Underserved Populations Without Decreasing

reply to this discussion with two references 

Professional Nursing and State-Level Regulations

Boards of nursing are equipped to regulate nursing in each state in the United States. It is however important to note that the regulations vary from one state to another. Over the years, there have been reforms in different states with the view of lifting restrictions to practice. It should be noted that expanded state NP practice regulations have come to be associated with greater NP supply and improved access to care among rural and underserved populations without decreasing care quality (Yang et al., 2021). Indeed, there is enough evidence supporting the lifting of restrictive practice. Thus, it is important that APRNs should be aware and understand existing regulations for the specific states where they practice in order to not only practice within their scope but to also identify opportunities for advocating for independent practice. This discussion will compare regulations as they apply to APRNs in the state of Maryland and Georgia.

Maryland Versus Georgia

In the state of Maryland, it is important to note that the board of nursing licenses qualified APRNs to full scope of practice. The regulations therefore allow a licensed and certified APRN to practice without supervision from a physician by carrying out duties such as evaluating the patient, diagnosing and treating the patient (American Association of Nurse Practitioners, 2021). On the other hand, the board of nursing of Georgia State allows restricted scope of practice for APRNs who are licensed and certified to practice within the state. This means that the licensure laws and regulations provided by the board of nursing restrict the APRN’s ability to be involved in at least one nursing practice’s element. The law requires supervision, delegation or management of team by another healthcare provider for the nurse practitioner to provide care for the patient (American Association of Nurse Practitioners, 2021). In both states, the APRN is required to register with the prescription drug monitoring program (PDMP) in order to prescribe opiates. However, in the state of Georgia, the regulations allow the APRN to only practice under a physician’s prescriptive authority (Georgia Department of Public Health, 2018). This regulation also applies for prescription of controlled substances. In the State of Maryland, the APRN has to get a DEA number and after that, they can independently prescribe schedule II to V of controlled substances. In the State of Georgia, the APRN can only be involved in prescribing schedule III to V control substance under the prescriptive authority of a physician (American Medical Association, 2017).

APRNs with Full Practice Authority

These regulations apply to advanced practice registered nurses with legal authority to practice within the full scope of their experience and education. For example, the prescriptive authority of APRNs in Maryland allows them to prescribe medications, including schedule II to V controlled substances independently or without supervision of physicians. This is however not the case for the APRNs in Georgia. In cases where there is need for supervision, the required agreements should be signed and NPs in Georgia will have to practice only within the scope that is allowed by the law. Notably, full scope of practice for NPs has come to be associated with improved access to care (Kandrack et al., 2021). It is unfortunate that nurses that are able to provide safe and quality care just like physicians do are restricted from doing so by state laws. Access to quality care has always been negatively impacted when NPs that are willing to deliver cost-effective, safe and quality care become restricted and this calls for an update in health policies in such states (Peterson, 2017).

Adherence to the Regulations

The APRNs have the responsibility and role to make sure that they are conversant with the regulations as per the specific state they work in. In order to adhere to the set regulations, it is very important for the APRN to be familiar with the state’s regulating board and ensure that the Nurse Practice Act for that particular state is read and understood. Notably, the APRN should be aware of the process and regulations put in place concerning licensing and authorizing them to practice. In conclusion, it is very important for every nurse practitioner to be well equipped and knowledgeable about the regulations of the state’s board of nursing and the scope of practice of that particular state and what it means. It is clear that each state is unique and different.

References

American Association of Nurse Practitioners. (2021). State practice environment. https://www.aanp.org/advocacy/state/state-practice-environment

American Medical Association. (2017). State law chart: Nurse practitioner prescriptive authority. AMA. https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/specialty%20group/arc/ama-chart-np-prescriptive-authority.pdf

Georgia Department of Public Health. (2018). Prescription Drug Monitoring Program. DPH. https://dph.georgia.gov/pdmp

Kandrack, R., Barnes, H., & Martsolf, G. R. (2021). Nurse practitioner scope of practice regulations and nurse practitioner supply. Medical Care Research and Review, 78(3), 208-217.

Peterson, M. E. (2017). Barriers to practice and the impact on health care: A nurse practitioner focus. Journal of the Advanced Practitioner in Oncology, 8(1), 74.

Yang, B. K., Johantgen, M. E., Trinkoff, A. M., Idzik, S. R., Wince, J., & Tomlinson, C. (2021). State nurse practitioner practice regulations and US health care delivery outcomes: A systematic review. Medical Care Research and Review, 78(3), 183-196.