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APRNs are primary care providers, pivotal in providing primary health care and preventive services in communities. Advanced practice nursing is defined by the Nurse Practice Act but governed by the Board of Nursing in different states or territories. Where the Nurse Practice Act falls short in interpretation, the Board of Registered Nursing guides the form of an opinion (American Nurses Association, n.d.). Advanced practice nurses should understand how these laws and regulations shape practice.
I am from California, and I chose Iowa for comparison. In both states, APRN nursing regulations allow advanced practice nurses to function as primary care providers with permission to certify disability pursuant to the unemployment insurance code section2708 (California Legislative Information, n.d.). Similarly, in both states, APRNs also sign POLST forms.
APRNs in California can prescribe controlled substances after fulfilling specific requirements, including six months of physician supervision, a pharmacology course, and another specific course about schedule II-controlled drugs. Iowa Board of Registered Nursing also allows nurse practitioners to prescribe Schedule II drugs after registering with the pharmaceutical board. Both states require the prescriber to be registered with the Drug Enforcement Agency.
Advanced Registered Nurse Practitioners in Iowa have autonomy in practice; alternately, they can collaborate with a physician or surgeon, but this is not a requirement of the Iowa Board of Nursing. APRNs in Iowa practice autonomously. California has a standardized procedure arrangement for advanced practice nurses to diagnose, treat, and prescribe. APRNs in California have career-long supervision, delegation, or team management by a physician. Largely, California regulations allow advanced nurse practitioners to approve, sign, or modify treatment plans after consultation with a physician.
California Board of Registered Nursing allows for using marijuana by nurses as long as it is not used within the workstation. The legislation makes it unlawful for an employer to eliminate hiring someone based on that person using Cannabis away from their workstation. The legislation further guides that a nurse who uses cannabis for medical purposes should also be exempted from this policy. On the contrary, recreational use of marijuana is illegal under Iowa law. A nurse may be affected even if the positive drug screen was done in another state that allows the use of marijuana. Potential employers usually forward positive marijuana screens where a nurse has a license.
Advanced Practice Registered Nurses with full legal authority to practice at full scope will have issues practicing autonomously in California because of the restricted practice legislation. One of the objectives of the ANA is to fight barriers to nursing practice so that nurses practice to the full extent of their education and training despite being in different territories. All nurses are licensed by their state of practice or by a multistate license. The Nurse Licensure Compact provides APRNs with a multistate license that allows nurses to practice in the home state and other compact states (NCSBN. (n.d.). Not all states are compact states.
Nurses adhere to the rules through continuous education to keep up with the latest practices and technology. Many approved colleges provide the necessary certification; some are state-specific, and others can be found online. Joining Professional organizations is also useful for sources of the latest information in the medical world.
explain how the regulatory environment and the regulations selected by your colleague differ from your state/region. Be specific and provide examples.
