Discussion: Certification and Licensure Plan NRNP 6675
Discussion: Certification and Licensure Plan NRNP 6675
Now that you are in the 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 the national PMHNP 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 (California).
Although a movement called the APRN Consensus Model is attempting to standardize NP regulations nationally, it is still the case that requirements vary state to state. In some states, NPs may establish an 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. The appropriate board, which may be the medical board, state board of pharmacy, or nursing board, grants prescriptive authority under state law for the appropriate state licensure.
The federal government grants the authority to write for a controlled substance, and the Drug Enforcement Administration (DEA) verifies this action through by the appropriate state board. Drug Enforcement Agency registration is granted at the federal level and has additional requirements/fees for the registration process.
In this Discussion, you will locate and review the practice agreements in the state in which you plan to practice, identify potential collaboration requirements in your state, and understand the certification and licensing process that you will need to follow.
Assignment 1: Evaluation and Management E/M NRNP 6675
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 as an Advanced Practice Registered Nurse (APRN) in your state?
What is the application process for certification in your state?
What is your state’s board of nursing website?
How does your state define the scope of practice of a nurse practitioner?
What is included in your state practice agreement?
How do you get a DEA license?
Does your state have a prescription monitoring program (PMP)?
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?
By Day 3 of Week 1
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.
Week 1: Nurse Practitioner Professional Issues
Psychiatric-mental health nurse practitioners are committed to the assessment, diagnosis, and treatment of psychiatric disorders in individuals and groups through psychotherapy and medication. Since the role of the PMHNP carries such responsibility, it is no surprise that there is a rigorous path to obtain and maintain your PMHNP certification and licensure.
PMHNPs currently have only one choice for certification, which is through the American Nurses Credentialing Center (ANCC). The ANCC offers the psychiatric/mental-health nurse practitioner (across the lifespan) board certification (PMHNP-BC). In many states, board certification is a necessary prerequisite to receiving an NP license. Even if board certification is not a requirement for state licensure, it may be a requirement to receive privileges in various hospitals and other health care facilities. Malpractice insurance providers may also require board certification prior to issuing coverage to NPs.
This week, you will review your state specific PMHNP certification and licensure requirements and scope of practice, as well as prescriptive authority issues.
Summarize nurse practitioner certification and licensure processes
Explain state-specific scope of practice for psychiatric-mental health nurse practitioners
Explain state-specific restrictions or limitations for practice
Explain nurse practitioner prescriptive authority and DEA registration processes
Required Readings (click to expand/reduce)
American Association of Nurse Practitioners. (2020). State practice environment. https://www.aanp.org/advocacy/state/state-practice-environment
On the map on the webpage, click on your state and review. After you complete the PMHNP Program, pass the certification exam, and get a job, you will need to revisit this website to apply for the privilege to practice as an APRN with your state Board of Nursing.
American Psychiatric Association. (2020). Telepsychiatry. https://www.psychiatry.org/psychiatrists/practice/telepsychiatry
Buppert, C. (2021). Nurse practitioner\’s business practice and legal guide (7th ed.). Jones & Bartlett Learning.
Chapter 1, What Is a Nurse Practitioner?
Chapter 2, Nurse Practitioner Scope of Practice
Chapter 3, State Regulation of the Nurse Practitioner Practice
Chapter 4, Federal Regulation of the Nurse Practitioner Profession
Chapter 5, Prescribing
Centers for Disease Control and Prevention. (2020). Using telehealth to expand access to essential health services during the COVID-19 pandemic. https://www.cdc.gov/coronavirus/2019-ncov/hcp/telehealth.html
Centers for Medicare & Medicaid Services. (2019). National provider identifier standard (NPI). https://www.cms.gov/Regulations-and-Guidance/Administrative-Simplification/NationalProvIdentStand
The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions.
Drug Enforcement Administration Diversion Control Division. (2020). Registration. https://www.deadiversion.usdoj.gov/drugreg/index.html
This site contains information about applying for your DEA registration number. This number is required for writing prescriptions.
After completing PMHNP Program and passing the PMHNP certification exam, complete the DEA application to request prescriptive privileges. Your DEA number will be renewable every five years.
