Respond of the ways listed below. Share an insight from having viewed your colleagues’ posts. Suggest additional actions or perspectives. Share insights after comparing state processes, roles, and limitations. Suggest a way to advocate for the profession. Share resources with those who are in your state.

In the state of New Hampshire, as in every state, there are guidelines set by the Nurse Practice Act which outline the role and responsibilities of Nurse Practitioners as providers. The purpose of this discussion is to outline the nurse practitioner certification and licensure processes with regards to state-specific restriction, prescriptive authority and the DEA registration process. Legislative and advocacy activities and professional issues will also be touched on. According to the Nurse Practice Act in the state of New Hampshire, an Advance Practice Registered Nurse (APRN) is a Registered Nurse (RN), licensed under the Board of Nursing under RSA 326-B:18 (Nurse Practice Act, n. d.). The Body responsible for licensure of the APRN is the New Hampshire Board of Nursing (NH BON, n.d.). Under the New Hampshire laws, APRN gain full authority with APRN licensure to prescribe medications and administer care. The state of New Hampshire provides APRNs with independence in their practice. These laws allow the APRNs to practice independently and make decisions about healthcare needs of an individual without having a written collaborative agreement in place with a physician. An NP has full independent practice authority and is licensed by the New Hampshire State Board of Nursing. They are recognized in state policy as primary care providers, which allows them prescriptive authority for drugs falling into schedule II, III, IV or V (American Medical Association, n.d.).

The APRN may assess, diagnose and prescribe treatment regimens through consultation, planning and collaborative management. They may perform all functions which are in line with their credentialing body and specialty area. The APRN also has ability to possess, prescribe and dispense controlled and non-controlled substances as defined by the NHBON and their credentialing body. National certifying boards recognized by the NHBON are the American Academy of Nurse Practitioners (AANP) and the American Nurses Credentialing Center (ANCC). To become certified the candidate must hold a Masters degree or higher, have a valid RN license as well as pass a certification exam in their specialty area (American Nurse Credentialing Center, n. d.). To prescribe medications, an APRN must have a DEA license which is granted from the Drug Enforcement Agency (DEA). An APRN must register with the U.S. Department of Justice and fill out an application for a DEA number. This can be done only after one has received an APRN license (AANP, n.d.).

ARPN’s can become advocates for patients and their communities at the legislative level, advocating for them on current health concerns. They can represent the people and plea for improving patient outcomes through approaching local governments with health-related concerns of the community. Currently the New Hampshire Nurse Practitioner Association is involved with legislative and advocacy activities regarding Changes in the Laws Governing Advanced Directives, POLST and Medical Surrogacy in New Hampshire in an attempt to simplify the terms, extend the surrogates tenure, and restriction on some experimental treatments and psychiatric commitments, in addition to other limitations (New Hampshire Nurses Association, 2021). As always, nurses have treated the “whole person”, and this advocacy falls in line with treating the person, not the diagnosis.

This may be an unpopular view, but I feel that as new providers it would be wise to have a collaborative agreement with a physician or mid-level provider for at least 2 years before practicing independently. In the bordering State of Maine, where I have a compact RN license, I will be able to practice in Maine once I receive my APRN.  In Maine, a new provider must have a collaborating physician for 24 months before practicing independently. I feel that this would be an appropriate requirement for a new APRN in the State of N.H. I was surprised when I first researched this topic that there is no minimum time frame where an APRN should have a collaborative physician before practicing independently. Also, an APRN can own their own practice without waiting for a period of time, this also surprised me. I consider these regulations to be a potential barrier that can impacting the nurse practitioner in my state due to inexperience. Having a collaboration agreement in my opinion would help a new APRN build confidence and help one on the path to being a safe provider. As APRN’s it is up to us be safe providers, and if that means collaborating with a physician or another provider regardless of the state law, then we must do what it takes to keep the patients safety foremost even in a state that allows complete autonomy as soon as one receives their APRN license.

References

American Association of Nurse Practitioners. Retrieved from https://www.aanp.org/legislation-regulation/state-legislation/statepractice-environment

American Medical Association. (n.d.). State law chart: Nurse practitioner prescriptive authority … https://www.ama-assn.org/system/files/2020-02/ama-chart-np-prescriptive-authority.pdf.

American Nurses Association. (2018). Retrieved from https://www.nursingworld.org/ American Nursing Credentialing Center.

New Hampshire Board of Nursing. (2018). Retrieved from https://www.oplc.nh.gov/nursing

Nurse Practice Act (n. d.). Occupations and Professions: Nurse Practice Act section 326-B:2. Retrieved from: http://www.gencourt.state.nh.us/rsa/html/XXX/326-B/326-B-2.htm Papadakis, M, McPhee, S, Rabow, M (2017) Current Medical Diagnosis & Treatment (56th ed). New York, NY: McGraw Hill. Sabol, V (2017). APRN Gerontology Certification. Geriatric Nursing, 38 (4) 365. Doi: 10.1016/

How to get information about obtaining a dea number. American Association of Nurse Practitioners. (n.d.). https://www.aanp.org/practice/practice-management/business-resources-for-nurse-practitioners/how-to-order-a-dea-number.

New Hampshire Nurses Association. (2021, August). New Hampshire Nurses Association | Nursing Network. https://nhnurses.nursingnetwork.com/nursing-news/185743-changes-in-the-laws-governing-advanced-directives-polst-and-medical-surrogacy-in-new-hampshire.

ANSWER

Response Essay

 An insight from the post

From the article, it is manifest that there are guidelines set by the Nurse Practice Act and are meant to outline the roles and responsibilities of each nurse practitioner. According to the article, New Hampshire, just like many other states, has its guidelines with various acts and certification processes for the nurses. Licensing of nurses is vital for any state to ensure that qualified nurses are in place and that quality health care is offered to the patients. According to the article, relevant bodies are given the authority and independence about making decisions about the health care of individuals, which has helped boost the quality of health care offered in the State. Just like New Hampshire, New Jersey’s RNs and LPNs are also licensed by a governing body referred to as the New Jersey Board of Nursing (Nursinglicensure.org, 2021). The board accredits nursing programs within the State. It gives accreditation to the nurses and ensures that the high quality of nurses and health care, in general, is attained.

Additional actions 

The Nursing regulation bodies in New Hampshire can additionally start collaborating and working with other regulatory bodies from other States in the country. This is since collaboration amongst different bodies can help enhance the quality of health care in the entire country (Moss, Seifert, & O’Sullivan, 2016). Through collaboration with other bodies, the various parties can brainstorm and develop new and better innovations that will positively affect the quality of healthcare provided to patients.

A way to advocate for the profession

To advocate for the profession, nurses can support the legal system for better treatment, legal options, and payment solutions for all patients. Nurses and the relevant bodies can also propose changes in the medical processes to ensure that it is available for all patients regardless of their social status (Tomajan, 2012). Ethics is also a  vital part of building a solid advocacy strategy. Medical professionals and other relevant bodies need to adhere to specific ethical standards in their jobs.

References

Moss, E., Seifert, P. C., & O’Sullivan, A. (2016). Registered Nurses as Interprofessional Collaborative Partners: Creating Value-Based Outcomes.

Nursinglicensure.org. (2021). Nursing License Requirements in New Jersey: Become a Nurse in NJ. Retrieved from https://www.nursinglicensure.org/state/nursing-license-new-jersey/

Tomajan, K. (2012). “Advocating for Nurses and Nursing” OJIN: The Online Journal of Issues in Nursing Vol. 17.