supported by the Amish community and opposed by CNMs and medical groups (Levinson, 2018). The non-nurse midwives practiced illegally because the Midwife regulation Law proscribes midwifery practice without a license, and Pennsylvania currently provides no path to licensure for non-nurse midwives (Levinson, 2018). In Pennsylvania, to certify, the individual must be licensed by the board, have the minimum education requirements, can practice without a physician, and lastly be required to carry malpractice insurance (Levinson, 2018). 

           According to the Florida state website, the requirements need to practice midwifery are they must have a high school diploma, 21 years of age, completion of an approved midwifery program for a minimum of 3 years, if an RN or LPN a reduction in clinical training if qualified (2021). Students must observe additional 25 women before allowing for a license. Once completed, the student will test their proficiency in core competencies that are required (Statutes &Constitution). The difference between the states is Pennsylvania allows for non-nurse midwives due to the Amish community. 

           In conclusion, regulations apply to APRNs and must be followed to practice within the scope of practice. The rules set guidelines and standards for professionals. APRNs must continue to meet the credited education required to keep their license up to date to ensure safety and competence in their chosen practice. 

Also Read:

REGULATION FOR NURSING PRACTICE STAFF DEVELOPMENT MEETING

EVIDENCE BASE IN DESIGN

THE ROLE OF THE RN/APRN IN POLICY-MAKING

ADVOCATING FOR THE NURSING ROLE IN PROGRAM DESIGN AND IMPLEMENTATION

THE ROLE OF THE RN/APRN IN POLICY EVALUATION

ASSESSING A HEALTHCARE PROGRAM/POLICY EVALUATION

GLOBAL HEALTHCARE COMPARISON MATRIX AND NARRATIVE STATEMENT

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. 

Carthon, J. M. B., Wiltse Nicely, K., Altares Sarik, D., & Fairman, J. (2016). Effective Strategies for Achieving Scope of Practice Reform in Pennsylvania. Policy, Politics & Nursing Practice, 17(2), 99–109. https://doi-org.ezp.waldenulibrary.org/10.1177/1527154416660700 

Levinson, L. (2018). Solving the Modern “Midwife Problem”: The Case for Non-Nurse Midwifery Legislation in Pennsylvania. Temple Law Review, 91(1), 139. 

Reynolds, A. M., Reynolds, C. J. & Craig-Rodriguez, A. (2021). APRNs’ controlled substance prescribing and readiness following Florida legislative changes. The Nurse Practitioner, 46 (6), 48-55. doi: 10.1097/01.NPR.0000751796.01625.17. 

Statutes & constitution: view statutes : Online sunshine. (2021, September 25). Retrieved September 25, 2021, from http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0400-0499%2F0467%2F0467.html. 

Sample Answer 2 for NURS 6050 Professional Nursing and State-Level Regulations

Mission of California Board of Registered Nurses to Protect the Public. 

The California Board of Registered Nursing (BRN) is responsible for ensuring that nurses in California meet the standards of practice and are competent to provide safe and effective care to patients. The mission of the California Boards of Nursing is to protect the people through the regulation of nursing practice. The BRN achieves its mission by setting standard for nursing, education, licensure, and practice. They investigate complaints made against nurses and take disciplinary action when necessary to protect the public from unsafe nursing practices. The boards work closely with schools, employers and other stakeholders to promote high-quality nursing care and to make sure the nurses are up to date with new policies and procedures license (California Board of Registered Nursing, n.d). 

California Key Regulations 

Key regulations can have significant impact on nursing practice in California. One example of a key regulation that has impact on nursing practice is the requirement for nurses to maintain a valid license. The board requires nurses to renew their licenses every two years and o complete continuing education requirements to ensure that they are up to date with the latest developments in the fields. Failure to maintain a valid license can result in disciplinary actions, including revocation of the license (California Board of Registered Nursing, 2021). Another key regulation that impacts nursing practice in California is the Nurse Practice Act (NPA). This act outlines the scope of practice for registered nurses and licensed vocational nurses in the state. It defines the legal and ethical responsibly for the nurses and sets standard for nursing education, licensure and practice (NCSBN, n.d). Nurses must adhere to the NPA to ensure that they are providing safe and effective care to patients. 

