Professional Nursing and State-Level Regulations
Instructions
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.
For this assignment, I live in the state of Texas. The second state you should write about can be Maryland.
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/region 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.
Assignment details
Post a comparison of at least two APRN board 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.
Solution
Professional Nursing and State-Level Regulations
State Boards of Nursing (BONs) outline regulations that define specific licensure and practice requirements that nurses in a state/region must follow as they continue to perform their professional roles. By understanding variations in BON regulations for different states, nurses are able to gain information that might be highly useful in the future in case they choose to change states or regions (Cassiani et al., 2020). This discussion will compare two Advanced Practice Registered Nurses (APRNs) BON regulations in the state of Texas with that of Maryland state.
The state of Texas and Maryland have different APRN BON regulations in relation to both practice and prescriptive authorities. With respect to practice authority, in the state of Texas, physician involvement is not required for APRNs to diagnose and treat illnesses under T.A.C. § 221.13 (c). However, physicians must follow laid down protocols for quality assurance and review before delegating duties to an APRN.
On the contrary, in the state of Maryland, APRNs performing diagnosis and treatment require close physician supervision for the initial 18 months of practice under Ann. Code Maryland Section 8- 302(b)(5) (AMA, 2017a). As far as prescriptive authority is concerned, APRNs in both Texas and Maryland have the authority to prescribe schedule II-V controlled substances. However, in the state of Texas, APRNs must make an application with the Texas Department of Public Safety for controlled substances registration before prescribing these substances. The Maryland BON required APRNs to obtain a Maryland Drug Control Number before prescribing controlled substances (AMA, 2017b).
APRNs who have the legal authority to practice within the full scope of their education and experience in Texas and Maryland must adhere to these regulations as they apply to their respective states. For example, those in Texas can practice without close physician supervision while those in Maryland must be supervised for the first 18 months of practice. Additionally, APRNs practicing in both states must obtain relevant documentation before prescribing schedule II-V controlled substances (AMA, 2017a; AMA, 2017b). Failure to adhere to these regulations can result in the revocation of licensure.
References
American Medical Association (AMA). (2017a). State law chart: Nurse Practitioner Practice Authority. https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/specialty%20group/arc/ama-chart-np-practice-authority.pdf
American Medical Association (AMA) (2017b). State law chart: Nurse Practitioner Prescriptive Authority. https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/specialty%20group/arc/ama-chart-np-prescriptive-authority.pdf
Cassiani, S., Lecorps, K., Rojas Cañaveral, L. K., da Silva, F., & Fitzgerald, J. (2020). Regulation of nursing practice in the Region of the Americas. Revista Panamericana de Salud Publica = Pan American Journal of Public Health, 44, e93. https://doi.org/10.26633/RPSP.2020.93