Professional Nursing and State-Level Regulations

Professional Nursing and State-Level Regulations

APRN State Regulations

The scope of practice for advanced nurse practitioners varies from one state to another in the United States. The professional bodies for advanced nurse practitioners, therefore, have regulations defining the scope of their practice. The general scope of practice for nurse practitioners includes the prescription of medications, formulation of diagnosis, ordering investigations, and interpreting test results (Phoenix & Chapman, 2020). However, some states emphasize that nurse practitioners work under the supervision of a physician, while others allow the nurse practitioner to make decisions independently.

The two regulations selected for this post include the authority to diagnose, prescribe, and order medication and the drug enforcement administration requirements. In Minnesota, nurse practitioners are authorized to make diagnoses, prescribe medications, procure and sign for over-the-counter medications, and initiate therapy. For drug enforcement requirements, nurse practitioners in Minnesota must comply with the federal Drug Enforcement Administration requirements for controlled substances (Attorney Drafting Areas, n.d.). However, in California, nurse practitioners are not authorized to prescribe medications, order medications, initiate new therapies, or sign for over-the-counter medications without the supervision of physicians (Board of Registered Nursing, n.d.). This rule also applies to controlled substances, as the nurse practitioners have no authority to administer controlled substances without the authority of the physicians. For instance, while a nurse practitioner in Minnesota may handle a patient independently without a physician’s supervision, a nurse practitioner in California is restricted and cannot fully practice within their scope and must, therefore, always work under the supervision of the physicians. Secondly, nurse practitioners in Minnesota can administer restricted substances such as opioids, given they adhere to the DEA rules, while nurse practitioners in California cannot administer the restricted substances.

Essentially, there are three levels of practice authority: restricted, reduced, and full practice authority. In my state, Minnesota, authorized Nurse Practitioners are granted full practice authority. This means they are allowed to perform fully within their scope without a physician’s supervision. Therefore, in Minnesota, registered nurses are able to order tests, interpret results, order drugs, prescribe prescriptions, and even make diagnoses (Nurse Journal Staff, 2023). On the other hand, a state like California has a restricted practice authority. Therefore, registered nurses in California must work under the physicians’ supervision regardless of their scope of practice, as they are not allowed to perform independently.

References

Attorney Drafting Areas. (n.d.). Sec. 148.235 MN statutes. Revisor.mn.gov. Retrieved September 21, 2023, from https://www.revisor.mn.gov/statutes/2022/cite/148.235

Board of Registered Nursing. (n.d.). Nurse practitioners: Laws & regulations. Rn.ca.gov. Retrieved September 21, 2023, from https://www.rn.ca.gov/pdfs/regulations/bp2834-r.pdf

NurseJournal Staff. (2023, July 21). Nurse practitioner practice authority: A state-by-state guide | NurseJournal.org. NurseJournal. https://nursejournal.org/nurse-practitioner/np-practice-authority-by-state/

Phoenix, B. J., & Chapman, S. A. (2020). Effect of state regulatory environments on advanced psychiatric nursing practice. Archives of Psychiatric Nursing, 34(5), 370-376. https://doi.org/10.1016/j.apnu.2020.07.001

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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.

Post a comparison of at least two APRN boards 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 the 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.