Nurse State Licensure Case Study

Credentialing from advanced practice registered nurses (APRNs) perspective is defined as “furnishing the documentation necessary to be authorized by a regulatory body or institution to engage in certain activities and use a certain title” (Hanson, 2014). Credentialing is also define from a local institutional process that consider specific documentations for APRN before they assume the practice role as APRN within their facility. In health care system, credentialing ensures individuals meet required standards of practice and is prepared to perform those duties implied by the credentials. National certification and education are considered as part of credentialing for APRN to acquire basic level of competence to practice. (Hanson, 2014)

Hi Swanthi, great post on the APN Consensus Model. In your post you mentioned many healthcare organizations had “criticized the inconsistencies in APRN practice and brought up concerns of patient safety issues due to these competency irregularities.” Although this model was developed in 2008, there are still many regulations and unclear terms that need to be clarify. I can see for nurses that are just beginning their APRN education will be able to eventually achieve the same licensure, accreditation, credentials, and education (LACE), but what about those are currently practicing now? If I was the APRN that had to take extra courses to be licensed in my state than I would feel a bit dissatisfied when another APRN from another state that required

A new NP graduate will need to apply for the initial certification as an advanced practice nurse prescriber by the state’s Board of Nursing. In Wisconsin, the N 8.03 statute lists the process which is continuous. The applicant submits a form and fee under the statute 440.05 and must provide evidence of passing a jurisprudence examination for advanced practice nurse prescribers (State of Wisconsin Board of Nursing, n.d.b.). Continuing education in pharmacology or therapeutics is mandatory, as well as a renewal fee.

According to reports found on the web page MEDPAGETODAY (2014) there has been an increase in the independent practice for advanced practice registered nurses (APRN). The article quotes data from the American Association of Nurse Practitioners (AANP) which reports 17 states and the District of Columbia allowing “full practice” with this meaning the APRN evaluates, diagnoses, orders testing, prescribes medication and initiates and manages treatments. 21 states require “collaborative agreement” with a physician and 12 requiring supervision of a physician. Collaborative agreement scope of practice varies by state and institution of employment.

As resistant as some states’ legislative and regulatory bodies are to grant APNs autonomy of practice, the damage being done by over-regulation is clear (Safriet, 1992). Physicians are forced into a position to either supervise the APN’s practice or be constantly consulted for approval of their practice decisions. Safriet (1992) described that in and of itself, this constant supervision may appear to patients that the APN is not competent to provide adequate or care equivalent to that of a physician. If the role of the APN is to bridge gaps in health care by relieving the medical establishment of some of the patient load by performing the same function as a physician in a primary care setting, it seems wholly unnecessary to restrain their scope of practice in those areas. This type of restrictions affect cost and patient care accessibility (Safriet, 1992). This was a problem stated in the article, however 25 years later, populations of patients remain unseen or cared for and APNs continue to be underutilized (Safriet, 1992). Rigolosi and Salmond (2014) cite the American Association of Nurse Practitioners (AANP) when they state that not utilizing nurse practitioners due to practice restrictions costs $9 billion annually in the US (p. 649).

Yes, Tennessee is a Nurse Licensure compact state since July,1,2003 ("Tennessee State Board of Nursing | NCSBN," n.d.). The implications are, a nurse who resides in the state of Tennessee and holds an unencumbered Tennessee multistate nursing license can have the ‘multistate privilege to practice’ in any of the other compact states unless the privilege has been disciplined or otherwise restricted. The Nurse Licensure Compact allows the nurses to practice in multistate without obtaining an additional license. However, “It is important for the nurses to understand that the Nurse Licensure Compact requires the nurse to adhere to the practice laws and rules of the state in which the client(s) receives care” ("Board of Nursing - TN.Gov-State of

