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Pennsylvania nursing Certification and Licensure

Pennsylvania nursing Certification and Licensure

Nursing Experts

Pennsylvania nursing Certification and Licensure

Pennsylvania is considered a reduced practice state, which means that a nurse practitioner must practice under a physician with a collaboration agreement outlining their joint practice (ANA,2021). Under a collaboration agreement, a nurse practitioner can deliver many health care services such as diagnose medical conditions, develop and implement treatment plans, order and perform diagnostic tests, and order and manage medications (Pennsylvania Coalition of Nurse Practitioners, 2021). Physician availability must be also outlined in the agreement. However, recently the PA senate passed bill 717 trying to change current practice. The proposed bill would allow nurse practitioner’s the ability to practice independently in the state after participating in at least a 3-year collaboration agreement with a physician (Phillips, 2019). This bill has a lot of support but has also met resistance by the house and is still in process of potentially becoming Pennsylvania law. Although nurse practitioners cannot practice independently currently, they are recognized in the state as primary care providers.

A nurse practitioner in Pennsylvania must have an RN license, successfully complete a master’s degree or post master’s certificate nurse practitioner program, and obtain national certification before applying for a Pennsylvania state license (Nursinglicensure.org, 2020). Application can be completed online with the Pennsylvania licensing system (PALS) and is approved by the state board of nursing. License renewal is every two years with a 30 continuing education hours requirement (AANP, n.d.).

A nurse practitioner in Pennsylvania can prescribe drugs, devices and Schedule II-V controlled substances (Pennsylvania Coalition of Nurse Practitioners, 2021). Buprenorphine-containing products can be administered by a nurse practitioner if both the nurse practitioner and collaborating physician are certified and trained accordingly (Pennsylvania Coalition of Nurse Practitioners, 2021). Prescriptive authority must also be outlined in the collaboration agreement between the physician and nurse practitioner. To obtain a DEA number, one must apply online through the U.S. Department of Justice, Drug Enforcement agency. Once issued, it will need renewed every three years.

There are multiple nurse practitioner organizations specific to Pennsylvania. Some are location specific within the state but share similar goals and mission statements. These organizations are there to support and promote practice through legislative and regulatory processes, provide continuing education, and advocate the roles of nurse practitioners in today’s health care (Pennsylvania Coalition of Nurse Practitioners, 2021).  The Pennsylvania Coalition of Nurse Practitioners (PCNP), Nurse Practitioner Assoc of Southwestern Pennsylvania (NPASP), Nurse Practitioners of Central Pennsylvania (NPCP), and Nurse Practitioners of Northeastern Pennsylvania (NEPA) are just some examples of the organizations available to Pennsylvania nurse practitioners.

References

AANP. (n.d.). Pennsylvania State Policy Fact Sheet. American association of nurse practitioners. Retrieved August 31, 2021, from https://www.aanp.org/advocacy/state/state-practice-environment/state-policy-fact-sheets/pennsylvania-state-policy-fact-sheet

AANP. (2021). State practice environment. American Association of Nurse Practitioners. Retrieved August 31, 2021, from https://www.aanp.org/advocacy/state/state-practice-environment

U.S. Department of Justice- Diversion control division. (n.d.). General information. Registration Procedures. Retrieved August 31, 2021, from https://www.deadiversion.usdoj.gov/drugreg/index.html

Nursinglicensure.org. (2020, November 4). Pennsylvania crnp requirements – how to become a nurse practitioner in pa. NursingLicensure.org – A more efficient way to find nursing license requirements in your state. Retrieved August 31, 2021, from https://www.nursinglicensure.org/np-state/pennsylvania-nurse-practitioner/

Pennsylvania Coalition of Nurse Practitioners. (2021). Scope of practice. Retrieved August 31, 2021, from https://www.pacnp.org/page/ScopeofPractice

Phillips, J. (2019, June 13). Pa senate bill to expand role of nurse practitioners – rcpa. RCPA. https://www.paproviders.org/pa-senate-bill-to-expand-role-of-nurse-practitioners/

 

Discussion: Certification and Licensure

Now that you are in your final course in your program, it is time to turn in earnest to preparing for certification and licensure. You will need to take and pass a national AGPCNP certification exam.  Once certified, you will then be eligible to apply for licensure as an advanced practice registered nurse (APRN) in the state desired. It will be up to you to ensure you are knowledgeable about the practice agreements, scope of practice, and prescriptive authority in your state.

Photo Credit: Getty Images/iStockphoto

Although there is a movement called the APRN Consensus Model to standardize NP regulations nationally, it is still the case that requirements vary state to state. In some states, NPs may establish independent practice without the supervision of an MD. Additionally, states are currently categorized as either allowing full practice, reduced practice, or restricted practice. Full practice states allow NPs to evaluate, order diagnostics, diagnose, and treat patients. They are licensed under the exclusive authority of the state board of nursing for the appropriate state. Many states may require prescriptive authority protocols in addition to collaborative agreement.

