The scope and Regulation of the APRN

Boards of Nursing (BONs) define the scope and regulation of the APRN. To comply, APRNs must be well aware of their scope and regulation practices in their respective state or territory. Regulations and scopes vary drastically, limiting access to the medically underserved and underutilizing the full scope of practice of the APRN (Bosse et al., 2017).

One constant variable that every BON requires is that the APRN obtains a graduate degree in nursing and passes a national certification in their pertinent specialty area (Milstead & Short, 2019).

In the state of Iowa, where I reside, the Iowa Board of Nursing defines the role and scope of the APRN. In Iowa, the APRN may practice independently; however, the APRN may establish a collaborative agreement with a physician if their practice determines necessity (Iowa Board of Nursing, 2020).

Illinois is 10 minutes from where I live; therefore, I will compare and contrast APRN roles and scopes for Illinois and Iowa. In Illinois, APRNs operate under reduced practice laws (American Association of Nurse Practitioners, 2022).

In Illinois, a written collaboration agreement detailing the terms between APRN and a supervising physician is required to practice (National Organizations for State and Local Officials, n.d.-a).

Another regulation that differs between states is prescribing rights. In Illinois, the collaborative agreement must define prescribing authority of the APRN.

APRNs can legally prescribe prescription medications and Schedule III-V controlled substances; APRNs may prescribe Schedule II controlled substances if delegated by supervising physician with appropriate guidelines met (National Organizations for State and Local Officials, n.d.-a).

Illinois is more restrictive with prescribing rights than Iowa. In Iowa, APRNs may prescribe drugs, devices, medical gases, and controlled substances upon registering with the U.S. Drug Enforcement Administration and the Iowa Board of Pharmacy (National Organizations for State and Local Officials, n.d.-b).

APRN regulation differences are vastly different between Iowa and Illinois. These differences deter me away from wanting to practice in Illinois.

APRNs in Illinois are not granted the right to practice at their full scope, and in Iowa, APRNs are granted that right.

A reason APRNs practicing in Iowa can practice at their full scope of practice may be because Iowa is a rural state, necessitating the need for full-practice APRNs (Neff et al., 2019).

Illinois may be considered a rural state, too; however, the presence of Chicago and other major cities may skew geographical and demographic data.

In my opinion, it is necessary to grant APRNs practicing in Illinois the full scope of their practice, thereby granting more access to health care.

 

 

References

Association of Nurse Practitioners. (2022). State practice environment. Retrieved on June 26, 2022, from https://www.aanp.org/advocacy/state/state-practice-environment

Bosse, 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.

Iowa Board of Nursing. (2020). Advanced registered nurse practitioner – role and scope. Retrieved on June 26, 2022, from https://nursing.iowa.gov/practice/advanced-registered-nurse-practitioner-role-scope

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Jones & Bartlett Learning.

National Organizations for State and Local Officials. (n.d.-a). Scope of practice policy: Illinois. Retrieved on June 26, 2022, from https://scopeofpracticepolicy.org/states/il/

National Organizations for State and Local Officials. (n.d.-b). Scope of practice policy: Iowa. Retrieved on June 26, 2022, from https://scopeofpracticepolicy.org/states/ia/

Neff, 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.

Nurses practicing in Today’s healthcare environment

Nurses practicing in today’s healthcare environment face increasingly complex ethical dilemmas. For nurses to fulfill their ethical commitments to patients, it is important to have understanding of ethical frameworks and concepts, as well as access to a wide range of information and to keep current with advances in ethical practices.

After choosing your topic, you will formulate a position and then proceed to support your
position from the relevant course resources.

Remember, there is no right or wrong
position. The important thing is how you support your stated position through relevant
course resources.

Process:
1. Select a topic from list below: end of life, nurse staffing or moral distress. Be
sure to choose a topic that you have a strong interest in or a strong personal
belief in.

2. Review course resources about your topic to familiarize yourself with the
different perspectives that exist on about your topic

3. Formulate a clear and concise essay. The aim of your paper is then to
support your position through ethical reasoning using course concepts.
4. Paper Overview:

a. Introduction Paragraph that engages the reader’s attention, identifies
your view point statement, and gives a brief overview of what the
essay will cover.

b. Identify how 2 different ethical theories would view the ethical dilemma

c. Identify how 2 or more Bioethical Principles are conflicted in this ethical
dilemma.

d. Identify relevant nursing standards or codes (CNO)

e. Conclusion Paragraph that provides a summary of the most salient
points.

Topics:.
End of life
 Help with a good death – in whichever way is desired, justifiable and
appropriate.

A broad, generic term for the right to die. Helping patients who
desire a hastened death to avoid further suffering and to die with dignity is an
expectation of a nurse however can be filled with distress and emotions for
the nurse.

It is also common during end-of-life care, where patients and
caregivers may experience charged emotions, grief, and loss.

Discuss the
role of the nurse in Ontario and the ethical dilemmas they face in end of life
care and supporting medically assisted death.

Louisiana’s outpatient facility and state policies

What are Louisiana’s outpatient facility and state policies regarding an inpatient hold? Does the patient have to be suicidal/homicidal or are there other criteria to place someone on hold?

    • How long are these holds for your state and to have them extended what is required?
    • Think about either your current place of employment or current clinical site.
  1. What are some potential biases you may have with a patient making suicidal statements?
    • If you have dealt with this, how did it go? If you have not yet, how do you think it will go?

Holistic care for patient with diabetes

Diabetes has many treatment options much of which the patient’s health behavior plays a significant role. Holistic care for patient with diabetes includes education, medication, diet, and exercise. Understanding the process of changing behaviors will help the HCP with strategies to support difficult health behavior changes (“noncompliant”) for patients.

Research and find information on The Transtheoretical Model of Behavior Change.

 

1. Define the preparation stage.

 

2. Discuss the nursing implications and related nursing intervention for the preparation stage as it pertains to the patient with diabetes.

 

3. Explain how understanding the process of changing behavior can help you facilitate a change for the patient with diabetes in order to help them gain better glycemic control. Be specific in your explanations.

 

you are using The Transtheoretical Model of Behavior Change to answer the three questions.

please cite references.

 

What are the 4 levels of structure of protein and how they are formed?

What are the 4 levels of structure of protein and how they are formed?.Briefly describe the difference between ionic and covalent bonds. Why do we say that life is based on carbon?.

Briefly describe the difference between ionic and covalent bonds

Briefly describe the difference between ionic and covalent bonds. Why do we say that life is based on carbon?.What are the 4 levels of structure of protein and how they are formed?

Explain the concept of a language acquisition device

Explain the concept of a language acquisition device and its genetic basis, including the researchers who proposed it.

Discuss three groups of archaebacteria

Discuss three groups of archaebacteria. By using appropriate examples, discuss three
ecological roles of bacteria. State the diversity of locomotion found in the following organisms.

Actinopods

b) Trypanosoma

c) Amoeba

cl) Paramecium

e) Giardia

 Describe the concept of Homeostasis

Describe the concept of Homeostasis and the connection to feedback systems or loops. Use appropriate language to explain this. [ KU – 6 Marks ] [ C – 2 Marks ] 3. Explain the mechanisms that acted on the body to produce the feedback loops. Explain all systems that acted on this. If you did not have results that showed feedback loops, explain which systems controlled the body to a level where changes in heart rate were not seen.

Name two advantages to asexual reproduction

Name two advantages to asexual reproduction and two disadvantages. Explain your answer Advantages: Disadvantages: