Discussion Response Paper

Discussion Response Paper

Hello Olufunmilayo,

Your discussion post was enlightening and allowed me to compare various perspectives with my state requirements. Most of the licensure requirements for advanced practice registered nurses in your state are similar to my state. Educational, monetary, experiential, and certification requirements are more or less similar. Your state and mine (Texas) are both members of the Nursing Licensure Compact (NLC). Your state joined the NLC more recently (National Council of State Boards of Nursing, 2021). Through this legislative move, I think nurses in both states can have multiple licenses (Bergman & Morley, 2022; Kappel, 2018). Your state still has reduced practice authority for nurses which I think will limit the scope of practice. While nurses are allowed to acquire prescription authority through the drug enforcement administration (DEA) and acquire DEA numbers, their perspective permission may still be limited by the reduced practice authority in your state.

One perspective that you overlocked was temporary licensures for nurses in your state. I looked up and found out that your state allows new graduating nurses to acquire temporary licensures through the state board of nursing (Pennsylvania Department of State, n.d.). I think this is a good step toward addressing the workforce shortage. In other states, nurses must submit all requirements before licensure and there is no room for a temporary permit to practice while awaiting approval and clearance of education credentials. There are various ways to advocate for the profession in your state, as well as in my state and other states. Through legislative approaches and the utilization of professional associations, our profession would be promoted to enhance its core goals of caring for humanity in all settings (Crawford & Yoost, 2022). Advocating for full practice authority will be key to improving practice scope.

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References

Bergman, E., & Morley, C. (2022). Public policy: Nurse licensure compact as a lesson in legislative action for the case management community. Professional Case Management, 27(1), 26–29. https://doi.org/10.1097/NCM.0000000000000542

Crawford, & Yoost. (2022). Fundamentals of nursing – Elsevier eBook on vitalsource (retail access card): Active learning for collaborative practice (3rd ed.). Elsevier Science Publishing. https://www.ncbi.nlm.nih.gov/books/NBK559012/

Kappel, D. M. (2018). The enhanced Nurse Licensure Compact (eNLC): Unlocking access to nursing care across the nation. NASN School Nurse, 33(3), 186–188. https://doi.org/10.1177/1942602X18765241

National Council of State Boards of Nursing. (2021, July 19). Pennsylvania enacts a nurse licensure compact (NLC). NCSBN. https://www.ncsbn.org/15998.htm

Pennsylvania Department of State. (n.d.). Nursing licenses apply online. Pennsylvania Department of State. Retrieved June 4, 2022, from https://www.dos.pa.gov/ProfessionalLicensing/BoardsCommissions/Nursing/Pages/Apply-Online.aspx

Respond to at least two of your colleagues on 2 different days in one or more of the ways listed below.

Share an insight from having viewed your colleagues’ posts.
Suggest additional actions or perspectives.
Share insights after comparing state processes, roles, and limitations.
Suggest a way to advocate for the profession.
Share resources with those who are in your state.
2 days agoolufunmilayo Bamiteko
Week 1 main discussion
COLLAPSE
Week 1 discussion: Nurse Practitioner Professional Issues

Olufunmilayo Bamiteko

PA NP Licensure and certification

 

Nurse Practitioner Licensure and certification in my state of Pennsylvania is not that different from those in other states of the United States. The nurse practitioners are registered nurses that embark on Master’s degree or Post master’s degree in Nursing. The basic requirements by law in 41 states of the United States is that Nurse practitioners should have master’s degree in Nursing (Buppert, 2021).

In order to be eligible for the nurse practitioner’s certification in Pennsylvania, the RN needs

to have completed an accredited, Board-approved master\’s or postmaster\’s nurse practitioner program or other Board-approved program that awarded an advanced degree or a course of study considered by the Board to be equivalent to that required for certification in PA state at the time the course was completed (www.dos.pa.gov,n.d).

This board approved program includes the specified hours of practicum courses and the didactic courses which equips the NP student with specific knowledge and competencies.

National certification is the certification by a Board-recognized national certification organization which required passing a nurse practitioner national certifying examination in a specialty.

In Pennsylvania state the nurse practitioner is known as the Certified Registered Nurse Practitioner (Buppert, 2021). For the licensure , the CRNP student shall receive sufficient clinical experience to become proficient in the specified specialty. Gearing towards nurse practitioner practice, the clinical hours must meet at least national certification requirements with a minimum of 500 hours. Certain specialties like FNP and PMHNP need additional hours because they care for multiple age groups and they practice in multiple care settings. This must be in place before applying for the certification (www.dos.pa.gov,n.d).