Another important area to consider and plan for is prescriptive authority. Prescriptive authority is granted under state law by the appropriate board. The board granting prescriptive authority may be the medical board, state board of pharmacy, or nursing board for the appropriate state licensure being pursued. The authority to write for a controlled substance is granted at a federal level and is verified through the Drug Enforcement Administration (DEA) by the appropriate state board. Drug Enforcement Agency registration is granted at the federal level and has additional requirements/fees for the registration process.

Finally, the legal landscape for NPs is constantly changing as the status of NPs as providers improves on a national level. Legislative changes may occur annually, bi-annually, or during an emergency legislative meeting at the state or federal level. These legislative sessions and any subsequent changes will significantly impact your scope of practice as a nurse practitioner.

For this Discussion, you examine professional issues for your state, including certification and licensure, scope of practice, independent practice, prescriptive authority, and legislative activities.

To prepare:

  • Review practice agreements in your state.
  • Identify whether your state requires physician collaboration or supervision for nurse practitioners and, if so, what those requirements are.
  • Research the following:
    • How do you get certified and licensed in your state?
    • What is the application process for certification in your state?
    • What is the primary nurse licensure office resource website in your state?
    • How does your state define the scope of practice of a nurse practitioner?
    • What is included in your state’s practice agreement?
    • How do you get a Drug Enforcement Agency (DEA) license?
    • How does your state describe a nurse practitioner’s controlled-substance prescriptive authority and what nurse practitioner drug schedules are nurse practitioners authorized to prescribe?
    • In what legislative and advocacy activities are your state nurse practitioner organization(s) involved?

By Day 3

Post a summary of your findings on your state based on the questions listed above. Explain the types of regulations that exist and the barriers that may impact nurse practitioner independent practice in your state. Be specific. Also, describe what surprised you from your research.

Read
a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on 2 different days in one or more 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.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

 

In the state of Pennsylvania, nurse practitioners are recognized as Certified Registered Nurse Practitioners (CRNPs) once licensed. CRNPs must have a master’s degree as well as have passed the certification exam. Once licensed, CRNPs must renew their license biannually (Pennsylvania Department of State, 2021).

In order to become certified as a CRNP in the state of Pennsylvania, the student must apply through the Pennsylvania State Board of Nursing. The Pennsylvania State Board of Nursing is the entity responsible for all nursing licensing in Pennsylvania. Once the student has completed all of their MSN coursework, official transcripts must be sent to the state BON. The student must also have current standing as a licensed registered nurse in the state. Finally, prescriptive authority approval must be obtained by completing required pharmaceutical education and submitting a separate application to the board (Buppert, 2021). Additional steps to the application process include child abuse clearance, criminal history check, educational verification and national certification.

Pennsylvania is a restricted practice state in that it does require collaboration with a supervising physician (Pennsylvania Coalition of Nurse Practitioners, 2021). CRNPs are also required to have a collaborative agreement in order to prescribe. CRNPs may prescribe schedule II-V controlled substances as outlined in the prescribing agreement with the supervising physician.

In Pennsylvania, a CRNP is defined as,

 “A professional nurse licensed in this Commonwealth who is certified by the Board in a specialty and who, while functioning in the expanded role as a professional nurse, performs acts of medical diagnosis or prescription of medical therapeutic or corrective measures in collaboration with a physician licensed to practice in this Commonwealth and in accordance with the act and this subchapter. Nothing in this subchapter is to be deemed to limit or prohibit a professional nurse from engaging in those activities which constitute the practice of professional nursing as defined in section 2 of the act (63 P.S. § 212). (Buppert, 2021).

 

One of the biggest barriers to being a CRNP in PA, as in many other states, is the requirement to collaborate with a physician. I grew up in MA where NPs can practice independently of physicians. Massachusetts is one of twenty-three states to enforce this regulation. The requirement of nurse practitioners to work with collaborating physicians is beneficial, especially as a new nurse practitioner, to provide a resource to the new CRNP. However, this can limit patient access to care, especially in rural areas. Nurse practitioners who wish to branch out on their own are unable to do so without having standing practice agreements with a collaborating physician.

References

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

Pennsylvania Department of State. (2021). Board of Nursing. Retrieved from https://www.dos.pa.gov

Pennsylvania Coalition of Nurse Practitioners. (2021). Scope of Practice. Retrieved from https://www.pacnp.org

NRNP_6565_Week1_Discussion_Rubric

Excellent
Point range: 90–100
Good
Point range: 80–89
Fair
Point range: 70–79
Poor
Point range: 0–69
Main Posting:

Response to the discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.

Points Range: 40 (40%) – 44 (44%)
Thoroughly responds to the discussion question(s).

Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.

No less than 75% of post has exceptional depth and breadth.

Supported by at least 3 current credible sources.

Points Range: 35 (35%) – 39 (39%)
Responds to most of the discussion question(s).

Is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module.

50% of the post has exceptional depth and breadth.

Supported by at least 3 credible references.

Points Range: 31 (31%) – 34 (34%)
Responds to some of the discussion question(s).

One to two criteria are not addressed or are superficially addressed.

Is somewhat lacking reflection and critical analysis and synthesis.

Somewhat represents knowledge gained from the course readings for the module.

