Professional Nursing and State-Level Regulations

State Boards of Nursing (BONs) outline regulations that define specific licensure and practice requirements that nurses in a state/region must follow as they continue to perform their professional roles. By understanding variations in BON regulations for different states, nurses are able to gain information that might be highly useful in the future in case they choose to change states or regions (Cassiani et al., 2020). This discussion will compare two Advanced Practice Registered Nurses (APRNs) BON regulations in the state of Texas with that of Maryland state.

The state of Texas and Maryland have different APRN BON regulations in relation to both practice and prescriptive authorities. With respect to practice authority, in the state of Texas, physician involvement is not required for APRNs to diagnose and treat illnesses under T.A.C. § 221.13 (c). However, physicians must follow laid down protocols for quality assurance and review before delegating duties to an APRN.

On the contrary, in the state of Maryland, APRNs performing diagnosis and treatment require close physician supervision for the initial 18 months of practice under Ann. Code Maryland Section 8- 302(b)(5) (AMA, 2017a). As far as prescriptive authority is concerned, APRNs in both Texas and Maryland have the authority to prescribe schedule II-V controlled substances. However, in the state of Texas, APRNs must make an application with the Texas Department of Public Safety for controlled substances registration before prescribing these substances. The Maryland BON required APRNs to obtain a Maryland Drug Control Number before prescribing controlled substances (AMA, 2017b).

APRNs who have the legal authority to practice within the full scope of their education and experience in Texas and Maryland must adhere to these regulations as they apply to their respective states. For example, those in Texas can practice without close physician supervision while those in Maryland must be supervised for the first 18 months of practice. Additionally, APRNs practicing in both states must obtain relevant documentation before prescribing schedule II-V controlled substances (AMA, 2017a; AMA, 2017b). Failure to adhere to these regulations can result in the revocation of licensure.

References

American Medical Association (AMA). (2017a). State law chart: Nurse Practitioner Practice Authority. https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/specialty%20group/arc/ama-chart-np-practice-authority.pdf

American Medical Association (AMA) (2017b). State law chart: Nurse Practitioner Prescriptive Authority. https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/specialty%20group/arc/ama-chart-np-prescriptive-authority.pdf