Background: APN, Licensing, and the Associated Challenges
- The changing landscape of nursing requires improved services;
- An assessment of nurses’ skills and competencies is required;
- A wide range of terms used in APN licensing complicates the understanding;
- Lack of consistency between regulations in different states reduces nurses’ mobility;
- Changes to the current APN licensing policies are required.
Licensure, Accreditation, Certification, and Education (LACE) Considerations
- Licensure: the provision of practice-associated guarantees to an APN;
- Accreditation: the process of determining the quality of education in different nursing schools;
- Certification: the assessment of nursing students’ knowledge and skills;
- Education: the provision of programs aimed at increasing nurses’ proficiency;
- LACE standards and considerations are different in each state.
LACE for APN Clinical Roles in California
- Requirements for licensure: completing an in-state program;
- Requirements for accreditation: attending an accredited program;
- Requirements for certification: 500 hours of clinical experience;
- Presence of clinical leadership and clinical research skills;
- Ability to provide patient education and consultations (“Advanced Practice Nurse requirements in California,” 2017).
LACE for APN Clinical Roles in Illinois and Comparison to California
- Requirements for licensure: graduate or post-master degree in nursing;
- Requirements for accreditation: attending an accredited program;
- Requirements for certification: substantial clinical experience;
- Application fee of $125 as a necessary component;
- Applicants from other states must have an official verification (“Advanced Practice Nursing Illinois,” 2017).
LACE for APN Clinical Roles in Washington and Comparison to California and Illinois
- Requirements for licensure: finishing an approved academic program;
- Requirements for accreditation: Council on Higher Education Accreditation recognition;
- Requirements for certification: clinical experience of at least 500 hours;
- Provision of the application fee for nurses;
- Certification provided by the National Certification Corporation.
Evidence-Based Strategies (EBS): Continuity between State Regulatory Boards
- Importance of maintaining continuity between state boards;
- Use of the existing legal system;
- Creation of regulations for maintaining the continuity intact;
- The active promotion of interdisciplinary communication among nurses (Rudner & Kung, 2017);
- Focus on compromise as the basis for conflict management.
EBS: Enhancing Communication and Reciprocity between Boards
- Using social media as the means of retaining communication and reciprocity between boards;
- Promoting interdisciplinary cooperation among boards;
- Altering the legal standards for cooperation between the boards;
- Shaping communication values to encourage boards to cooperate;
- Addressing cross-cultural and economic factors preventing boards from reciprocity.
EBS: Introducing a System of Rigid Standards for Decision-Making
- A clear and well-developed value system and nursing philosophy across boards;
- The active promotion of patient-centered values and the focus on improving patient outcomes;
- Using observations within the community to determine the necessary improvements;
- Focusing on the needs of all stakeholders, including nurses, to improve the quality of services;
- Introducing opportunities for nurses to improve their skills and acquire new knowledge;
- Cooperating to design new educational programs for patients and nurses alike.
Independent NP Practice in Florida: Obligatory Supervision of Physicians as the Current Status Quo
- The current status: no independent practice for nurses in Florida;
- The necessity for nurses to be supervised by physicians or other healthcare practitioners;
- Nurses can monitor patients and introduce changes to drug therapies;
- Nurses are allowed to run diagnostic tests and define possible therapies for managing patients’ needs;
- However, nurses must be supervised by physicians (“Advanced Registered Nurse Practitioner requirements in Washington,” 2017).
Conclusion: Addressing Current Issues Related to APN Licensing
- The lack of clear and uniform standards across boards;
- The absence of cooperation among members of different boards;
- Need to introduce more opportunities for nurses to develop crucial competencies;
- The necessity to offer a more patient-centered approach;
- The urgency of enhancing communication and collaboration.
References
Advanced Practice Nurse requirements in California. (2017). Web.
Advanced Registered Nurse Practitioner requirements in Washington. (2017). Web.
Advanced Practice Nursing Illinois. (2017). Web.
Rudner, N., & Kung, Y. M. (2017). An assessment of physician supervision of nurse practitioners. Journal of Nursing Regulation, 7(4), 22-29.