National Panel for Psychiatric Mental Health NP Competencies. (2003). Psychiatric-mental health nurse practitioner competencies. National Organization of Nurse Practitioner Faculties (NONPF). https://cdn.ymaws.com/www.nonpf.org/resource/resmgr/imported/PMHNPcomps03.pdf
Stewart, J. G., & DeNisco, S. M. (2019). Role development for the nurse practitioner (2nd ed.). Jones & Bartlett Learning.
Chapter 1, Historical Perspectives: The Art and Science of Nurse Practitionering
Nurse Practitioner Core Competencies
Nurse Practitioners’ Unique Role
Chapter 13, Quality, Safety, and Prescriptive Authority
Substance Abuse and Mental Health Services Administration. (2020). Become a buprenorphine waivered practitioner. https://www.samhsa.gov/medication-assisted-treatment/buprenorphine-waiver-management/apply-for-practitioner-waiver
This site contains information about applying for a practitioner waiver to prescribe or dispense buprenorphine under the Drug Addiction Treatment Act of 2000 (DATA 2000).
After you obtain a Drug Enforcement Agency (DEA) number and completed 24-hour medication-assisted treatment (MAT) waiver training, you may apply to Substance Abuse and Mental Health Services Administration (SAMSHA) for MAT waiver to be able to prescribe Schedule III, IV, or V opioid drugs for the maintenance and detoxification treatment of opioid use disorders relapse prevention.
Zakhari, R. (2021). The psychiatric-mental health nurse practitioner certification review manual. Springer Publishing Company.
Chapter 2, The Role of the Psychiatric-Mental Health Nurse Practitioner: Regulations and Scope of Practice
Chapter 3, Theoretical Foundations of Care and Nonpharmacological Therapies
Consult these professional organization websites as needed.
American Psychiatric Nurse Association (APNA) https://www.apna.org
International Society of Psychiatric-Mental Health Nurses (ISPN) www.ispn-psych.org
National Alliance on Mental Illness (NAMI) https://www.nami.org
National Council for Behavioral Health (NCBH) www.thenationalcouncil.org
National Institute of Mental Health (NIMH) https://www.nimh.nih.gov/index.shtml
Substance Abuse and Mental Health Services Administration (SAMHSA) www.samhsa.gov
Discussion: Certification and Licensure Plan NRNP 6675 Example
I intend to practice in California after completing my nursing and receiving the necessary licensure. The California Board of registered nursing licenses and certifies nurses for practice in the state. To qualify for the licensure and certification to practice in California, one must have completed the relevant level of nursing training and passed the relevant nursing council examination.
For certification as advanced practice registered nurses (APRNs), the applicants must submit copies of their transcripts electronically and only through the nursing school, college, university, or the organization providing the transcripts. Most importantly, the applicant must first be licensed as a registered nurse (RN) in the state of California.
Applying for certification and licensure as an APRN is entirely done online through the board’s website and the board’s email (California Board of Registered Nursing, n.d.). Various documents required are stated and submitted through email. The website defines the scope of practice for various APRNs and public health nurses (Huynh & Haddad, 2021). The state of California has multiple regulations that define the nursing practice.
The California Nursing Practice Act defines these regulations as well as the bruising scope for licensed nurses in the state (California Board of Registered Nursing, 2013). The Drug Enforcement Authority (DEA) certification application is made through the United States Department of Justice. What surprised me from my research was that California is one of the few states that grant nurses full practice authority.
Physical supervision and collaboration are not required for independent practice. However, this authority is only granted to these registered APRNs who have completed at least 4600 hours of practice under physician supervision before the transition to full authority. The timeline restriction is one of the barriers that I expect to meet during practice. However, I hope it is for the best. This law was passed and will be applied into practice from 2023 (Nurse.org, n.d.). California is a state that I cherish, and can wait to practice and enjoy the full authority of practice.
California Board of Registered Nursing. (n.d.). Advanced practice and certification. Rn.ca.Gov. Retrieved February 27, 2022, from https://www.rn.ca.gov/applicants/ad-pract.shtml
California Board of Registered Nursing. (2013). California nursing practice act. Board of Registered Nursing. https://www.rn.ca.gov/pdfs/regulations/npr-i-15.pdf
Huynh, A. P., & Haddad, L. M. (2021). Nursing Practice Act. In StatPearls [Internet]. StatPearls Publishing.
Nurse.org. (n.d.). California grants Nurse Practitioners full practice authority by 2023. Nurse.Org. Retrieved February 27, 2022, from https://nurse.org/articles/california-nurse-practitioners-full-practice/