NURS 6050 Discussion: Professional Nursing and State-Level Regulations
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.
- 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..
By Day 3 of Week 5
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 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.
By Day 6 of Week 5
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.
*Note: Throughout this program, your fellow students are referred to as colleagues.
RE: Main Post – Week 5 Risa Weaver
Advanced Practice Registered Nurse Board of Nursing Regulations for Minnesota and Florida
Similarities and Differences
I compared two advanced practice registered nurse (APRN) boards of nursing regulations of Minnesota and Florida. I will begin by reviewing some similarities of the two states’ regulations and then delve right into the differences between the two states.
Florida and Minnesota both are regulated by their respective Boards of nursing (BON), and in addition, Florida is also regulated by the Board of Medicine American Association of Nurse Practitioners, [AANP], (2021). National Council of State Boards of Nursing, [NCSBN], (n.d.-b). indicates that Florida APRNs practice under a restricted license, under both the Board of Medicine (BOM) and Board of Nursing (BON). Both boards govern APRN practice and licensure in Florida, transferring the authority from the BON to the BOM Bosse et al. (2017). Likewise, in Minnesota, APRN’s practice under the most pliable scope of practice; a full, unrestricted practice regulatory structure AANP (2021).
APRN’s in Minnesota is one of the four specialists with master’s degrees including, “Clinical Nurse Specialist (CNS), Certified Registered Nurse Anesthetist (CRNA), Certified Nurse Midwife (CNM), and Certified Nurse Practitioner (CNP)” (Minnesota Board of Nursing, n.d.). The national certification exam appropriate to role and focus is required after education is completed. In addition, recognition and authority to practice are granted via licensure and registration National Council of State Boards of Nursing [NCSBN], (n.d.-a). Also, APRNs in Minnesota are authorized to prescribe schedule 2-5 medications and can diagnose NCSBN (n.d.-a). NSCBN (n.d.-a) further expresses continuing competence includes that the APRN must maintain national certification congruent with role and focus. Lastly, disciplinary records are in the same database that contains nurse registry data and held there indefinitely and available to the public NCSBN (n.d.-a).
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Like Minnesota, APRNs in Florida include “Certified Nurse Practitioner (CNP), Certified Nurse Midwife (CNM), Clinical Nurse Specialist (CNS), and Certified Registered Nurse Anesthetist (CRNA)” (NCSBN, n.d.-b). Like that of Minnesota, the National Certification exam is required after education is completed to obtain the Nurse Practitioner degree. Dissimilar to Minnesota, recognition, and authority to practice is granted via licensure only NCSBN (n.d.-b). Also, according to NCSBN (n.d.-b) unlike Minnesota regulation, APRNs in Florida can only prescribe with full authorization within protocol under a supervising physician and can diagnose. Again, different from Minnesota, continuing competence includes that the APRN complete continuing education (CE) credits documented with a vendor or CE broker each biennial renewal NCSBN (n.d.-b).
According to the APRN Consensus Model by State scoring grid (NCSBN, n.d.), Minnesota scored “28 points – 100%” and Florida “21-27 points – 75-96%”. The difference is Florida APRNs must have a “written collaborative agreement under independent practice” and prescribing whereas Minnesota does not need the written collaborative agreement for independent practice and prescribing as a regulation (NCSBN, n.d.-b).
Apply regulations to Full-Scope of Practice
APRN’s in Minnesota have legal authority with an independent full scope of practice and prescription authority post achievement of RN license, graduate degree, and becoming nationally certified as an APRN. What that entails for Minnesota, is different for Florida in areas related to state legislation that outlines the scope of practice among nurse practitioners within each respective state. The regulations I have selected include medication prescription rights of nurse practitioners and continuing competence of the APRN degree. The BON is the ultimate source for any nurse practitioner for a strong and reliable resource for reviewing the scope of practice. The BON has the Nurse Practice Act that contains the scope of practice of APRN’s Milstead & Short (2019). It is in the APRN’s best interest to understand their scope of practice thoroughly and soundly. By doing so, it allows the provider to provide competent care, for regulations are present to protect the public, not oneself.
APRN’s must engage voluntarily and actively in self-regulation of their degrees to maintain obeying the blueprint of rights of being a trusted APRN including adhering to regulations. With each state being governed by its BON and or other organizations, each state has regulations that are specific to them Milstead & Short (2019). Nurses must look within at their values and standards that frame their ethical blueprint combined with legal regulations. Together these values provide guiding staples to provide safe and competent care Milstead & Short (2019). For example, when obtaining a specialty, a nurse needs to follow the set standards of that organization and use them within her/his scope of practice and application. And if working in another state, or within her state, staying up-to-date on current regulations, for some part of health care is always active in court attempting to be reformed. Laureate Education (2018) describes the very fact the regulations merit tracking for these very regulations apply to our practice. Furthermore, tracking regulations will keep APRNs informed of current regulations that may have been removed, altered, or simply by establishing parameters of how the law will be implemented Laureate Education (2018).
American Association of Nurse Practitioners. (2021). State Practice Environment. Retrieved June 25, 2021, from aanp.org
American Nurses Association. (n.d.). ANA enterprise. Retrieved from http://www.nursingworld.org
Bosse, J., Simmonds, K., Hanson, C., Pulcini, J., Dunphy, L., Vnhook, P., & Poghosyan, L. (2017). Position statement: Full practice authority for advanced practice registered nurses is necessary to transform primary care. Nursing Outlook, 65(6), 761-765.
Laureate Education (Producer). (2018). The Regulatory Process [Video file]. Baltimore, MD: Author.
Minnesota Board of Nursing. (n.d.). Advanced Practice Registered Nurse (APRN) Licensed General Information. Retrieved June 21, 2021, from https://www.mn.gov
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.
National Council of State Boards of Nursing (NCSBN). (n.d.-a). United States-Minnesota. Retrieved June 22, 2021 from https://www.regulatoryatlas.com/jurisdiction-detail?Jurisdiction=Minnesota
National Council of State Boards of Nursing (NCSBN). (n.d.-b). United States-Florida. Retrieved June 22, 2021 from https://www.regulatoryatlas.com/jurisdiction-detail?Jurisdiction=Florida