Post is cited with fewer than 2 credible references.

Points Range: 0 (0%) – 30 (30%)
Does not respond to the discussion question(s).

Lacks depth or superficially addresses criteria.

Lacks reflection and critical analysis and synthesis.

Does not represent knowledge gained from the course readings for the module.

Contains only 1 or no credible references.

Main Posting:

Writing

Points Range: 6 (6%) – 6 (6%)
Written clearly and concisely.

Contains no grammatical or spelling errors.

Further adheres to current APA manual writing rules and style.

Points Range: 5 (5%) – 5 (5%)
Written concisely.

May contain one to two grammatical or spelling errors.

Adheres to current APA manual writing rules and style.

Points Range: 4 (4%) – 4 (4%)
Written somewhat concisely.

May contain more than two spelling or grammatical errors.

Contains some APA formatting errors.

Points Range: 0 (0%) – 3 (3%)
Not written clearly or concisely.

Contains more than two spelling or grammatical errors.

Does not adhere to current APA manual writing rules and style.

Main Posting:

Timely and full participation

Points Range: 9 (9%) – 10 (10%)
Meets requirements for timely, full, and active participation.

Posts main discussion by due date.

Points Range: 8 (8%) – 8 (8%)
Posts main discussion by due date.

Meets requirements for full participation.

Points Range: 7 (7%) – 7 (7%)
Posts main discussion by due date.
Points Range: 0 (0%) – 6 (6%)
Does not meet requirements for full participation.

Does not post main discussion by due date.

First Response:

Post to colleague’s main post that is reflective and justified with credible sources.

Points Range: 9 (9%) – 9 (9%)
Response exhibits critical thinking and application to practice settings.

Responds to questions posed by faculty.

The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.

Points Range: 8 (8%) – 8 (8%)
Response has some depth and may exhibit critical thinking or application to practice setting.
Points Range: 7 (7%) – 7 (7%)
Response is on topic, may have some depth.
Points Range: 0 (0%) – 6 (6%)
Response may not be on topic, lacks depth.
First Response:

Writing

Points Range: 6 (6%) – 6 (6%)
Communication is professional and respectful to colleagues.

Response to faculty questions are fully answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in Standard, Edited English.

Points Range: 5 (5%) – 5 (5%)
Communication is mostly professional and respectful to colleagues.

Response to faculty questions are mostly answered, if posed.

Provides opinions and ideas that are supported by few credible sources.

Response is written in Standard, Edited English.

Points Range: 4 (4%) – 4 (4%)
Response posed in the discussion may lack effective professional communication.

Response to faculty questions are somewhat answered, if posed.

Few or no credible sources are cited.

Points Range: 0 (0%) – 3 (3%)
Responses posted in the discussion lack effective communication.

Response to faculty questions are missing.

No credible sources are cited.

First Response:

Timely and full participation

Points Range: 5 (5%) – 5 (5%)
Meets requirements for timely, full, and active participation.

Posts by due date.

Points Range: 4 (4%) – 4 (4%)
Meets requirements for full participation.

Posts by due date.

Points Range: 3 (3%) – 3 (3%)
Posts by due date.
Points Range: 0 (0%) – 2 (2%)
Does not meet requirements for full participation.

Does not post by due date.

Second Response:

Post to colleague’s main post that is reflective and justified with credible sources.

Points Range: 9 (9%) – 9 (9%)
Response exhibits critical thinking and application to practice settings.

Responds to questions posed by faculty.

The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.

Points Range: 8 (8%) – 8 (8%)
Response has some depth and may exhibit critical thinking or application to practice setting.
Points Range: 7 (7%) – 7 (7%)
Response is on topic, may have some depth.
Points Range: 0 (0%) – 6 (6%)
Response may not be on topic, lacks depth.
Second Response:

Writing

Points Range: 6 (6%) – 6 (6%)
Communication is professional and respectful to colleagues.

Response to faculty questions are fully answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in Standard, Edited English.

Points Range: 5 (5%) – 5 (5%)
Communication is mostly professional and respectful to colleagues.

Response to faculty questions are mostly answered, if posed.

Provides opinions and ideas that are supported by few credible sources.

Response is written in Standard, Edited English.

Points Range: 4 (4%) – 4 (4%)
Response posed in the discussion may lack effective professional communication.

Response to faculty questions are somewhat answered, if posed.

Few or no credible sources are cited.

Points Range: 0 (0%) – 3 (3%)
Responses posted in the discussion lack effective communication.

Response to faculty questions are missing.

No credible sources are cited.

Second Response:
Timely and full participation
Points Range: 5 (5%) – 5 (5%)
Meets requirements for timely, full, and active participation.

Posts by due date.

Points Range: 4 (4%) – 4 (4%)
Meets requirements for full participation.

Posts by due date.

Points Range: 3 (3%) – 3 (3%)
Posts by due date.
Points Range: 0 (0%) – 2 (2%)
Does not meet requirements for full participation.

Does not post by due date.

Total Points: 100

 

Nurse Practitioner Practice Agreement, Certification, and Licensure in Pennsylva

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