Question #1
Advanced nursing practice is dynamic; the scope is constantly evolving through acquisition of new knowledge, technology and general changes in the health care delivery system. The state is constantly coming up with new rules and regulations for advanced practice registered nurses (APRNs). According to Watson & Hillman (2010), the state of Texas recently passed legislation authorizing joining of the APRN Compact. APRN Compact is a seamless border for APRN practice, whereby APRNS are given licensures by the states where they practice.
Texas Board of nursing has made notable strides in redefining the role of APRNs in patient care in the past decade. Thomas et al. (2010), note that before 1999, the continued competency requirements of the Board were limited to education contact hours. The Board slowly began reviewing the requirements in an effort to find effective methods of empowering APRNs. The Board funded pilot projects and studies to assure the public of safe nursing practice. The Board also worked with key stakeholders such as Texas Nurses Association (TNA) to come up with a new competency framework. TNA came up with a comprehensive document outlining a new model for APRN career movement and influences on competencies. The comprehensive document inspired the Texas Board to revise its Continuing Competency Rules (Thomas et al., 2010). The revisions were published in the Texas Register under the Texas Administrative Procedure Act (2010). One of the proposed changes in the Texas Administrative Procedure Act was specialty certification in the nurse’s area of practice as a way of acknowledging continuing competency. Another proposed rule change was that any continuing education contact hour must be related to the nurse’s specialty (Thomas et al., 2010).
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Questions #2
Watson & Hillman (2010), state that all states in the U.S. have different nursing practice laws and regulations for advanced practice nursing. Though the state laws are unique, they touch on common aspects of advanced practice nursing such as licensure requirements, educational training, licensure renewals, and grounds for disciplinary action.
However, the difference in terms of scope of practice across the states has implications for professional nurses. Nurses in certain states have to work hard to meet strict requirements while others do not struggle much because of the lenient requirement in their states. For example, 42 nursing state boards require advanced practice nurses to attain the national certification first, while the others states do not require the national certification.
Some progressive state boards have come up with more policies to empower APRNs, hence the difference in terms of scope of practice is not entirely harmful to APRNs.
Watson & Hilman (2010) also assert that the difference in the scope of nursing across the states gives nurses dual legal liabilities. APRNs must practice by the rules of the state board and by the rules of their advanced standing agency. APRNs and other nurses have found themselves in trouble for failing to comply with the both state rules and the rules of the advanced standing agency. The difference in scope of practice creates liability issues for nurses, and APRNs planning to practice nursing in other states must make themselves aware of the different nursing rules in the new state to avoid liability issues. With the shortage of nurses across the nation, state board should aim at creating almost uniform rules that will allow APRNs to work anywhere without having to seek multiple certifications.
References
Thomas, M. B., Benbow, D. A., & Ayars, V. D. (2010). Continued competency and board regulation: One state expands options. The Journal of Continuing Education in Nursing , 41 (11), 524-528.
Watson, E., & Hillman, H. (2010). Advanced practice registered nursing: licensure, education, scope of practice, and liability issues. Journal of Legal Nurse Consulting , 21 (3), 25-29.