Key Regulations for Nursing Practice in California and Montana 

Two key regulations that are in important to focus on by BRN and Montana Board of Nursing (MBON) in this discussion are the scope of practice and prescriptive authority: 

-In California, the scope of practice for APRN’s they are authorized to diagnose and treat illnesses, order in interpret diagnosis test, and prescribe medications. However, APRN’S must worked under the supervision of a physician (California Board of Registered Nursing, 2021).   

-In Montana, the scope of practice for APRNs is defined by the MBON. APRNs in Montana are authorized to diagnose and treat illness, order and interpret diagnostic test and prescribe medications However, APRNs in Montana have full practice authority, which means that do not need to work under the supervision of a physician (Montana Board of Nursing,2021). 

-Another important APRN regulation to fucus is on prescriptive authority. In California, APRNs are authorized to prescribe medications, but they must have standardized procedure in place that outlines their prescriptive authority. The must also registers with the Drug Enforcement Administration (DEA) (California Board of Registered Nursing, 2021).   

– In Montana, APRNs also have prescriptions authority, but they must obtain a separate license from the MBON in order to prescribe medications. APRNs must also register with the DEA. This regulation is design to ensure that prescribing medications is safe and appropriate (Montana Board of Nursing,2021). 

References 

California Board of Registered Nursing . (nd). About us. Retrieved from https://www.rn.ca.gov/about_us/  

Links to an external site. 

California Board of Registered Nursing . (2021). Laws and regulations. Retrieved from https://www.rn.ca.gov/about_us/  

Links to an external site. 

California Board of Registered Nursing. (2021). Scope of practice for advance practice registered nurses. https://www.rn.ca.gov/scope-of-practice-for-advanced-praxctice-registaered -nurses/  

Links to an external site. 

Montana Board of Nursing. (2021). Advanced practice registered nurse (APRN) scope of practice. https://boards.bsd.dli.mt.gov/nur/aprn-scope-of-practice 

NCSBN. (n.d.). Find your nurse practice act.  https://www.ncsbn.org/policy-gov/npa  

Sample Response for NURS 6050 Professional Nursing and State-Level Regulations

Hi Megan, 

Great post and insight. In California, the NPs have been lobbying for autonomous practice, but they have encountered significant resistance from the physicians, according to a recent story I read. It was a legal dispute because the California Medical Association claimed that NPs had less training than doctors and that permitting NPs to practice independently could lower the quality of care and put patients at danger (Ibarra, 2022). 

According to the report, the NP law falls into two categories because it essentially established two new subcategories of nurse practitioners. Beginning in January, nurse practitioners who have worked a minimum of 4,600 hours or three full years in clinical practice in California are eligible to qualify for the first category (Ibarra, 2022).   They will be able to start working without contractually required medical supervision, but only at specific hospitals where at least one physician or surgeon already practices. The idea is that nurse practitioners would still have access to doctors for consultation as necessary (Ibarra, 2022). 

Nurse practitioners will have complete practice authority under this second classification, free from any setting constraints. In addition, nurse practitioners should have the option of starting their own medical office. As a result of the progressive implementation, qualified nurse practitioners will most likely achieve full independence by January 2026(Ibarra, 2022). 

References: 

Ibarra, A. B. (2022, November 16). Nurse practitioner requirements are changing, allowing them to practice without physician supervision. CalMatters. https://calmatters.org/health/2022/11/nurse-practitioner-requirements/ 

Sample Response for NURS 6050 Professional Nursing and State-Level Regulations

Hey Megan, 

This was a very thorough explanation and beautifully detailed. Every state has different APRN regulations which guides on how nurses are supposed to undertake their roles. It can be described as disappointing and at the same time somewhat fascinating considering that there still exist a lot of limitations that the NP practice in various states such as California has imposed (Vincent et al., 2019). California is a full practice state. “All nurses are permitted to evaluate patients, interpret diagnostic tests, and offer all manner of services including prescribing medications. Also, they can help with controlled services which are done under the exclusive licensure authority and the nursing board of the state. The national academy of medicine recommended this model. It was initially referred to us the Institute of Medicine and also the national council of state boards of nursing” (AANP, 2019).For example, nurses in California do their work with minimal or close to no supervision. However, in New Mexico nurses have to operate based on doctor’s recommendations. 

References 

California Board of Registered Nursing. (2021). Scope of practice for advance practice registered nurses. https://www.rn.ca.gov/scope-of-practice-for-advanced-praxctice-registaered -nurses/Links to an external site. 

