Respectful Substantive comments add to the discussion and provide your fellow students with information that will enhance the learning environment.

1..The peer postings should be at least one paragraph (approximately100 words).

2.Please be sure to validate your opinions and ideas with in text citations and references in APA 6th edition format.

Jason’s Perspective:

In the United States, APRN practice is regulated at the state level by legislation. The title of the article that I chose to review is “The Full Practice Authority Initiative:

Lessons Learned from Nevada.” The article is intended to be useful for the states that have yet to pass full practice authority legislation. According to Duncan and

Sheppard (2015), “Legislative restrictions in many states currently prevent NPs from practicing to the full extent of their education and training” (p. 611). The authors

identify eight of the primary barriers Nevada faced and overcame in hopes to assist other states in their attempts with this initiative. Duncan and Sheppard (2015)

note, “A total of 8 significant barriers to FPA legislation were identified: lack of a clear vision, lack of physician support, inability to address all stakeholders, lack of a

strong coalition with leadership and legislative experience, lack of vital resources, NP role recognition, community and regulatory organizations, and social media” (p.

612). The number one factor dividing various types of practice across state lines is physician oversight. Ward (2015) notes, “Full recognition of APRN practice offers

many potential advantages for patients and communities. The main advantage is increased access to health care. The expanded payment coverage of CNS services by

the Centers for Medicare & Medicaid Services created by the ACA increases access to health care by offering another provider option” (p. 210).

In the state of Georgia, APRN’s receive authorization from the Georgia Board of Nursing. The current requirements are 1.) current RN license in state of GA 2.)

masters of science degree (or higher) in nursing 3.) advanced pharmacology must be included in the curriculum or completed as a separate course 4). national

certification through an approved certifying agency (NursingLicensure.org, 2018). According to NursingLicensure.org(2018):

Application forms are available for download from the Board website (http://sos.ga.gov/index.php/licensing/plb/45/authorization_as_an_aprn). CNS and NP

applicants will note on the application the type of nurse practitioner or clinical nurse specialist practice that corresponds with their preparation. A certification

verification form is included in the application packet. The licensing agency asks that the certification agency submit verification via email to the address listed in

the packet. The transcript is to be included in the packet in a sealed envelope. Applicants who answer “yes” to questions about legal convictions or board

disciplinary actions will need to provide detailed letters of explanation as well as supporting documents. Noncitizens will include a copy of a document that

establishes qualified alien status. The application fee is $60. Application forms require notarization. Required materials should be sent together in a nine by

twelve envelope to the Board office in Macon. The licensing agency communicates primarily by email. Applicants can monitor status online (NursingLicensure.org,

2018, para. 6).

The requirements of the state of Georgia differ from other states primarily in the prescriptive authority. FNP’s in certain states like Nevada have no requirement for

physician involvement for nurse practitioner prescriptive authority (Duncan & Sheppard, 2015).

References

Duncan, C. G., & Sheppard, K. G. (2015). The full practice authority intitiative: lessons learned from Nevada. The Journal for Nurse

Practitioners, 11(6), 610-617. Retrieved from www.npjournal.org

NursingLicensure.org. (2018). https://www.nursinglicensure.org/

Ward, C. W. (2015). It’s time to recognize APRN practice nationally. Medsurg Nursing, 24(4), 210-211. Retrieved from

http://www.medsurgnursing.net/

April’s Perspective:

Article Summary

The article I chose to utilize for this assignment is entitled “30^th Annual APRN Legislative Update: Improving access to healthcare one state at a time.” The January 2018 article, published in The Nurse Practitioner journal, provides a great overview of Nurse Practitioner practice on both the national and state-by-state level. The body of the article summarizes national and state efforts, changes, and accomplishments affecting the APRN profession during the 2017 year. Prescriptive authority, practice authority, and reimbursement changes are highlighted for states that made progress in such areas. For example, NPs in both South Dakota and Illinois were granted full practice authority in 2017. Additionally, North Dakota adopted the APRN Compact for Licensure, becoming just the third state behind Wyoming and Idaho to do so. The APRN Compact would allow for NPs who hold a state license in one compact state to also practice in another compact state without obtaining a separate state license, much like the Nursing Licensure Compact which currently includes 26 states. The article also contains a map highlighting each state in a different color to designate practice authority laws. A table is also included that summaries the total number of APRNs per state. The end of the article contains an appendix of sorts, arranged alphabetically by state. For each state, the legal authority, reimbursement, and prescriptive authority regulations are listed (Phillips, 2018).

Personal View of Nurse Practitioner Scope of Practice

In regards to the information contained in the article, I feel it is a good summary of the recent actions impacting NP practice nationally. As a future NP, it is exciting to see the leaps and bounds that the NP profession is making, and I will look forward to reading the yearly updates each January in this journal. I also appreciate the state-by-state breakdown of NP practice, as it makes the task of finding information for each state relatively easy. I am actually surprised that the scope of practice for NPs varies so much from state to state and that there are not more states that allow full practice authority for NPs. The map adds a good visual of how states are grouped according to scope of practice; for example, the majority of full-practice authority states are in the northwest of the country. Additionally, the table showing the number of NPs per state is very interesting. For me, it really puts into perspective how small and scarcely populated my home state of Montana is when compared to larger states such as California and New York! While Montana only has 1,021 practicing NPs, both California and New York have over 23,000 NPs in practice (Phillips, 2018).

Scope of Practice for Montana and North Dakota

I live in eastern Montana, about 30 miles from the North Dakota border. The likelihood is that I will practice as an NP in either one of the states. I feel lucky that both of these states grant full-practice authority to NPs, meaning that NPs can independently evaluate and diagnose patients, order and interpret diagnostic test, initiate and mange treatment plans, and prescribe medications and controlled substances without physician oversight or collaboration (American Association of Nurse Practitioners, 2018). In both states, NPs are independently authorized to prescribe all medications, including Schedules II-V controlled substances, using their own DEA number. Additionally, NPs in Montana and North Dakota are permitted to receive and dispense drug samples. As stated above, North Dakota just entered the APRN Compact for Licensure (Phillips, 2018). Living on the border of Montana and North Dakota, this is something that may be beneficial for me in the future, as I may choose to practice in both states.

References

American Association of Nurse Practitioners. (2018). State Practice Environment. Retrieved from https://www.aanp.org/advocacy/state/state-practice-environment

Phillips, S. (2018). 30th Annual APRN Legislative Update: Improving access to healthcare one state at a time. The Nurse Practitioner, 43, 27-54. doi: 10.1097/01.NPR.0000527569.36428.ed