Professional Nursing and State-Level Regulations NRSE 6050 Title: Professional Nursing and State-Level Regulations NRSE 6050

In the United States, different states have APRN boards that are tasked with developing unique regulations to govern how nurse practitioners operate within clinical settings (Yang et al., 2021). Broadly, the regulations set by these boards fall under three broad categories full practice, reduced or restricted. This analysis compares the Practices of APRNS in the state of Maryland where I live, and to another state, North Carolina where practice restrictions differ. In Maryland, Nurse Practitioners have the authority to independently prescribe medications, diagnose conditions, and administer treatments, their counterparts in North Carolina do the same but under the keen supervision of physicians (McMichael & Markowitz, 2023). To demonstrate this by example, a Nurse practitioner in Maryland would be able to autonomously manage chronic conditions like diabetes. Quite the opposite, a Nurse Practitioner in North Carolina would require the oversight and close supervision of a physician to engage in activities such as making adjustments to insulin regimens.

Needless to say, these regulations by APRN boards impact nursing practice in several ways. According to McMichael & Markowitz (2023), in states where nurses have full practice authority for example in Maryland, these healthcare professionals are free to exercise their legal right of practicing autonomously. In their report on this, Alexander and Schnell (2019) wrote that in full practice states, these professionals are authorized to engage independently in activities such as prescribing medications, diagnosing medical conditions, and providing treatments. The benefit this authority has is allowing APRNs to optimize their skills. More importantly, this full practice authority demonstrates a commitment to recognizing the full scope of nursing practice expertise. Suffice it to say, that nurse practitioners must adhere to these stipulated regulations and a practical way in which they can do this is by ensuring that they fully understand the specific requirements that these regulations have. Secondly, they must appreciate the differences between different states, especially those planning to move from one state to another. These two approaches are necessary to ensure that these practitioners abide by the set practice regulations.

Every State has different laws and regulations that impact APRNs practice, determined by individual state legislation and specific agency (Milstead & Short, 2019). The Nurse Practice Act (NPA) defines the regulation of nursing practice, which varies by State, and is governed by its state Board of Nursing (BON) to regulate the practice of nursing with the primary focus to protect the public health, safety, and welfare of its citizens.

The American Nurses Association (ANA) represents all APRNs’ interest and believes that patients’ interests are best served by a health care system in which many different types of qualified professionals are available, accessible, and working together – collaboratively. Therefore, the scope of practice needs to reflect a professional’s true expertise (American Nurses Association, n.d.).

Starting July 2020, APRNs in Florida were able to practice independently, without a physician’s supervision, and to operate primary care practice in family medicine, general pediatrics, and general internal medicine. To qualify, the APRN needs to accumulate 3,000 hours of experience under physician supervision. APRNs have to complete minimum graduate-level course work in differential diagnosis and pharmacology and have not been subject to disciplinary action within the past five years (Florida Board of Nursing, n.d.).

The passage of the bill demonstrates a commitment to the modernization of the way health care is delivered. APRNs can practice to the full extent of their education and abilities to provide the most efficient quality care to patients (American Nurses Association, n.d.). With this passage, people from Florida will have more access to health care, particularly in rural areas that are often underserved.

In contrast, although Texas recently eliminated the requirement of on-site physician supervision for Nurse Practitioners, they remained under restricted practice. State law requires a physician to provide continuous supervision, but the constant physical presence is not needed (Nurse Practitioner Schools, 2019). APRNs provide patient care by delegation from physicians.

A physician must delegate the prescriptive authority through a written document prescribed by law, and certain limitations apply to prescribing Controlled Substances (CSs), as schedules III-V. Schedule II may also be delegated depending on the patient’s pressing needs (Coalition for Nurses in Advanced Practice, n.d.). Supervising physicians are mandated to track prescriptions written by APRNs, perform chart reviews,