APRN Practice in California
Advanced Practice Registered Nurses (APRNs) work under a restricted practice bracket in California. This means that APRNs must work under the direction of a physician for some functions, like prescribing, ordering tests, or some modes of practicing (American Nurses Association, 2024). Unfortunately, these requirements decrease the autonomy of APRNs, and they have to practice under medical direction, which consequently makes California less favorable compared to full-practice states.
California has, nevertheless, moved in the right direction to increase APRN practice capabilities. The passage of Assembly Bill (AB) 890 in 2020 represents a significant legislative shift. Unlike other states, this law allows nurse practitioners (NPs) to work independently, without collaborating with a physician, after going through a transition period under certain circumstances (California Board of Registered Nursing, 2022). AB 890 was enacted in January 2021 and is fully adequate in achieving the ability of NPs to practice independently in primary care. However, there are still restrictions to full practice authority (FPA), as there are restrictions for APRNs in some healthcare organizations. The move to full practice independence has been opposed, especially by physicians, who suggest that independent practice of nurse practitioners may compromise safety.
Notably, the COVID-19 outbreak somewhat relaxed some of these measures, for instance, allowing APRNs to practice independently to fill the demand of healthcare workers during the pandemic (Sampedro et al., 2020). However, all these changed slightly, and many restrictions have again been implemented.
Subsequently, the factors above are likely to continue excluding full practice authority in California, given that physicians’ organizations exert pressure to limit the nurse practitioner autonomy (Kleinpell et al., 2023). However, APRNs and their professional associations remain devoted to lobbying for FPA.
As an aspiring APRN, I plan to advocate through professional organizations such as the California Association for Nurse Practitioners (CANP) and actively participate in efforts to push for full practice authority and other legislative changes that benefit APRNs and patients alike.
References
American Nurses Association. (2024). Advanced practice registered nurses (APRN). ANA. https://www.nursingworld.org/practice-policy/workforce/what-is-nursing/aprn/
California Board of Registered Nursing. (2022). Assembly Bill 890. California Board of Registered Nursing. https://www.rn.ca.gov/practice/ab890.shtml
Kleinpell, R., Myers, C. R., & Schorn, M. N. (2023). Addressing barriers to APRN practice: Policy and regulatory implications during COVID-19. Journal of Nursing Regulation, 14(1), 13–20. https://doi.org/10.1016/s2155-8256(23)00064-9
Sampedro, A. D., Gonzalez, A., Delgado, V., Flowers, M., Maltseva, T., & Olenick, M. (2020). COVID-19 and advanced practice registered nurses (APRNs): Frontline update #1. The Journal for Nurse Practitioners, 16(8). https://doi.org/10.1016/j.nurpra.2020.06.014
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Week 1: Discussion Question – APRN Practice in Your State
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Discussion Prompt
In 275 words, give a synopsis of the current level of practice and practice climate for APRNs in your state of licensure (MY STATE IS CALIFORNIA). Incorporate what you have learned from the Buppert readings, and from investigating your state BRN website. If yours is a full practice state, discuss how your state adopted full practice authority (FPA). If your state is restricted, describe the restrictions to practice and the current political climate surrounding FPA (for example, is there any pending legislation to move to FPA? Are there any eased regulations or expedited licensure due to Covid-19?). Discuss major barriers to FPA in your state. Finally, discuss how you plan to be involved in your state’s governance and/or advocacy for APRNs. Include at least two references from an official state or government website or from the BRN for your state.
APRN Practice in California
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