The applicant will identify the type of application needed (initial, endorsement, or reinstatement) and provide other pertinent information.

\”The applicant will need to arrange to have official transcripts sent directly to the licensing agency before approval is given to take the certification exam. A nurse who is seeking certification on the basis of a post-master program will need to submit both master\’s and post-master transcripts.\” (www.dos.pa.gov,n.d).

\”The licensing agency will also require primary source verification of national certification. A professional who has held advanced practice licensing in another state will need to verify license status( www.dos.pa.gov,n.d).

APRN Certification Application process in PA

The application Process In Pennsylvania for the APRN certification, involves the nurse practitioners having the option of applying online. The required documentation includes educational verification form and verification of successful completion of 3 hours of child abuse training(www.dos.pa.gov,n.d).

Future nurse practitioners in Pennsylvania need to complete an educational program at the masters or post-masters’ level.

The Board of nursing must accredit or approve the program. Proof of completing a Board-approved education program and official transcript should be sent to registrar of the State Board of Nursing

If you graduated from an out-of-state nursing program, you should request that the official transcript be sent directly from that program to the registrar of the State Board of Nursing. No student copies or student-submitted copies will be accepted. The transcripts must also designate the degree or certificate awarded, as well as the month, day and year the program was completed(www.dos.pa.gov,n.d).

Next, aspiring nurse practitioners need to obtain certification on the national level.

However, In PA , the national certification requirement applies only to those who were initially licensed after February 7, 2005.

In order to earn the national certification, after the RN receives the postgraduate education, he or she must apply to take the exam through through a Board-recognized national certification organization; American Academy of Nurse Practitioners (AANP), or American Nurses Credentialing Center (ANCC) depending on the specialty.

For initial State licensure, no experience is needed , however applicants must fulfil the following:

Completed 3 hours of Board-approved continuing education in child abuse recognition and reporting.

Proof of the CRNP’s current national certification in his or her area of specialty.

Personal check, cashier’s check or money order for $100 made payable to the “Commonwealth of Pennsylvania.” (www.dos.pa.gov,n.d).

Mail application, supporting documents and fee must be sent to Pennsylvania State Board of Nursing, P.O. Box 2649, CRNP Applications, Harrisburg, PA 17105-2649.

CRNPs need to pay an additional fee of $50 for the prescriptive authority.

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Prescriptive Authority (CRNP)

If you are applying for prescriptive authority, you must include the following with your completed application:

Evidence that you have completed the required 45 hours of course work in advanced pharmacology

Personal check, cashier’s check or money order for $50 made payable to the “Commonwealth of Pennsylvania.”

Each additional application for CRNP prescriptive authority is $30 and does not require verification of advanced pharmacology.

Mail application, supporting documents and fee to: Pennsylvania State Board of Nursing, P.O. Box 2649, CRNP Applications, Harrisburg, PA 17105-2649(www.dos.pa.gov,n.d).

 

Only CRNPs who have been granted prescriptive authority approval may prescribe

drugs. Prescriptive authority approval, like the CRNP certification, must be renewed biennially to be valid

All the above useful information can be obtained via the Pennsylvania state’s board of nursing website, which is https://www.dos.pa.gov

The scope of practice of a nurse practitioner in PA

The shortage of doctors in the early 1960s led to the emergence of advanced practice nurses and led to an improvement in their scope of practice (Buppert, 2021).

The term scope of practice is used to specify the extent of privileges permitted by state law for a given class of allied health provider based on specific criteria like education, training, experience, and special qualifications(Reich & Fisher,2014).

The Scope of practice of CRNP in PA , stipulates in sections 8.2 (a) and (b) that a CRNP needs to function within the scope of practice of the particular clinical specialty area in which the nurse is certified by the board (www.dos.pa.gov,n.d). The scope of practice of NP in Pennsylvania further specified that a certified registered nurse practitioner may perform acts of medical diagnosis or prescription of medical therapeutics or corrective measures in collaboration with a physician licensed to practice in and in accordance with regulations promulgated by the board(Buppert, 2021).

The onus is on the CRNP to decide if a specific duty or function is within their scope of practice. The

board is currently developing regulations related to CRNPs and their practice (www.dos.pa.gov,n.d). .

Pennsylvania state practice agreement

The collaborative agreement must address the availability of the physician to the NP through direct communication or telecommunication, a plan for emergency services, and the physician’s regular review of the charts and records of patients under the NP’s care. NPs are recognized as primary care providers in Pennsylvania (www.dos.pa.gov,n.d).

