Nursing Practice Regulation

Nursing Practice Regulation

Introduction

Board of Nursing (BON) refers to government regulatory bodies whose responsibilities are setting the standards for safe nursing practices. BONs are situated in all the fifty-nine states of the United States of America and are members of the National Council of State Boards of Nursing (NCSBN) (Lyon & Wade, 2016). The states board of nursing decides the scope of practices for a nurse within its state. The main objectives for each state BON are to issue nursing licenses, certification and accreditation following the nursing practice act.

BON Analysis

Every state has its set board of nursing standards that govern the nursing practice. The expectation of each one of them is to regulate the practice of caregiving by ensuring the set policies are observed. The BON is mandated to preserve and safeguard the welfare and health of the public by employing only competent and qualified caregivers (Russell, 2017). BON is concerned with four broad focus areas of nursing; education, practice, licensing, and discipline. In terms of education, the board defines the curriculum and programs that nursing expertise need to major in for qualification (Spector, Hooper, Silvestre, & Qian, 2018). Such programs may include; online nursing programs, continuing education unit, simulation standards for schools, and evidence-based nursing education.

Based on the Nursing Practice Act, the board regulates the clinician services by ensuring that each state as clearly authenticated standards. These policies define how nurses should perform care and manage the delegated duties to members (Lyon & Wade, 2016). In addition to education and practice, the board is also responsible for licensing. This is the process by which the board grants authority to individuals to engage in clinical services. BON arrives at such decisions after considering the qualifications and credentials of the aspiring individuals. Licensing entails three procedures (Brown, 2017); verification of graduation from an approved medical teaching institute, approval of successful completion of the National Council License Exam, and investigation of the criminal background of the clinical aspirants.

The BON is also responsible for overseeing the discipline of nursing practitioners. It ensures that the public is protected from harm that may be intentionally or unintentionally performed by clinicians (Oyeleye, 2019). According to the Nursing Practice Act, BON is allowed to issue appropriate levels of discipline that may extend to the termination of the nursing license (Lyon & Wade, 2016). Depending on the intensity of the harm caused, the board may strategize to administer discipline forms such as monetary fines, limited license restriction, and license suspension.

Registered Nurse First Assistant

According to the states board of nursing, RNFA is defined as a registered nurse first assistant. RN first assistants must have an associate Bachelor of Science degree in nursing or a diploma from a recognized hospital nursing school (Lesley, 2018). These practitioners work alongside surgeons in the OR to provide care to patients under operation. The scope of work for an RNFA varies depending on the state; therefore, the licensee should be aware of the acceptable practices in the different environments (Oyeleye, 2019). RNFA functions are delegated by surgeons, as stated by the professional associations for nursing practice. These associations say that RNFA must practice according to the institutional policies of the facility in which they are delivering services. The board also states that RNFA’s work should be based in accordance with their job description and delineated privileges. According to the US legal justice system framework, RNFAs have a duty to adhere to the standard of care measured by their specialized skills and knowledge that are in line with the current standard care of the profession. For instance, the duties of RNFAs to patients exists until the surgery is completed or incase an alternative caregiver takes over (Lesley, 2018). In case of compensation or injury, the RNFA has to act appropriately so that in the event of a problem, the jury recognizes the efforts of the practitioner were consistent and sincere.

Regulations of State Board of Nursing on APRN

Advanced practice registered nurses (APRNs) are registered nurses who receive additional education, in the form of master’s degree or higher within one of the four advanced practice roles. These advanced practice roles are; anaesthetists, nurse-midwives, clinical nurse specialists and nurse practitioners (Wholihan & Tilley, 2016). The board regulates APRNs through licensing, after approval of completion of appropriate medical programs. The board also requires the advanced practice registered nurses to partake supplementary exams and possess additional professional requirements. However, these regulations vary in every state.

Consensus Model for APRN Regulation

The consensus model for advanced practice registered nurses was developed by the APRN Consensus Work Group and the National Council of State Board of Nursing (NCSBN). The scheme guides for different states to adopt uniformity in the regulation of the APRN roles (Litchman et al., 2018). It also aims to unite the nursing programs, the public, the medical practitioners and the state and national legislature in understanding the roles of APRNs. The model was first developed in 2008 and was a result of a series of discussions around defining the part of advanced practice registered nurses (Russell, 2017). It also outlines the different educational and clinical standards that APRNs must meet to earn national certification, state licensure and practice privileges.

