PROFESSIONAL NURSING AND STATE-LEVEL REGULATIONS NURS 6050
APRNs treat and diagnose illnesses, advise the public on health issues, manage chronic disease, and engage in continuous education to remain ahead of any technological, methodological, or other developments in the field (American Nurses Association, 2023). I currently live in Illinois, where advanced nurse practitioners work independently but are required to sign a written collaboration agreement with the supervising physician. The agreement must describe the categories of care, treatment, or procedures that may be provided. They also need at least 250 hours of continuing education or training and at least 4,000 hours of clinical experience. Prescriptive authority must also be outlined in the collaborative agreement and may include drugs and Schedule III substances. Schedule II-controlled substances may still be prescribed if delegated by the supervising physician and if certain requirements outlined in the rules are met (Illinois Scope of Practice Policy—State Profile, n.d.).
In the United States, there are three types of practice regulations for APRNs, which include: Full: In full practice authority states, nurse practitioners can perform the full scope of practice without a supervising or collaborating physician. They can diagnose a patient, order tests, prescribe medication, and operate their own independent practices; one of the states is Maryland (Clarke, 2021). Reduce: In reduced practice states, nurse practitioners can perform some of their scope of practice without physician supervision. These restrictions typically involve operating their own practices or prescribing certain types of medications. They rarely involve the nurse practitioner’s ability to order tests or diagnose conditions, one of the states is Ohio State (Clarke, 2021).
Restricted Practice: In restricted practice states, nurse practitioners must work under the supervision of a physician for all their scope of practice. While they may have extensive autonomy in some nurse practitioner functions, they are not acting as independent practitioners. One of the states is Texas (Clarke, 2021).
APRNs may adhere to regulations by joining an organization such as American Nurse Association to known more of what it required in their state and have more education, knowledge, skills, and experience necessary to provide basic and comprehensive primary care services which contribute to health care setting (Bosse et al.)
For a person to be considered a professional, they must meet the minimum requirements of that profession and follow the regulations that govern the profession. Regulation of Advanced Practice Registered Nurses (APRN) varies from state to state. The scope of practice also differs from state to state. There are some differences in regulations between the state of Michigan and Maryland. The Public Health Code regulates APRNs in Michigan. They can independently prescribe non-scheduled medications but require a doctor to cosign for the prescription of schedule 2-5 medications (Michigan Board of Nursing, 2021). APRNs cannot sign a death certificate but can participate in ward rounds, perform house call visits without a collaborating doctor (Michigan Board of Nursing, 2021). The Nurse Practice Act governs APRNs in Maryland. They can sign a death certificate. They have to register with the Prescription Drug Monitoring Program to be allowed to prescribe schedule 2-5 drugs (Maryland Board of Nursing, 2021). In Michigan, certified nurse-midwives must partner with physicians to offer care to patients, while in Maryland, they are allowed to practice independently without entering into a physician collaboration.
APRNs have the skills, education, and clinical knowledge to offer specialized care to their patients. Complying with these regulations will allow them to identify and beware of their practice areas and the boundaries of their operations. The regulation stipulates the necessary certifications required for an individual to practice. An example is all APRNs must obtain certification from the Maryland Board of Nursing before being allowed to practice. Nurses can adhere to these regulations by finishing the mandatory course hours to become APRNs. They can also ensure that their license is updated, participate in continuous education programs to ensure they are up to date with new nursing knowledge
References
Maryland Board of Nursing. (2021). Pages – Advanced practice registered nursing. https://mbon.maryland.gov/Pages/advanced-practice-index.aspx
Michigan Board of Nursing. (2021). Michigan board of nursing. SOM – State of Michigan. https://www.michigan.gov/lara/0,4601,7-154-89334_72600_72603_27529_27542_91265-59003–,00.html