Discuss week 5

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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.

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.

APA format and at least 3 references

Then respond to two peers in apa format and 2 references

According to the National Council of State Boards of Nursing, (NCSBN), Advanced Practice Registered Nurses, APRN, are registered nurses with a masters or post master’s degree and special credentials and play a vital role in the healthcare system in the United States. (n.d.). APRN’s are able to assess and diagnose patients, as well as order tests and prescribe medication when needed. (n.d.). Unfortunately, there are state regulations that prevent full practice authority (FPA) for them which creates issues such as preventing cost-effective, efficient care for the lower socioeconomic population. (Bosse, et.al., 2017). 

It is estimated by experts that there will be a shortage of primary care providers by 2025 due to the regulations preventing Nurse Practitioners full practice authority. (Neff, et. al. 2018).  Full practice authority limitations and regulations limit an APRN’s ability to fully practice within their scope. American Association of Nurse Practitioners explained that FPA will mean that NP’s do not have to partner with physicians and practice under their own umbrella under (2020). California is a restricted state, meaning NP’s in CA have to practice under a physicians umbrella. Arizona, is a state where NP’s have full practice and do not have restrictions like in California. NP’s in AZ are able to have their own practice independently, while in CA, NP’s aren’t able to open their private practice just yet. (AANP, 2022). Another difference between NP’s in CA and AZ are the national certifications. While CA requires NP’s to have an RN license and a graduate degree, AZ requires it’s NP’s to have an RN license, a graduate degree and a national certification in order to obtain a state license. (AANP, 2022). In order for NP’s in CA to gain FPA, a bill has to be introduced and passed into legislature; fortunately for CA practitioners, a bill of that nature is already in motion and signed. Governor Gavin Newsom passed a bill into legislature allowing NP’s full practice authority. (Brusie, 2020). The bill goes into effect January 2023, but until then, CA will remain an restricted state.

Peer 2

Since every state has its regulatory bodies for Advanced Practice Registered Nurse (APRN), knowing the rules and regulations of their state regulatory bodies is imperative. Regulation is essential in healthcare to supervise the healthcare professionals to standardize patient care and public safety (Milstead & Short, 2019). The regulatory bodies in the state I live in, Virginia, are the Board of Nursing (BON) and the Board of Medicine. On the other hand, the Maryland Nurse Practitioners regulatory body is the only regulatory body. Nurse Practitioners (NPs) in the Commonwealth of Virginia cannot practice without a joint license from BON and the Board of Medicine (Virginia’s Legislative Information System, 2022). Those regulatory bodies play pivotal roles in protecting public safety. The two states I wanted to compare for this discussion are Virginia and Maryland.

The regulatory structure of the state where I live, Virginia, the APRN practice is restricted. According to the American Academy of Nurse practitioners (AANP n.d.), Virginia state practice and licensure laws limit NPs from practicing independently. They require physician supervision to provide patient care. For the NPs to qualify to practice autonomously until July 2022, they should have only two years of full-time clinical experience under a practice agreement with a physician, which is equivalent to 1,800 hours per year (Virginia Department of Health Professions Board of Nursing, 2022a). But then after, they need the equivalent of five years of full-time clinical experience. In addition, NPs may prescribe Schedule II-VI medications under physicians’ oversight (Virginia Department of Health Professions Board of Nursing, 2022b). If NPs meet the BON and Board of Medicine requirement criteria, they can prescribe medication by collaborating with a physician.

Maryland state practice and licensure laws allow NPs full autonomy to assess, diagnose, and manage complex medical conditions without physician supervision at any time. And they also have full prescriptive authority under the state of BON licensure (AANP, 2022). According to the National Conference of State Legislatures (NCLS, 2022), NPs can prescribe Schedule II-V controlled substance medications and are recognized in state policy as primary care providers.

According to Neff et al. (2018), to reduce the primary care shortage in rural and underserved areas, one solution is to expand the Nurse Practitioner workforce. The five years wait period in Virginia for NPs to practice independently won’t help the growing shortage of primary care providers, especially in rural parts. Understanding the states’ rules and regulation is essential for APRNs to practice within the allowed scope of practice. NPs are a solution for the American healthcare provider shortage. As a healthcare provider, being accountable and responsible to the state regulation helps improve healthcare access and protect legal matters. The full practice authority of APRNs in Virginia needs new legislation that NPs have the authority to practice independently at any time to improve healthcare access.


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