Peer Response – Professional Nursing and State-Level Regulations

Peer Response – Professional Nursing and State-Level Regulations

Responding to Peer One

Hello,

Thank you for the input you provided. It’s interesting to compare Mississippi and Alaska’s APRN laws, especially when Minnesota’s regulations are taken into account. The regulatory framework for APRNs in Minnesota is similar to Alaska’s more permissive approach but differs from Mississippi’s tougher laws. Minnesota, like Alaska, enables nurse practitioners to work freely without the supervision of a physician. In Minnesota, nurse practitioners have the freedom to deliver a full range of treatments to their patients without the necessity for a collaborative agreement with a physician (Haney, 2023). This method is more in line with Alaska’s autonomous practice model, which allows nurse practitioners to make full use of their education and expertise.

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However, there are some differences between Minnesota’s and Alaska’s regulations. Minnesota, like Mississippi and Alaska, may have special requirements for nurse practitioners to have the ability to prescribe restricted medications. The number of hours required for advanced pharmacology and clinical drug therapy may vary between states, and Minnesota may have its own requirements for getting this authority. Minnesota’s regulations governing the authorization to prescribe restricted medications may include extra procedures such as obligatory pain management and addiction treatment training or certification in order to successfully combat the opioid epidemic (Crowley et al., 2023). These specialized standards demonstrate the state’s dedication to careful prescription and the prevention of substance misuse problems. As a result, Minnesota nurse practitioners must stay up to date on changing rules and educational requirements to ensure they meet the state’s unique standards for prescription-controlled medications safely and responsibly.

In summary, while Minnesota’s APRN laws are comparable to Alaska’s more independent practice model, there may be differences in terms of particular prescription authorization requirements and other areas of practice. Understanding these distinctions is critical for APRNs in Minnesota to ensure compliance with state rules while providing the best care possible to their patients.

References

Crowley, C., Palmer, C., & Rombocos, J. (2023). Designing and implementing a nursing curriculum on opioid use disorder. All Electronic Theses and Dissertations. https://spark.bethel.edu/etd/923/

Haney, B. (2023). 35th annual APRN legislative update. The Nurse Practitioner, 48(1), 20–47. https://doi.org/10.1097/01.npr.0000903012.03553.a4

Responding to Peer Two

Hello,

Thank you for your contribution. It’s worth contrasting the regulatory conditions for APRNs in Maryland and Texas with what’s going on in Minnesota. APRNs in Minnesota are permitted to practice autonomously without the need for physician supervision (Haney, 2023). This implies they can diagnose, treat, and prescribe medications without the direct supervision of a physician, which is consistent with Maryland’s autonomy. APRNs in Minnesota, unlike in Maryland, have prescriptive authority, allowing them to prescribe drugs within their area of practice. Because APRNs in Minnesota can provide a more extensive range of services, this distinction can significantly influence the level of care and convenience for patients.

Minnesota, like Texas, may have APRN certification requirements. Similar to Texas, Minnesota’s regulatory body may impose certain educational criteria and licensing procedures. The crucial distinction, however, is the delegation of prescriptive authority. APRNs in Texas can seek prescriptive authorization but must work under physician supervision, but APRNs in Minnesota have the option of autonomous prescription (Phillips, 2022). Furthermore, APRNs in Minnesota are allowed to diagnose, treat, and manage a wide range of health issues independently, in addition to independent prescriptions. This increased autonomy not only provides more freedom in healthcare delivery but also answers the state’s healthcare needs, particularly in rural areas where access to physicians may be limited. Furthermore, Minnesota’s commitment to promoting advanced practice nursing demonstrates the state’s appreciation for APRNs’ important role in enhancing overall healthcare outcomes and patient access to quality treatment.

In conclusion, while Maryland and Minnesota have equal levels of APRN autonomy, Minnesota stands out for affording APRNs prescriptive ability, providing an even higher level of patient care and convenience. This distinction illustrates the diverse regulatory landscape in each state, as well as the disparities in opportunities and duties for APRNs across the country.

References

Haney, B. (2023). 35th annual APRN legislative update. The Nurse Practitioner, 48(1), 20–47. https://doi.org/10.1097/01.npr.0000903012.03553.a4

Phillips, S. J. (2022). 34th annual APRN legislative update. The Nurse Practitioner, 47(1), 21–47. https://doi.org/10.1097/01.npr.0000802996.14636.1c

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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.

Post 1

Mississippi APRN Regulations Compared to Alaska APRN Regulations

An advanced practice registered nurse (APRN) is a registered nurse who has furthered one’s degree to become a nurse anaesthetist, nurse midwife, or nurse practitioner. Like a registered nurse, APRNs have to follow their state’s board of nursing regulations. These regulations differ from state to state, so advanced practising nurses must be knowledgeable about their personal state’s regulations. Below, I will compare Mississippi regulations to Alaska regulations and see how they are similar and how they differ.
Advanced practice registered nurses in Mississippi are required to practice under a licensed physician. The Mississippi Board of Nursing (BON) requires the licensed physician and APRN to formulate and submit a collaborative agreement. The agreement has many rules that require the physician to live within 75 miles of the APRN’s practising location, review 10% of the APRN’s charts monthly, and conduct a face-to-face meeting quarterly. The nurse practitioner is required to keep a log of all charts reviewed under their care. (Mississippi Board of Nursing, n.d.). Differently, Alaska allows nurse practitioners to practice independently with no physician supervision (Department of Commerce, Community, and Economic Development, 2023). The regulations set by the Mississippi BON are more restrictive for a nurse practitioner looking to practice under his or her full scope, while Alaska BON allows nurse practitioners to meet their full potential.
Both Mississippi and Alaska BON require nurse practitioners to fill out and submit an additional application with extra fees to gain the right to prescribe scheduled two through 5 drugs. (Mississippi Board of Nursing, n.d.) (Department of Commerce, Community, and Economic Development, 2023). The Alaska BON requires that nurse practitioners submit proof of 15 hours studying advanced pharmacology and clinical drug therapy.  Mississippi BON requires proof of 40 contact hours spent on advanced practice nursing in the past 2 years, with 5 of the hours being in prescribing controlled drugs (Advocacy Resource Center, 2017).
Advanced practice registered nurses in Mississippi can practice under a reduced scope of practice. Mississippi BON states that under state certification, nurse practitioners can practice their full scope of education, training, and certification (Mississippi Board of Nursing, n.d.), but they still require collaboration agreements. This is considered a reduced scope of practice since collaboration is required, but it does not restrict the nurse practitioner from practising everything she is qualified for (Hawaii Pacific University, 2023). APRNs in Alaska can fully practice their scope of practice. Since nurse practitioners in Alaska are not required to collaborate with a certified physician, their scope of practice is not reduced, as is the case with nurse practitioners in Mississippi (Hawaii Pacific University, 2023).
Adherence to the regulations of Mississippi by a nurse practitioner makes it more difficult and time-consuming to practice versus the regulations of Alaska. For example, a nurse practitioner in Mississippi has to take the time to document all the cases she reviewed in a spreadsheet or document so that a physician can review files. An Alaskan nurse practitioner practising independently does not have to set time aside to log. Prescription regulations are similar for both states, but Mississippi regulations require more contact hours for application. Both Alaskan and Mississippian nurse practitioners could complete the required hours on a platform like HealthStream that offers an unlimited amount of certified education units.

Post 2

Professional Nursing and State Regulations

In Maryland, the Maryland Board of Nursing (MBON) requires that nurses complete specific educational requirements and licensing to be allowed to work as APRNs in the state. Additionally, MBON does not give prescriptive authority to the APRNs even though they can practice independently (“Advanced Practice Registered Nursing”, 2021). On the other hand, the Texas Board of Nursing requires that nurses obtain certification from the body before practising as a nurse, and APRNs are allowed to apply for the ability to prescribe but have to work under the supervision of a physician (“Texas Board of Nursing – Advanced Practice Information,” 2021).

Whereas both state regulators of nursing practice require APRNs to receive the requisite certificates of practice, differences exist in the privileges that nurses enjoy from the regulation. In Maryland, for example, APRNs are certified to practice independently without the supervision of a physician (“Advanced Practice Registered Nursing,” 2021). Texas nurses, on the other hand, are licensed but not allowed to practice independently (“Texas Board of Nursing – Advanced Practice Information,” 2021). Additionally, the Maryland Board of Nursing does not allow APRNs to prescribe medications for their nurses, whereas Texas APRNs are allowed to apply for prescriptive authority.

APRNs are highly qualified professionals who have the requisite knowledge, skills, and education to provide special treatment to community members. Complying with the regulations helps these nurses identify their scope of practice and the applicable boundaries thereof (Salganicoff, 2018). Moreover, APRNs are required to possess the requisite years of professional experience and the necessary certifications before joining the school to advance their degrees (Salganicoff, 2018). For instance, both Texas and Maryland Boards of Nursing require that every RN should obtain a certificate from the respective board before registering to become an RN. An example of how nurses can adhere to the regulations is by accomplishing all the mandatory educational requirements to qualify as nurse specialists.