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 (6^th 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.