I will compare two APRN board of nursing regulations in my state, California, and another state with full practice authority for APRNs, Colorado.
Regulation 1: Collaboration or Supervision
- California: APRNs in California must collaborate with or be supervised by a physician. Collaboration is defined as a “formal relationship in the provision of patient care that is documented in a written practice agreement.” Supervision is defined as “the direct oversight of the activities of the APRN by a physician pursuant to a written practice agreement.”
- Colorado: APRNs in Colorado have full practice authority, which means that they do not need to collaborate with or be supervised by a physician.
Regulation 2: Prescribing Authority
- California: APRNs in California have prescriptive authority, but there are some restrictions. For example, APRNs cannot prescribe Schedule II controlled substances without a written delegation from a physician.
- Colorado: APRNs in Colorado have full prescriptive authority.
How the Regulations Differ
The two main differences between the APRN board of nursing regulations in California and Colorado are the requirements for collaboration or supervision and the restrictions on prescribing authority.
- Collaboration or supervision: In California, APRNs must collaborate with or be supervised by a physician, while in Colorado, APRNs have full practice authority and do not need to collaborate with or be supervised by a physician.
- Prescribing authority: In California, APRNs have prescriptive authority, but there are some restrictions, such as the inability to prescribe Schedule II controlled substances without a written delegation from a physician. In Colorado, APRNs have full prescriptive authority.
How the Regulations Apply to APRNs with Full Scope of Practice Authority
APRNs with full scope of practice authority, such as those in Colorado, are able to practice independently and without the need for physician collaboration or supervision. This means that they can diagnose and treat patients, order and interpret tests, and prescribe medications without having to involve a physician.
Examples of How APRNs Can Adhere to the Selected Regulations
Here are some examples of how APRNs with full scope of practice authority can adhere to the two selected regulations:
- Collaboration or supervision: APRNs in California can adhere to the collaboration or supervision requirement by having a written practice agreement with a physician. The practice agreement should outline the roles and responsibilities of the APRN and the physician, as well as the process for communication and consultation.
- Prescribing authority: APRNs in both California and Colorado can adhere to the prescribing authority requirements by following the state’s laws and regulations on prescribing. This includes obtaining and maintaining a current prescribing license, following the state’s formulary, and keeping accurate records of all prescriptions.
Example of How an APRN Can Adhere to the Selected Regulations
An APRN with full scope of practice authority in Colorado could adhere to the selected regulations by:
- Having a written practice agreement with a physician, even though it is not required by law. This agreement could serve as a resource for the APRN and the physician in case there are any questions or concerns about the APRN’s practice.
- Prescribing medications in accordance with the state’s laws and regulations. This includes obtaining and maintaining a current prescribing license, following the state’s formulary, and keeping accurate records of all prescriptions.
Conclusion
The APRN board of nursing regulations in different states can vary significantly. It is important for APRNs to be familiar with the regulations in their state of practice. APRNs with full scope of practice authority have a great deal of autonomy, but they also have a responsibility to practice in a safe and ethical manner. By adhering to the state’s regulations, APRNs can help to protect the public and maintain the integrity of the nursing profession.
