Maryland Registered Nurse Certification and Licensure

Maryland Registered Nurse Certification and Licensure

Regulation, in the context of healthcare, refers to the authority vested in governing bodies to oversee and enforce legislation (Milstead & Short, 2019). Each state has its specific set of rules, certification criteria, and licensing requirements for advanced practice registered nurses (APRNs), all designed to ensure public safety by regulating the activities of healthcare professionals. These regulations are formulated by the board of nursing in accordance with the Nurses Practice Act, with the primary objective of safeguarding the community through the establishment of qualifications for entry into the nursing profession (Bosse et al., 2017). Additionally, they are responsible for upholding consistent standards of practice.

In Maryland, my home state, the primary prerequisite for becoming a certified nurse practitioner is the completion of a board-approved nurse practitioner program and successful completion of a board-approved examination (Maryland Board of Nursing, 2019). The Maryland Board of Nursing maintains a list of approved NP programs across the country, which includes institutions like Walden University. In cases where a program is not listed, NP candidates can apply for approval, provided the program is recognized by the US Department of Education or the Council for Higher Education Accreditation. MBON (Maryland Board of Nursing) has identified four approved organizations for board certification: the American Nurses Credentialing Center, the American Academy of Nurse Practitioners, the Pediatric Nursing Certification Board, and the National Certification Corporation.

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South Carolina Nursing Practice Certification and Licensure

To obtain a Maryland NP license, MBON requires the submission of various documents, including a copy of the current RN license, the certification application, a declaration of resident form, a sealed official transcript, a copy of the current national certification or a letter indicating eligibility for the certification exam. Effective October 2015, an additional requirement stipulates that applicants must have a mentor for 18 months from the date of application, with the mentor being a Maryland licensed Nurse Practitioner or Physician in good standing (Maryland Board of Nursing, 2019).

In terms of scope of practice, Maryland NPs are recognized as primary care providers after completing 18 months of mentorship with a physician or an experienced NP, following successful licensure examination. They have the authority to operate independently, performing functions authorized by law, which include but are not limited to patient assessments, diagnoses, and ordering and interpreting laboratory tests (Maryland Board of Nursing, 2019).

To obtain a Drug Enforcement Administration (DEA) license in Maryland, NPs can apply for a Maryland State Controlled Dangerous Substances (CDS) license through the Office of Controlled Substances Administration (OCSA). This process entails completing the CDS application form and mailing it to the Maryland Department of Health- Public Health Services Office of Controlled Substances Administration. Maryland NPs possess full prescriptive authority, which does not require physician involvement, allowing them to prescribe drugs classified under Schedules II, III, IV, and V (Maryland Board of Nursing, 2019).

The Nurse Practitioner Association of Maryland (NPAM) is an organization in the state with a dedicated legislative committee responsible for monitoring NP practice issues in accordance with state laws and regulations. The committee comprises members from various regions of Maryland and engages in legislative and advocacy activities. These activities involve assessing legislative and regulatory matters affecting NP practice, developing action plans, educating legislators, and advocating for necessary changes. Additionally, the organization formulates a legislative agenda, collaborates with NPAM lobbyists to create legislation, promotes legislative initiatives among its members, legislators, and the public, reviews health-related bills introduced by other groups in the legislature, and provides recommendations to NPAM regarding support or opposition to such bills. NPAM also builds relationships with other healthcare stakeholders representing nursing, medicine, education, government, business, and the community (Nurse Practitioner Association of Maryland, n.d.).

While the majority of regulations in Maryland favor NP independent prescriptive and practice authority, a potential barrier to independent practice is the regulation enacted in October 2015, which mandates that newly certified NPs must have a physician mentor for 18 months before they can practice independently.

It is noteworthy how different states vary in terms of NP independent practice authority. Maryland NPs enjoy several independent functions beyond prescribing drugs and ordering diagnostic and therapeutic measures. For instance, they can complete a death certificate if the deceased was under their care, certify to the Department of Transportation when an individual requires special consideration for specific health reasons, and serve as witnesses for advance directives (Maryland Board of Nursing, 2019). Discovering these additional independent functions has inspired me to consider future service to my community, given the extensive scope of practice available to NPs in Maryland.

In conclusion, the full practice authority of APRNs plays a critical role in providing high-quality, accessible, and cost-effective healthcare services to the public (Bosse et al., 2017). With the aging population and increased access to healthcare due to the Affordable Care Act, there is a growing demand for healthcare providers, particularly primary care practitioners. The removal of restrictions on APRNs will enable them to practice to the fullest extent of their training and qualifications, addressing the increasing healthcare needs of the population. APRNs are highly educated and trained professionals, and expanding their scope of practice is crucial to meeting the evolving healthcare demands of the country.

References

Bosse, J., Simmonds, K., Hanson, C., Pucini, 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. https://doi.org/10.1016/j.outlook.2017.10.002

Buppert, C. (2021). Nurse practitioner’s business practice and legal guide (7th ed.). Jones & Bartlett.

Maryland Board of Nursing. (2019). Nurse practitioner: Scope and standards of practice. https://mbon.maryland.gov/Documents/proposed-regs-for-20171113-md-register.pdf

Milstead, J. A., & Short, N. M. (2019). Overview: Economics and finance of healthcare. In Health policy and politics: A nurse’s guide (6th ed., pp. 171–211). Jones & Bartlett Learning.

Nurse Practitioner Association of Maryland. (n.d.). Maryland legislative districts and NPAM legislative committee. https://www.npamonline.org/page/35 Maryland Registered Nurse Certification and Licensure.

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