Vincent, F. Y., Jewpanya, P., Lin, S. W., & Redi, A. P. (2019). Team orienteering problem with time windows and time-dependent scores. Computers & Industrial Engineering, 127, 213-224. 

Sample Answer 3 for NURS 6050 Professional Nursing and State-Level Regulations

All APRNs are regulated by the state of the Board of Nursing, meaning all APRNs have to withhold an active registered nurses’ license and pass a national state exam. The Board of Nursing exists in every 50 states and provides the licensure and regulations specific to each nurse practitioner’s scope of practice. APRN stands for Advanced practice registered nurses; this allows the acknowledgment that the registered nurses have completed their master’s and post-master certificates. APRNs are becoming an essential part of the U.S. healthcare system. APRNs can provide clinical services and preventive care for mental health patients.  

The B.O.N. are responsible for delivering specific requirements that APRNs must achieve to be certified, such as having additional educational requirements, needing extra continued academic hours, and requiring malpractice insurance, among many other credentialing requirements. APRN’s regulations can vary from state to state. During my initial obtaining of licensure for my RN, it was in NJ, and I later transferred to Pennsylvania.  

I’ve noticed some differences in the requirements for licensing as a registered nurse in the two states. While continuing and furthering my education, I need to know the scope of APRNs as my goal is to be a P.M.H.N.P.   

 Comparison of Pennsylvania and New Jersey Licensure for APRN 

Pennsylvania Requirements for APRNs are obtaining a master’s degree, 3hrs of continuing education, one examination, malpractice insurance, and having a collaborator. In Pennsylvania, all A.P.R.N.s must complete 3hrs of hours of Board-approved continuing education in child abuse recognition and reporting for initial licensure; The C.R.N.P. student shall receive sufficient clinical experience to provide depth and breadth in a given specialty or with designated populations geared to nurse practitioner practice. Clinical hours must meet at least national certification requirements with a minimum of 500 hours(Pennsylvania Department of State, n.d.). 

On the other hand, the New Jersey Board of Nursing requires outlines for stricter academic regulations, such as pharmacology, in which most of your academic hours should be dedicated to pharmacy. Completion of a graduate-level 3-credit course in Pharmacology from a school duly accredited by a national accrediting agency approved by the Board; or a pharmacology course of at least 45 hours integrated into the Masters in Nursing program (Njconsumeraffairs.gov, n.d). 

 Both states require a collaborating physician. New Jersey licensed prescribers of medications in New Jersey must use uniform prescription blanks (N.J.P.B.s) and obtain prescriptive authority with D.E.A. and C.D.S. (Njconsumeraffairs.gov, n.d). 

Pennsylvania practice states A CRNP may collaborate only with physicians with current licenses to practice in this Commonwealth. A CRNP with prescriptive authority approval may when acting in collaboration with a physician as outlined in a prescriptive authority collaborative agreement and within the C.R.N.P.  

A CRNP authorized to prescribe or dispense controlled substances shall register with the D.E.A; The C.R.N.P. shall notify the Board, in writing, whenever a prescriptive authority collaborative agreement is updated or terminated, and, when appropriate, shall file the “Change Of Prescriptive Authority Collaborative Agreement” form and the amended prescriptive authority collaborative agreement with the Board and pay the fee.   

References: 

Certified registered nurse practitioner licensure requirements snapshot. Pennsylvania Department of State. (n.d.). https://www.dos.pa.gov/ProfessionalLicensing/BoardsCommissions/Nursing/Pages/Certified-Registered-Nurse-Practitioner-Licensure-Requirements-Snapshot.aspx  

Njconsumeraffairs.gov. (n.d.). https://www.njconsumeraffairs.gov/nur/Pages/APN-Certification.aspx  

Sample Response for NURS 6050 Professional Nursing and State-Level Regulations

Grat post kiana, did you know that the American Association of Nurse Practitioners (AANP) has identified four core areas of Nurse Practitioner (NP) practice that are the same across all states: assessment and management of patient health, diagnosis and treatment of health problems and conditions, consultation with other healthcare providers, and education of patients and families regarding health promotion and disease prevention. However, the rules and specifications for Advanced Practice Registered Nurses may vary by state, and perhaps even by areas within a state (APRNs). There will be a comparison of two Florida APRN board of nursing regulations with at least one other state or region. 