A written collaboration agreement between the physician and the Nurse practitioner is required, and the agreement must be signed by both the NP and the physician and agree to the details of their collaboration. Pa. Code §49.21.251 (www.pacnp.org, n.d).

How to obtain a DEA license

The authority to write for a controlled substance is granted at a federal level and is verified

through the Drug Enforcement Administration (DEA) by the appropriate state board. Drug Enforcement

Agency registration is granted at the federal level and has additional requirements/fees for the

registration process(www.dos.pa.gov,n.d).

 

Health care providers who prescribe controlled dangerous substances are licensed by the DEA. The DEA licenses NP as mid-level practitioners. The DEA will assign the NP a DEA number, if the NP has no felony on record, If the NP has a practice site and if state laws permit NPS to prescribe controlled substances(Buppert, 2021).

​

PA Prescription monitoring program (PMP) .

 

To help prevent prescription drug abuse and protect the health and safety of Pennsylvanian communities, Pennsylvania\’s Prescription Drug Monitoring Program (PDMP) collects information on all filled prescriptions for controlled substances(www.dos.pa.gov,n.d).

This information helps health care providers safely prescribe controlled substances and helps patients get the treatment they need www.dos.pa.gov,n.d).

 

 

How does PA state describe a nurse practitioner’s controlled-substance prescriptive

authority? and what nurse practitioner drug schedules are nurse practitioners authorized to

prescribe?

 

The type of prescriptive authority for NPs in Pennsylvania is physician collaborated, other types found in other states include Full scope-of-practice regulation which entails association with higher supply of nurse practitioners in rural and primary care health professional shortage counties(Mark & Patel , 2019). Others include restrictive and reduced.

CRNPs who hold prescriptive authority approval from the PA Board of nursing are currently limited to prescribing Schedule II controlled substances for up to a 72-hour dose and Schedule III and IV controlled substances for up to 30-days(www.dos.pa.gov,n.d).

Under the new regulations, there are new time limits. A CRNP with prescriptive authority approval who wishes to prescribe under the new time limits must file a Prescriptive Authority Change Form with the Board. (www.dos.pa.gov,n.d).

CRNPs may not use the new time limits until the Change Form has been submitted and the CRNP has received a letter back from the Board. The Prescriptive Authority Change Form is available on the Board’s website under “Applications.” (www.dos.pa.gov,n.d).

 

In order to fill a prescription, A prescribing CRNP should be prepared to provide a copy of his/her prescriptive authority collaborative agreement, prescriptive authority approval number, Pennsylvania CRNP certification number and specialty, DEA number and NPI number if applicable. (www.dos.pa.gov,n.d).

 

Types of regulations that exist and the barriers that may impact nurse practitioner

independent practice in PA state.

 

The nurse practitioners are regulated by PA state board of nursing and the following regulations

are followed

I.The nurse practitioners must have current unrestricted license after they complete their

nursing program

ii. Professional experience should be possessed by the nurse practitioners,

iii The nurse practitioners must also have passed their examination during their study period and

 

become certified in their area of specialty.

 

 

The barriers that may impact nurse practitioner independent practice in PA state.

 

1. Lack of access to health care

2. lack of understanding of the APRN role, and lack of

professional recognition

3. Poor technology and lack of machinery in the hospitals

4. Limitation in the scope of NP practice due to collaboration with physician

 

5. State licensure regulates NP practice and is a barrier to NPs practicing to the fullest extent of

their education and training( Peterson, 2017)

 

My surprise about this research is the variations in the scope-of-practice regulations across the

nation. The patients in the states that have independent practice nurse practitioners will have more access to health care and reduced visit to the ER.

 

 

References

Buppert, C. (2021). Nurse practitioner\’s business practice and legal guide (7th ed.). Jones & Bartlett

Learning.

 

https://www.dos.pa.gov/ProfessionalLicensing/BoardsCommissions/Nursing/Pages/Certified- Registered-Nurse-Practitioner-Licensure-Requirements-Snapshot.aspx

 

https://www.pacnp.org/page/ScopeofPractice

 

Mark, B. A., & Patel, E. (2019). Nurse Practitioner Scope of Practice: What Do We Know and Where Do

We Go? Western Journal of Nursing Research, 41(4), 483–487.

https://doi.org/10.1177/0193945918820338

 

 

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), 74–81.

 

Reich, D. L. & Fischer G.W(2014). Perioperative Transesophageal Echocardiography: A Companion to

Kaplan\’s Cardiac Anesthesia. Elsevier.