APRN Regulations Discussion Essay

Respond to at least two of your colleagues* on two different days and explain how the regulatory environment and the regulations selected by your colleague differ from your state/region. Be specific and provide examples.

Response 2

APRN regulations in Florida & New York vs California & Alabama

Florida is a restricted practice state and New York is a full practice state (AANP, 2023). APRN Regulations Discussion Essay

In comparing both states, the state of New York nurse indicates practitioners practicing for more than 3,600 hours are exempt from requirements for written practice agreements and written practice protocols. Instead, these nurse practitioners must have collaborative relationships with one or more licensed physicians qualified to collaborate in the specialty involved or a hospital that provides services through physicians. The nurse practitioner must complete and maintain a form to which the NP shall attest, that describes such collaborative relationships.

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“Collaborative relationship” means that the NP shall communicate, whether in person, by telephone or through written (including electronic) means, with a licensed physician qualified to collaborate in the specialty involved or, in the case of a hospital, communicate with a licensed physician qualified to collaborate in the specialty involved and having privileges at such hospital, for the purposes of exchanging information, as needed, in order to provide comprehensive patient care and to make referrals as necessary. Such form shall also reflect the nurse practitioner’s acknowledgment that if reasonable efforts to resolve any dispute that may arise with the collaborating physician or, in the case of a collaboration with a hospital, with a licensed physician qualified to collaborate in the specialty involved and having privileges at such hospital, about a patient’s care are not successful, the recommendation of the physician shall prevail (NYSED, 2023). Florida traditionally had no such requirement related to supervised practice hours required before autonomy.  However, in 2020, Florida introduced a new law allowing certain nurse practitioners to practice autonomously. Prior to the autonomous practice law, nurse practitioners could practice in Florida pursuant to a collaborative/supervisory protocol as defined by Florida Statute 464.012.  Florida Statute 464.0123 allows the Florida Board of Nursing to register an individual as an advanced practice registered nurse or as an autonomous advanced practice registered nurse if the nurse practitioner has completed, in any state, jurisdiction, or territory of the United States, at least 3,000 clinical practice hours, which may include clinical instructional hours provided by the applicant, within the 5 years immediately preceding the registration request while practicing as an advanced practice registered nurse under the supervision of an allopathic or osteopathic physician who held an active, unencumbered license issued by any state, jurisdiction, or territory of the United States during the period of such supervision. APRN Regulations Discussion Essay

In the state of New York, no physician shall enter into practice agreements with more than 4 nurse practitioners who are not located on the same physical premises as the collaborating physician. In contrast, the state of Florida allows medical doctors to supervise APRNs offering primary care services at no more than 4 satellite offices in addition to the primary place of practice. An MD may supervise APRNs offering specialty services at no more than 2 satellite offices in addition to the primary place of practice. A board-certified/eligible MD in plastic surgery or dermatology must supervise APRNs offering primarily dermatologic or skin care at no more than 1 satellite office in addition to the primary place of practice (floridanursing.gov, 2023).

Controlled substance prescribing for nurse practitioners is different from New York to Florida. In New York, ARNPs can prescribe controlled substances independently, without physician collaboration or supervision after 3,600 hours. In Florida, ARNPs may prescribe narcotics, but schedule II narcotics must be a week’s supply or less. An exception to this is only for certified psychiatric ARNPS when prescribing psychiatric controlled substances.

In the state of Florida, nurse practitioners would need to ensure that they have a collaborative agreement with a medical doctor that is current and meets the state’s requirements for the life of their career. The amount of effort this would take to maintain would mean the nurse practitioner would have to continue a good relationship with the practicing medical community and remain abreast of the legal and statutory requirements of these written practice agreements and protocols.  Whereas in the state of New York, if the nurse practitioner has been practicing for more than 3600 hours, they do not need a written practice agreement with a medical doctor. This difference would obviously make practicing in the state of New York as a nurse practitioner much easier than it would be in Florida. The state of New York is considered one of the best states for nurse practitioners based on salary, job availability, and scope of practice laws. APRN Regulations Discussion Essay

               References

State practice environment. (n.d.). American Association of Nurse Practitioners. https://www.aanp.org/advocacy/state/state-practice-environmentLinks to an external site.

http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0400-0499/0464/Sections/0464.0123.htmlLinks to an external site.

Autonomous advanced practice registered nurse. (n.d.). Florida Board of Nursing. Retrieved September 26, 2023, from https://floridasnursing.gov/licensing/autonomous-advanced-practice-registered-nurse/Links to an external site.

Practice information for nurse practitioners. (n.d.). New York State Education Department. Retrieved September 26, 2023, from https://www.op.nysed.gov/professions/nurse-practitioners/professional-practiceLinks to an external site.

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Thank you for your post. Florida and California are some of the renowned states that mandate the practice of nursing practice and the development of evidence-based practices. The role of the nursing boards in the two states is to implement the strategies and mechanisms that ensure healthcare service delivery and attainment of the best quality of care. Professionals are mandated to follow the standards of practice and ensure that the needs of individuals and populations are adequately addressed (Kleinpell et al., 2023). Nursing professionals must develop safe and effective practices, provide primary healthcare services, and incorporate evidence-based practices within the collaborative environment. APRN Regulations Discussion Essay

These practice standards include maintaining minimum practice hours, completing the basic sciences and continuing professional development, and ensuring high-quality and individualized healthcare services that support independent practice. In Florida, nursing professionals have the authority to practice independently and offer primary healthcare services, provided they maintain the minimum standards for nursing practice. Advanced Nursing professionals can prescribe a wide range of medications, ranging from schedules II- V (Zhang & Patel, 2022). However, to be effective in providing these services, professionals need to demonstrate competence and provide outstanding performance in the management of individualized healthcare services.

In some states, nursing professionals have restricted experience and minimize the capacity of nursing professionals to work collaboratively toward addressing the underlying healthcare issues and risks. Advanced nurse practitioners must incorporate new strategies, such as evidence-based practices in service delivery (Peterson, 2019). However, with restricted practice, professionals are unable to provide certain primary care services, relying on collaborative agreements and other strategies that limit the capacity of professionals to attain the best healthcare outcomes. Advanced nurse practitioners for ensuring that the desired healthcare outcomes are adequately addressed. APRN Regulations Discussion Essay