Nurse Practitioner Independent Practice in Maryland: A Summary
Regulations and Scope of Practice:
Maryland falls under the category of full practice authority states for Nurse Practitioners (NPs). This means NPs can practice independently without physician collaboration or supervision. They can assess, diagnose, treat patients, order and interpret diagnostic tests, and prescribe medications, including controlled substances, within their specific area of practice.
Certification and Licensure:
To become a certified APRN in Maryland, you must:
- Hold an active RN license in Maryland.
- Graduate from an accredited Master of Science in Nursing (MSN) program or Doctor of Nursing Practice (DNP) program in your chosen NP specialty.
- Pass the national certification exam specific to your NP specialty offered by a national certifying organization recognized by the Maryland Board of Nursing.
- Apply for and receive certification from the Maryland Board of Nursing (MBON).
Application Process:
The application process for APRN certification involves submitting the following documents to the MBON:
- Completed application form
- Official transcripts verifying your nursing education
- National certification examination results
- Fingerprint verification
- Attestation form from your NP program director
- Verification of continuing education (CE) credits
- Payment of required fees
MBON Website:
The Maryland Board of Nursing website is https://mbon.maryland.gov/Pages/default.aspx.
Scope of Practice Definition:
Maryland defines the scope of practice for NPs as the “activities that a nurse practitioner may perform, within the limits of that nurse practitioner’s education, training, certification, and experience.” This includes:
- History taking and physical examination
- Ordering and interpreting diagnostic tests
- Diagnosis and treatment of a wide range of health conditions
- Prescribing medications, including controlled substances
- Education and counseling of patients
Practice Agreement:
Maryland requires a one-page consultation agreement between the NP and a collaborating physician. This agreement simply verifies the NP has a physician they can consult with if needed but does not require physician oversight or co-signature for patient care.
DEA License:
NPs in Maryland need a separate Drug Enforcement Administration (DEA) license to prescribe controlled substances. You can find information and application procedures on the DEA website https://www.dea.gov/.
Prescription Monitoring Program (PMP):
Maryland has a mandatory PMP called the Maryland Prescription Drug Monitoring Program (PDMP). NPs are required to register with the PDMP and check it before prescribing controlled substances.
Controlled Substance Prescriptive Authority:
NPs in Maryland can prescribe all schedules of controlled substances (Schedules II-V) within their scope of practice and in accordance with their DEA license.
Surprises:
One surprising aspect was the high level of autonomy granted to NPs in Maryland. While supervision is a common requirement in many states, Maryland’s full practice authority allows NPs to function independently, potentially increasing access to healthcare services in underserved areas.
Additional Notes:
This summary provides an overview of regulations and requirements. It’s crucial to consult the MBON website and relevant legal resources for the most up-to-date and comprehensive information. This summary is not a substitute for professional legal advice.