The model is based on four essential nursing elements; licensing, accreditation, certification, and education. Licensing pertains granting of authority to work as a clinician. The APRN Consensus Model views accreditation as a review and approval by a recognized agency of education degree in the specified nursing roles (Sabo, Chesney, Tracy, & Sendelbach, 2017). Moreover, the scheme defines certification as where the board of nursing formally acknowledges the skills and knowledge acquired according to the stated terms of the nursing profession. The model identifies an APRN practitioner as a person who has; completed an accredited graduate-level education program in one of the four recognized APRN roles; one who has excelled in a national examination that measures APRN, and one who has acquired advanced clinical knowledge preparing him to offer direct care to patients.

Up to date, the model has had a significant impact on national APRN certification organizations. For instance, the American Nurses Credentialing Centre (ANCC), consolidated her streamlined certification options to incorporate the recommendations outlined in the model. The fervent changes made in the model have helped improve the educational requirements for certification and licensing (Sabo et al., 2017). This has helped create a pool of professional workforce that will continually satisfy the growing demand for medical services. Besides that, the model outlines the four advanced roles of APRNs and their corresponding certifications. For instance, it identifies nursing practitioners and their respective parts of diagnosing and treating patients, providing physical examinations and health assessments prior surgeries, and patient case management (Litchman et al., 2018). According to the model, clinical nurse specialists should work to improve the patient’s health outcomes through mentorship, patient education, among others. It identifies certified health anaesthetists as specialists who provide full-spectrum anaesthesia across the patients’ lifespan in various diverse environments (Russell, 2017). The certified nurse-midwives are entitled to offer a full range of reproductive health care services which include, gynaecological care, preconception counselling, postpartum care, and infant care.

Where RNFA fits in the Consensus Model

In the new proposed model, RNFAs are fit for certification and licensing. After acquiring a degree or diploma in a recognized institution, registered nurses first assistants should be certified and obtain licenses from the states board of nursing. The RNFAs also fall in the field of nursing practitioners, but this entirely depends on the specific states’ board of nursing restriction on such advanced roles.

Conclusion

As the world diversifies, so does the services provided need to. In terms of professional fields, the various regulatory bodies need to advance and be flexible to accommodate the multiple changes in such areas. The health sector, for instance, requires a pool of qualified and skilled personnel who will execute their services satisfactorily. Development of regulatory bodies such as the states Board of Nursing and the National Council of State Board of Nursing has helped to create a reliable healthcare staff. These bodies have enabled the creation of outlined standards, guidelines and requirements that govern the nursing practice.

Additionally, the body has provided alternative educational programs that professional caregivers must possess to qualify for handling patients. Through the continued inventions, the consensus model was developed, which acts as a linker between the states regulatory bodies, the education programs, the clinicians, and the public. It helps bring uniformity in the scope of work of the medical practitioners.

References

Brown, L. A. (2017). License Protection for Nurse Practitioners. The Journal for Nurse Practitioners, 13(2), e83-e85.

Lesley Doughty, R. N. (2018). The Registered Nurse First Surgical Assistant Paving the way. The Dissector, 46(2), 28-31

Litchman, M. L., Schlepko, T., Rowley, T., McFarland, M., & Fiander, M. (2018). A scoping review of Advanced Practice Registered Nurses Consensus Model outcomes: Part four of a four-part series on critical topics identified by the 2015 Nurse Practitioner Research Agenda. Journal of the American Association of Nurse Practitioners, 30(12), 710-723.

Lyon, K. C., & Wade, A. R. (2016). Is your state board of nursing an “arm of the state”?. Journal of Nursing Regulation, 7(3), 48-51.

Oyeleye, O. A. (2019). The Nursing Licensure Compact and Its Disciplinary Provisions: What Nurses Should Know. OJIN: The Online Journal of Issues in Nursing, 24(2).

Sabo, J. A., Chesney, M., Tracy, M. F., & Sendelbach, S. (2017). APRN consensus model implementation: the Minnesota experience. Journal of Nursing Regulation, 8(2), 10-16.

Spector, N., Hooper, J. I., Silvestre, J., & Qian, H. (2018). Board of Nursing approval of registered nurse education programs. Journal of Nursing Regulation, 8(4), 22-31.

Russell, K. A. (2017). Nurse practise acts guide and govern Update 2017. Journal of Nursing Regulation, 8(3), 18-25.

Wholihan, D., & Tilley, C. (2016). Fundamental skills and education for the palliative advanced practice registered nurse. Advanced practice palliative nursing, 13-22.