In the state of Florida, APRNs must hold a current and valid license as a registered nurse, a master’s degree or higher in nursing or a related field, and a national certification that is specific to the APRN role and population focus. As a requirement for renewal, APRNs must have completed a minimum of 15 contact hours in pharmacotherapeutics during the previous 24 months. A signed collaborative agreement is also necessary for APRNs to practice in partnership with a doctor or another APRN. An agreed-upon plan of care and protocols must be in place before the APRN can start giving patient care, according to the collaboration agreement. 

In comparison, the state of California requires that APRNs hold a valid registered nurse license and a master’s degree or higher in nursing or a related field. California also requires APRNs to obtain a national certification that is specific to the APRN role and population focus. California does not, however, demand pharmacotherapeutics continuing education as a requirement for renewal. In California, APRNs must additionally get the Board of Registered Nursing’s approval before they can start providing patient care, in addition to the collaborative agreement that Florida mandates.   

References 

American Association of Nurse Practitioners (AANP). (2021). APRN Regulatory Model. Retrieved from https://www.aanp.org/advocacy/state-policy/aprn-regulatory-model 
California Board of Registered Nursing. (2021). Advanced Practice Registered Nurses. Retrieved from https://www.rn.ca.gov/regulations/aprn.shtml 
Florida Board of Nursing. (2021). Advanced Registered Nurse Practitioners. Retrieved from https://floridasnursing.gov/advanced-registered-nurse-practitioners/ 
New York State Education Department. (2021). Advanced Practice Registered Nurse. Retrieved from https://www.op.nysed.gov/prof/nurse/aprn.htm 
Texas Board of Nursing. (2021). Advanced Practice Registered Nurses. Retrieved from https://www.bon.texas.gov/aprn_practice.asp 

Sample Response for NURS 6050 Professional Nursing and State-Level Regulations

Kiana, 

    Thank you for your information about APRN practice in Pennsylvania and New Jersey. Unlike the states you reviewed, Arizona is a “full practice state” and does not require a collaborating Physician. Licensure requirements for Arizona include an RN license, a graduate degree in an APRN role, and certification from a national accrediting body. The continuing education requirements that the certifying agency requires meet obligations for the state statute. In Arizona, APRNs can refer patients to physical therapy, authorize DNR orders, sign death certificates, and order life-sustaining treatments (American Association of Nurse Practitioners, 2022). 

References 

American Association of Nurse Practitioners. (2022, October). State practice environment. Retrieved June 29, 2023, from https://www.aanp.org/advocacy/state/state-practice-environment  

Comparison of APRN Regulations in Maryland and California

It’s essential that NPs and policy makers have a clear understanding of how their state laws and regulations impact their practice (State Practice Environment, n.d.). 

Full Practice in Maryland: State practice and licensure laws permit all NPs to evaluate patients; diagnose, order and interpret diagnostic tests; and initiate and manage treatments, including prescribing medications and controlled substances, under the exclusive licensure authority of the state board of nursing. This is the model recommended by the National Academy of Medicine, formerly called the Institute of Medicine, and the National Council of State Boards of Nursing (State Practice Environment, n.d.). Maryland nursing leaders believe patients will benefit from new state legislation that allows nurse practitioners to work independently of physicians. The law also gives independent NPs the ability to open their own practices. Gov. Larry Hogan signed the Nurse Practitioner Full Practice Authority Act into law in May, making Maryland the 21st state to have passed such legislation. American Association of Nurse Practitioners President Ken Miller, PhD, RN, CFNP, FAAN, FAANP, called the passage of the Maryland law “very rewarding.” Fifty years of data prove “that NPs provide high-quality, cost-effective and safe care that can improve access and make healthcare delivery more efficient when NPs are authorized to practice at the top of their education and national certification,” said Miller, a Maryland resident. The measure allows nurse practitioners, who usually have two years of post-graduate education and advanced training, to prescribe certain drugs and diagnose and treat routine and complex medical conditions without physician oversight. Prior to the law, nurse practitioners were required to maintain attestation or collaborative agreements with physicians as a pre-condition of licensure and practice. The push to allow nurse practitioners to practice with full autonomy has gained momentum across the nation in recent years. Local and national advocates say nurse practitioners given their education and experience and the shortage of primary care providers can deliver the same quality of care as licensed physicians. Patients will have numerous choices to choose from for the healthcare services with all the NP who will be graduating and hired to provide care for them (Farmer, 2021). 

