Professional Nursing and State-Level Regulation
Boards of Nursing (BONs) exist in all 50 states, the District of Columbia, American Samoa, Guam, the Northern Mariana Islands, and the Virgin Islands. Similar entities may also exist for different regions. The mission of BONs is the protection of the public through the regulation of nursing practice. BONs put into practice state/region regulations for nurses that, among other things, lay out the requirements for licensure and define the scope of nursing practice in that state/region.It can be a valuable exercise to compare regulations among various state/regional boards of nursing. Doing so can help share insights that could be useful should there be future changes in a state/region. In addition, nurses may find the need to be licensed in multiple states or regions.To Prepare:Review the Resources and reflect on the mission of state/regional boards of nursing as the protection of the public through the regulation of nursing practice.Consider how key regulations may impact nursing practice.Review key regulations for nursing practice of your state’s/region’s board of nursing and those of at least one other state/region and select at least two APRN regulations to focus on for this Discussion..BELOW IS THE QUESTION———————–Post a comparison of at least two APRN board of nursing regulations in your state/region with those of at least one other state/region. Describe how they may differ. Be specific and provide examples. Then, explain how the regulations you selected may apply to Advanced Practice Registered Nurses (APRNs) who have legal authority to practice within the full scope of their education and experience. Provide at least one example of how APRNs may adhere to the two regulations you selected.BELOW IS THE REQUIRED READING———————Required ReadingsMilstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.Chapter 4, “Government Response: Regulation” (pp. 57-84)American Nurses Association. (n.d.). ANA enterprise. Retrieved September 20, 2018, from http://www.nursingworld.orgBosse, J., Simmonds, K., Hanson, C., Pulcini, J., Dunphy, L., Vanhook, P., & Poghosyan, L. (2017). Position statement: Full practice authority for advanced practice registered nurses is necessary to transform primary care. Nursing Outlook, 65(6), 761-765.Halm, M. A. (2018). Evaluating the impact of EBP education: Development of a modified Fresno test for acute care nursing. Worldviews on Evidence-Based Nursing, 15(4), 272-280. doi:10.1111/wvn.12291National Council of State Boards of Nursing (NCSBN). (n.d.). Retrieved September 20, 2018, from https://www.ncsbn.org/index.htmNeff, D. F., Yoon, S. H., Steiner, R. L., Bumbach, M. D., Everhart, D., & Harman J. S. (2018). The impact of nurse practitioner regulations on population access to care. Nursing Outlook, 66(4), 379-385. doi:10.1016/j.outlook.2018.03.001Peterson, C., Adams, S. A., & DeMuro, P. R. (2015). mHealth: Don’t forget all the stakeholders in the business case. Medicine 2.0, 4(2), e4. doi:10.2196/med20.4349.PLEASE MAKE SURE TO PUT 4 REFERENCES NOT MORE THAN 5 YEARS OLD WITH 7th EDITION WITH APA FORMAT.please make sure to go through the grading rubric that was attached. CORE SKILL: distinguishing the LEVELS of regulation and knowing which body does what. Students routinely conflate boards, associations, and accreditors — and that conflation is the thing the assignment is designed to expose.
THE CENTRAL DISTINCTION — BOARDS OF NURSING vs. PROFESSIONAL NURSING ASSOCIATIONS:
— A BOARD OF NURSING is a GOVERNMENTAL, STATE regulatory agency. Its authority derives from STATUTE (the state’s Nurse Practice Act, enacted by the legislature). Its mission is PROTECTION OF THE PUBLIC — not protection or advancement of nurses. It has ENFORCEMENT POWER: it grants, denies, restricts, suspends, and revokes licenses; it disciplines; it approves nursing education programs; it promulgates regulations that carry the force of law. MEMBERSHIP IS NOT OPTIONAL — if you practice in the state, you are subject to it.
— A PROFESSIONAL ASSOCIATION (ANA, AANP, AACN, specialty organizations) is a PRIVATE, VOLUNTARY, membership organization. It advances the PROFESSION and its members: it sets standards of practice and codes of ethics (influential but not, in themselves, law), certifies specialists, lobbies, publishes, and educates. It has NO enforcement power over licensure. Membership is voluntary and dues-based.
THE SENTENCE THAT DEMONSTRATES YOU UNDERSTAND IT: a BON protects the PUBLIC FROM nurses; an association advocates FOR nurses. That asymmetry is the whole point, and it explains why a BON can discipline you while an association can only expel you from itself.
NCSBN: the National Council of State Boards of Nursing is not itself a regulator — it is the organization THROUGH WHICH boards act collectively. It develops the NCLEX, coordinates the NURSE LICENSURE COMPACT (multistate licensure — know whether your state participates), and produces model rules. A common student error is calling NCSBN a national board of nursing; there is no such thing, because nursing regulation is a STATE police power under the Tenth Amendment.
BOARD COMPOSITION AND APPOINTMENT: typically gubernatorial appointment; typically a mix of RNs, APRNs, LPNs, and PUBLIC/consumer members. The presence of public members is not decoration — it is structural evidence of the public-protection mandate, and pointing that out is a good analytic observation.
SCOPE OF PRACTICE AND APRN AUTHORITY: the practice environment varies by state — FULL PRACTICE, REDUCED PRACTICE, or RESTRICTED PRACTICE authority (AANP maintains the map). This variation determines whether an NP can practice and prescribe independently, and it is the single most consequential regulatory fact in advanced practice. Name YOUR state’s status specifically; a generic answer will not score.
ALSO: the accreditation layer (CCNE, ACEN) is a THIRD, separate thing — voluntary, non-governmental, and about EDUCATION PROGRAMS rather than individual licensure.
FOR THE STAFF DEVELOPMENT MEETING FORMAT: explain how two board members are selected in your state, and identify TWO SPECIFIC REGULATIONS from your state’s NPA and explain how they influence your practice — be concrete (delegation rules, prescriptive authority, mandatory reporting, continuing education requirements, or the duty to report an impaired colleague).
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