I believe the Future of Nursing report can impact the APRN role in many different ways. One major way I feel the report can directly impact the APRN role is the recommendation to remove the scope-of-practice barriers. The recommendation includes, "States with unduly restrictive regulations should be urged to amend them to allow advanced practice registered nurses to provide care to patients in all circumstances in which they are qualified to do so"(Institute of Medicine, 2010, p. S-9). I currently reside in Missouri and I intend to continue practicing in Missouri even after I become an APRN. Unfortunately, Missouri is one of the most restricted states in regards to the scope of practice for APRNs. According to the Kaiser Family Foundation

Nursing is a field where there are high levels of autonomy due to the nature of the job. However, this autonomy also increases the risk of harm to the general public if practiced by an unqualified nurse. In order to minimize that harm, it is important for nurses to undergo licensure and certification. Licensure is the legal authority granted by the state to practice within the scope of nursing whereas certifications are issued by non-governmental organizations which acknowledge that a nurse is qualified and competent in a specific field.

As our healthcare continue to evolve, Advanced Nurse Practitioners' role is a crucial key component in the way health care is delivered in multiple settings, particularly in the primary care to improve patient's health outcomes. Nevertheless, the existing barriers limit nurse practitioners to practice to full capacity or extent of their training and education. One of the main obstacles faced by the advanced practitioners are the laws that govern the profession. Presently, NP practice rules and regulations vary from state to state(Hain and Fleck, 2014).

Reflecting over the last eight weeks has really opened my eyes to how much I have learned. Until this class, I thought that each state required the same things to become an Advanced Practice Nurse (APN). I just assumed each state had a board, like the Mississippi board of Nursing. It was really interesting that each state requires different things. I also was not aware that some states allow independent nursing without a collaborator. The state of Mississippi requires that the APN be in collaboration with a physician. I never really thought that this would ever be an option for the state of Mississippi. With that being said, I can understand why physicians would feel threatened with job security. I reside in a rural

This legislation was introduced in hopes of reconsidering the law by allowing independent practice of the advanced practice registered nurse (APRN) in the state of Pennsylvania. Pennsylvania law currently states that an APRN must work under the direct supervision of a physician (Fairman, Rowe, Hassmiller, & Shalala,

Advanced practice nurses (APRNs) are increasingly playing a crucial role in the healthcare delivery system as they positively impact the accessibility of primary and specialty care in both rural and urban Minnesota. Fortunately for advanced practice nurses, Minnesota continues to answer the call of the Institute of Medicine (IOM) for states’ adaptation of laws and policies that would promote advanced practice nurse practicing at their fullest degree of their education and training ( IOM, 2010). The scope of practice for APRNs in Minnesota and its governance will be discussed in this paper

Thank you for your informative post regarding the Advanced Practice Registered Nurses (APRNs) barriers in utilizing their full potential to practice their education and training. According to Kunic and Jackson (2013), the Institute of Medicine report titled “The Future of Nursing: Leading Change, Advancing Health,” also identified other political and regulatory barriers which include: (a) the resistance of organized medicine to support expanded APRN scope of practice, (b) the resistance of state legislators to introduce bills that expand scope of practice for APRNs, (c) restrictive credentialing and privileging practice within health care institutions, (d) a lack of public awareness and recognition of the education, training, and clinical

In respond to the letter from the Ohio Board of Nursing received on 9/26/2016 requesting for documentation for nursing employment in the state of Ohio prior to nursing license application, I am pleased to inform you that, I have never worked as a nurse in the state of Ohio prior to applying for my nursing license with the state of Ohio or currently. If I marked yes on my licensure application, I apologize as this may have been done in error and not deliberately.

I really learnt a lot in this course. I believe completing this course equipped me with the knowledge and gave me a clearer understanding of policies and politics for advanced practice nurses and other health care providers. The area that I would really like to keep up with regards the barriers to practice for APNs. APNs in many states are facing legislative battles due to barriers to independent practice. According to the American Association of Nurse Practitioners (AANP), only 20 states including DC have a full practice, while 19 states have reduced practice and 12 states have restricted practice (AANP, 2016). The Institute of Medicine has proposed policy change to remove barriers to practice for APRNs that Congress and State legislatures