Restricted Practice in California: State practice and licensure laws restrict the ability of NPs to engage in at least one element of NP practice. State law requires career-long supervision, delegation or team management by another health provider in order for the NP to provide patient care (State Practice Environment, n.d.). California is 1 of 22 states, and the only western state that restricts NPs by requiring them to work with physician oversight. A large body of research has linked such restrictions to a lower supply of NPs, poorer access to care for state residents, lower use of primary care services, and greater rates of hospitalization and emergency department visits. Although dozens of studies demonstrate that the quality of NP care is comparable to the quality of physician care, and that there is no difference in care when there is no physician oversight, proponents of scope of practice restrictions continue to argue that oversight is necessary for quality care (California’s Nurse Practitioners: How Scope of Practice Laws Impact Care, 2020).

Even before the COVID-19 pandemic, many recognized that permitting nurse practitioners to practice to the fullest extent of their training and education was crucial to providing sufficient health care around the country. In recent years, there has been an influx of evidence that demonstrates the benefit of expanded NP scope of practice regarding access, quality, and the cost-effectiveness of care. Furthermore, many of the restrictions imposed on NPs limit their ability to access the market and compete with physicians and other health care providers, such as physician assistants, and may deprive patients of the benefits of competition among healthcare providers. At the beginning of the pandemic in March 2020, Governor Newsom signed an executive order giving the California Department of Consumer Affairs (DCA) the authority to loosen restrictions on scope of practice laws for NPs temporarily. However, unlike several other states that suspended their supervision requirements in the face of COVID-19, the DCA only issued a waiver that temporarily lifted the restrictions on how many NPs a physician could oversee at once. AB 890 now goes much further in providing two routes for NPs to practice independently and join other states in the country that permit independent practice after a transitional period. (Alex Montague, Health Policy Researcher, 2020).

Here are some scopes of Practice for NPs in Maryland: NPs in are authorized to sign medical orders for life-sustaining treatment forms. Before full practice authority can be granted, an NP must have a regulated collaborative relationship for 18 months with a physician or NP who has full practice authority. An NP may independently prescribe and dispense drugs, devices and Schedules II-V controlled substances. NPs are recognized in state policy as a primary care provider. A primary care provider is a nurse practitioner certified in any of the following areas of specialization: adult, pediatric, geriatric, OB/GYN, school nurse or family (Maryland Scope of Practice Policy – State Profile, n.d.). With the scopes of practices and regulations, an APRN can adhere based on the State where she got her license by following the guidelines mentioned above with the help of legislators as well since they are the ones making the laws. As a Maryland healthcare professional, I can start by creating a network where I will include the MD, legislators and other NPs and RNs so that we can elaborate a plan that can be suitable for all while making sure patients are receiving an equitable and affordable care. 

Reference

Alex Montague, Health Policy Researcher. (2020, December 15). Expanding Scope of Practice for Nurse Practitioners in California: AB 890 Compromises to Permit Independent Practice. The Source on HealthCare Price and Competition. https://sourceonhealthcare.org/expanding-scope-of-practice-for-nurse-practitioners-in-california-ab-890-compromises-to-permit-independent-practice/Links to an external site. 

California’s Nurse Practitioners: How Scope of Practice Laws Impact Care. (2020, December 22). California Health Care Foundation. https://www.chcf.org/publication/californias-nurse-practitioners/Links to an external site. 

Farmer, R. (2021, May 3). Maryland passes new law giving NPs practice autonomy from physicians. Nurse.com Blog. https://www.nurse.com/blog/maryland-adopts-new-legislation-giving-nps-autonomy-to-practice-independently-of-physicians/Links to an external site.

Maryland Scope of Practice Policy – State Profile. (n.d.). Scope of Practice Policy. https://scopeofpracticepolicy.org/states/md/Links to an external site. 

State Practice Environment. (n.d.). American Association of Nurse Practitioners. https://www.aanp.org/advocacy/state/state-practice-environmentLinks to an external site.

