Nurse Practitioner Professional Issues
According to Torrens et al. (2020), nurse practitioners are advanced practice registered nurses with more significant autonomy than registered nurses. The scope of practice for nurse practitioners differs among various states in the USA. This paper evaluates the certification, licensure, scope of practice limitations for practice, and the DEA registration process.
Nurse Practitioner Certification and Licensure Processes
Certification and licensure are required for nurse practitioners to legally discharge their duties. The educational requirements include becoming a registered nurse and pursuing a postgraduate degree (Nurse Practitioner, n.d.). To become a registered nurse, a person should complete a bachelor’s degree and have an associate degree or a diploma (Nurse Practitioner, n.d.). Additionally, the nurse should pass the National Council licensure exam to become a registered nurse. Registered nurses who want to become nurse practitioners must have a bachelor’s degree (Nurse Practitioner, n.d.). These programs should be obtained from accredited institutions. A licensure exam is not required to become a nurse practitioner (Nurse Practitioner, n.d.).
According to Nurse Practitioner (n.d.), certification of nurse practitioners is done by national organizations in specific nursing practice specialty areas. This is done after the successful completion of nurse practitioner certification exams. States have various requirements and can use the results from the certification exams and other predetermined factors to license nurse practitioners (Nurse Practitioner, n.d.). Nurse practitioners should apply for licensure in the specific state where they want to practice. The licensure process by the state is accomplished by the state’s Board of Nursing specifically (Nurse Practitioner, n.d.).
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Scope of Practice for Psychiatric-Mental Health Nurse Practitioners
According to Smith et al. (2020), in Virginia, the psychiatric mental health nurse practitioner must have five years of full-time clinical experience to be certified as an independent practitioner. Furthermore, during these five years, the nurse practitioner must have worked in partnership with a physician (Smith et al., 2020). A psychiatric mental health nurse practitioner has the authority to prescribe specific controlled substances and devices when certain requirements are met. The specified controlled substances are Schedule II to VI controlled substances (Scope of Practice Policy, n.d.). Those who have not been certified as independent practitioners are allowed to prescribe after written or electronic authorization from a physician (Scope of Practice Policy, n.d.). Those who have been certified as independent practitioners can prescribe controlled substances and devices without the need for written or electronic authority from a physician (Scope of Practice Policy, n.d.). Psychiatric mental health nurse practitioners are not acknowledged as primary care providers in Virginia (Scope of Practice Policy, n.d.).
State-Specific Restrictions or Limitations for Practice
In Virginia, the regulations have established some limitations on the practice of psychiatric mental health nurse practitioners. They are not recognized as primary care providers (Scope of Practice Policy, n.d.). This implies that a specific patient population cannot be allocated to them. They are required to collaborate with interdisciplinary team members in the management of patients (Scope of Practice Policy, n.d.). This is also applicable to certified independent psychiatric mental health nurse practitioners. They are expected to collaborate with other members of the interdisciplinary team and formulate plans for referrals to physicians (Scope of Practice Policy, n.d.).
Restrictions to prescription exist. Psychiatric mental health nurse practitioners are permitted to prescribe certain controlled substances. The permitted schedules are II to VI (Smith et al., 2020). Additionally, those who are not certified as independent practitioners must obtain written or electronic authorization from team care physicians before for the prescription to be legal (Scope of Practice Policy, n.d.). This evidence must be submitted to the Boards of Medicine and Nursing upon request.
Nurse Practitioner Prescriptive Authority and DEA Registration Processes
Nurse practitioners have prescriptive authority over specific controlled substances and devices. Nurses with independent prescriptive authority are not required to get a prescriptive authority license. However, they are required to comply with the laws that regulate the practice of other prescribers (Virginia Department of Health Professional, n.d.). To obtain the prescriptive authority, an application fee of $35 is required (Virginia Department of Health Professional, n.d.). For those nurse practitioners who are not eligible for prescriptive authority, they can still prescribe controlled substances and devices after obtaining written or electronic authorization from a care team physician (Smith et al., 2020). The written and electronic authorizations clearly state the nurse practitioner’s scope of prescription. Prescriptive authority is limited to schedule II to VI substances (Smith et al., 2020).
All nurse practitioners who prescribe and dispense controlled substances must register with the Drug Enforcement Authority. The online registration for new applicants is available on the website of the U.S Department of Justice (American Association of Nurse Practitioners, n.d.). Thereafter, the applicants can contact the headquarters of the Drug Enforcement Authority (DEA) to seek a physical copy of the order (AANP, n.d.). The forms are available within ten working days. Applicants are required to complete and submit Form 222a (AANP, n.d.). This form should be delivered about thirty days after the shipment of Form 222 (AANP, n.d.). The address of the DEA Registration unit is P.O Box 28083, Washington D.C. 20038-8083(AANP, n.d.).
What Surprised me from my Research
I was surprised to learn that nurse practitioners must have a full-time clinical experience of five years as licensed practitioners under the supervision of a physician to be certified as independent practitioners. Initially, I thought that licensure by the state sufficed to make psychiatric mental health nurse practitioners independent practitioners. Furthermore, the fact that the state of Virginia fails to recognize nurse practitioners as primary care providers surprised me. I have always considered nurse practitioners to be primary care providers who can fulfill the needs of a specific patient population.
References
American Association of Nurse Practitioners. (n.d.). How to Get Information About Obtaining a DEA Number. https://www.aanp.org/practice/practice-management/business-resources-for-nurse-practitioners/how-to-order-a-dea-number
Nurse Practitioner. (n.d.). Nurse Practitioner License Requirements: Change is in the Air. https://www.nursinglicensure.org/articles/nurse-practitioner-license/
Scope of Practice Policy. (n.d.). Virginia Scope of Practice Policy-State Profile. https://scopeofpracticepolicy.org/states/va/
Smith, S., Buchanan, H., & Cloutier, R. (2020). Virginia NP scope of practice: A legislative case study. The Nurse Practitioner, 45(2), 33–37. https://doi.org/10.1097/01.NPR.0000651120.61281.12
Torrens, C., Campbell, P., Hoskins, G., Strachan, H., Wells, M., Cunningham, M., Bottone, H., Polson, R., & Maxwell, M. (2020). Barriers and facilitators to the implementation of the advanced nurse practitioner role in primary care settings: A scoping review. International Journal of Nursing Studies, 104, 103443. https://doi.org/10.1016/j.ijnurstu.2019.103443
Virginia Department of Health Professional. (n.d.). Licensed Nurse Practitioners – Elimination of Prescriptive (Rx) Authority License. https://www.dhp.virginia.gov/Boards/Nursing/AbouttheBoard/News/Announcements/Content-309536-en.html
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Question 
My State is Virginia
This week, you will be reviewing certification, licensure, prescriptive authority, and scope of practice requirements specific to your state. The learning objectives for this are:
Nurse Practitioner Professional Issues
Summarize nurse practitioner certification and licensure processes
Explain the state-specific scope of practice for psychiatric-mental health nurse practitioners
Explain state-specific restrictions or limitations for practice
Explain nurse practitioner prescriptive authority and DEA registration processes
You have several resources that you are required to read this week.
Post a summary of your findings on your state based on the questions listed above. Explain the types of regulations that exist and the barriers that may impact nurse practitioner independent practice in your state. Be specific. Also, describe what surprised you from your research.
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