Professional Nursing and State-Level Regulations

Professional Nursing and State-Level Regulations

Regulations specific to professional nursing and state-level regulations interact to shape nursing practices and the scope of practice for the various nursing roles. State-level nursing practice regulations also have an impact on healthcare delivery outcomes in the U.S by regulating elements of nursing care such as the healthcare workforce, accessibility of nursing care, maintenance of the quality of care, improving utilization, and management of the costs of care (Yang et al., 2020). Each state and region in the U.S have Boards of Nursing (BONs), which regulate the nursing profession and nursing practices to ensure ethical quality and safe care. Each state’s BON in the U.S has established regulations for APRNs. The rules for an APRN’s scope of practice vary from state to state and may grant or restrict their practice authority.

I’m from Maple Grove, Minnesota. The Minnesota BON is responsible for licensing and regulating nursing practices throughout Minnesota. The BON regulations, therefore, govern the scope of practice for nurses, including APRNs. The two rules of focus are those related to APRNs’ scope of practice about practice and prescriptive authority regulations. The Minnesota BON grants APRNs full practice and prescriptive authority. This means APRNs can practice and prescribe medications without a physician’s supervision.

On the other hand, Wisconsin BON has restricted the scope of practice for APRNs. APRNs must practice under a general supervisory medical protocol that delegates clinical practices from physicians to APRNs. This means that APRNs in Wisconsin have reduced practice regardless of their advanced level of education in nursing practice. Most of the U.S, as per research, is increasingly relying on APRN roles in primary care (Barnes et al., 2018). Restrictive BON regulations act as a barrier to access to health care.

References

Barnes, H., Richards, M. R., McHugh, M. D., & Martsolf, G. (2018). Rural and nonrural primary care physician practices increasingly rely on nurse practitioners. Health Affairs, 37(6), 908–914. https://doi.org/10.1377/HLTHAFF.2017.1158/ASSET/IMAGES/LARGE/FIGUREEX4.JPEG

Yang, B. K., Johantgen, M. E., Trinkoff, A. M., Idzik, S. R., Wince, J., & Tomlinson, C. (2020). State Nurse Practitioner Practice Regulations and U.S. Health Care Delivery Outcomes: A Systematic Review. Https://Doi.Org/10.1177/1077558719901216, 78(3), 183–196. https://doi.org/10.1177/1077558719901216

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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 to protect 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.