NURS 6050 Regulation for Nursing Practice Staff Development Meeting

Nursing regulations are the backbone of our profession, ensuring that we provide safe, effective, and ethical care to our patients. They set the standards for education, licensure, and ongoing professional development. Understanding these regulations is crucial for maintaining the integrity of our practice and safeguarding the well-being of those we serve.​

Regulating organizations known as boards of nursing are in charge of granting licenses and managing nurse supervision in a given area. Professional nurse associations, on the other hand, are groups that support nurses’ rights, offer learning materials, and aid in the advancement of nurses’ careers in general.​

Functions of a Board of Nursing​

• Issue and renew nursing licensure.​
• State nursing practice laws and regulations enforcement.​
• Checking complaints and disciplining as required.​
• Standards-setting for nursing education.​

Purpose of a Professional Nurse Association​

• Promoting nurse rights locally, state-wide, and nationally.​
• Offering educational and professional development opportunities.​
• Building nurse community through networking and collaboration.​
• Participating in healthcare policy initiatives.

California Board of Registered Nursing (BRN)

• These members include representatives from different nursing specialties, educators, and public members. Membership of this board is by appointment.​
• The Board’s policy-making body is composed of nine members, four members of the public and five registered nurses make up the board​
• Seven members are chosen by the governor.​
• A member is appointed by the Senate President.​
• A member is chosen by the Speaker of the Assembly.​

​ Members of the California Board of Registered Nursing

State Regulation Relating to Nurse Scope of Practice

California Nursing Practice Act (NPA): Section 2725 – Standards of Competent Performance.​

Regulation Overview​

• Section 2725 of the NPA establishes the standards of competent performance for registered nurses in California.​
• It outlines the expectations for nursing practice, emphasizing skills, knowledge, and judgment necessary for safe and effective patient care.​

Influence on the Nurse’s Role​

• The regulation sets a standard for the nurse’s professional conduct, competence, and ethical practice.​
• It guides nurses in providing patient-centered care, promoting evidence-based practice, and maintaining the highest standards of professionalism.​

​Influence on Healthcare Delivery, Cost, and Access

• Nurses following the standards set by the NPA contribute to patient safety and positive health outcomes.​
• By emphasizing competent and evidence-based practice, the NPA may indirectly contribute to cost-effective care by minimizing errors.​
• A workforce adhering to the NPA contributes to the overall trust in the healthcare system, potentially encouraging patient access to services.​

Impact on Cross-Cultural Nursing Care/Education​

•  To avoid unconscious prejudice, it is expected of nurses to be conscious of their own cultural identities.​

State Regulation Relating to Advanced Practice Registered Nurses (APRNs)

• One regulation for Advanced Practice Registered Nurses (APRNs) in California is related to the CARES Act of 2020​
• This act included Nurse Practitioners (NPs) and Clinical Nurse Specialists (CNSs) to the Medicare Benefit Policy Manual as “allowed practitioners.“​
• Certification and recertification of home health services by CNSs and NPs in California is subject to regulatory approval.​
• To be eligible for payment, the NP or CNS must be nationally certified and be in compliance with state law regarding their practice.

​Influence on the Nurse’s Role

• Expanded scope of practice for Nurse Practitioners (NPs) and Clinical Nurse Specialists (CNSs) to certify and recertify home health services​
• Increased responsibility for NPs and CNSs to establish a patient’s plan of care and certify the patient’s eligibility​
• Enhanced professional recognition of NPs and CNSs as “allowed practitioners” ​

Influence on Healthcare Delivery, Cost, and Access​

• Improved Healthcare Delivery as it eliminates the need for a supervising physician to sign orders, thereby reducing delays.​
• Reduced Healthcare Costs by streamlining the process and reducing the need for hospital visits.​
• Increased Access to Care Especially in rural or underserved areas, where there may be a shortage of physicians, this regulation can increase access to care

Conclusion

Understanding nursing regulations is vital for healthcare professionals to navigate the complex landscape of practice. As healthcare evolves, staying informed about the latest regulations, such as those outlined in the Nursing Practice Act, is crucial for providing safe, effective, and culturally competent care.

References

Advanced Practice Registered Nurses (APRN) Practice and the CARES Act of 2020 (n.d.)Frequently Asked Questions (FAQs) related to Advanced Practice Registered Nurses (APRN) Practice and the CARES Act of 2020 Retrieved on Jan 06, 2024 from chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.rn.ca.gov/pdfs/regulations/faqs_aprn.pdf​

American Nurses Association. (n.d.). Retrieved on Jan 07, 2024 from https://www.nursingworld.org/practice-policy/advocacy/state/aprn-state-law-and-regulation/​

Cms.gov. (n.d.) Home Health Manual Update to Incorporate Allowed Practitioners into Home Health Policy Retrieved on Jan 06, 2024 from chrome extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.cms.gov/files/document/r10438bp.pdf​