Advanced Practice Registered Nurses Consensus Model Discussion Questions
What is the status of implementation of the advanced practice registered nurses Consensus Model in your state? Discussion should include the following: What titles are used for APRNs? Are all four APRN roles recognized in your state? If not, which roles are not recognized? Is the term “licensure” used for APRN roles in your state? If not, what term(s) are used? Is a graduate or post graduate degree required in your state to practice in an advanced practice role? Is national certification required in your state to practice in an advanced practice role? Does APRN roles allow for independent practice in your state? Not independent? No authority? Do the APRN roles allow for independent prescribing in your state? Not independent? No authority?
Is there legislation currently being proposed in your state legislature regarding the APN role? Is the legislation related to the APRN consensus Model? To find out, go to the state legislature websites and search for current state legislation. Use search terms such as ‘nurse’, ‘nursing’, etc.
Implementation of Consensus Model for APRN Practice Licensure, Accreditation, Certification, and Licensure in Florida – Sample Paper
Introduction
The United States has the chance to change the health care system and nurses should and can play a basic role in this change. In order, to attain this transformation, nurses need to practice their training and their education fully. Nevertheless, advanced practice registered nurses (APRNs) continue to be troubled by practice restrictions scope and reimbursement equality (Ncsbn, 2014). The APRN Consensus Model is a model of a health policy that defines practice regulation of APRN that include requirement for Licensure, Accreditation, Certification, and Education. The consensus model offers states guidance to create uniformity in APRNs LACE regulation. States are required to have implemented the regulations of Consensus Model by 2015. Although a number of states have implemented some consensus model aspects, there are still different variations from one state to another (Phillips, 2012). This paper evaluates the implementation of Consensus model in Florida.
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Consensus Model in Florida
Different states have attained different levels of APRN. In Florida, there are three general specialization areas recognized for advanced practice nurses. They include certified registered nurse anesthetist (CRNA), certified nurse midwife (CNM), and nurse practitioner (NP). The Clinical nurse specialist (CNS) is acknowledged as an RN license basic upgrade, but not as a general specialty area in advanced practice nursing. Licensing seems to be the most embraced aspect of consensus model. This goes hand in hand with the educational attainment whereby under the Florida education department rules, a nursing education program need to be accredited by one the two education departments of the United States.
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The Florida acknowledged nursing program accrediting agencies include the Commission on Collegiate Nursing Education (CCNE) and the National League of Nursing Accrediting Commission (NLNAC). The APRNs practice scope varies extensively by specialty and state. For instance, in the nurse practitioners (NPs) case, most of APRN numerous roles permit NPs to treat and diagnose without involvement of a physician. However, others including Florida require a formal association between a physician and an NP, documented in writing. In Florida, APRN is known as ARPN. This is referred to as advanced registered nurse (ARNPs) (Graduatenursingedu.org, 2 014).
Currently Florida is embracing the four ARNP aspects that include licensing, education, certification and credential. The term licensure is employed in ARNP roles in Florida. In this case education is always the first ARNP achievement where every nurse to be involved in ARNP practices must achieve a degree in his or her area of specialization. These individuals must also complete an advanced pharmacotherapeutics or pharmacology courses at post graduate ARNP education level to qualify for licensing. Although Florida Nursing Board does not does not list ARNP licenses specialization areas, a number of ARNPs specialize in a certain patient population or role. Certification is needed for the three of the acknowledged ARNPs practices by the Florida Board of Nursing. However, independent agencies of national certification have their own specific educational, examination and experience requirements. Licensing is then offered to any nurse with social security number and it involves completion of ARNP licensing form. The operational Licensing renewed is done after every 2 years and checks on the education advancement since the first issue. Thus, it acts as a form of credential to the ARNP qualified individuals. Continues education acts as a requirement for maintaining the ARNP license after every two year. This encourages more learning and knowledge advancement for all nurses who wish to maintain their license (Graduatenursingedu.org, 2014).
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Florida does not allow for independent practices for their ARNP qualified nurses. However, there are currently some efforts trying to negotiate for the advancement of the ARNP licensed nurses in Florida to adopt independent practices. Currently, ARNP in Florida has to work under the supervision of a physician. Similarly, Florida ARNP certified nurses are not allowed to work independently to prescribe any medication to their patients. They still work under physician and any of their practices with the patient must be documented to allow for further intervention by the physician. However, there is currently a bill in the state assembly trying to provide this independence to the ARNPs nurses in the state. ARNPs nurses in Florida also do not have any authority to sign documents such as death certificate and involuntary examination among others (Flan.org, 2014b).
Legislative Involvement
The Florida ARNPs is currently experiencing a number of restrictions in their operation in the state. Currently all ARNPs are currently required to work under the supervision of the physician. In this regard, ARNPs are denied opportunity to diagnose and treat the diagnosed condition. They are denied an opportunity to prescribe medication for any patient including those with simple medical condition. Thus, despite of advanced learning, they still have to work under a physician and the records of each patient must go through a physician for a patient to be treated. In this regard, there has been a legislative in the state pushing for ARNPs independence in the state. The 2014 HB 7071 Advanced Registered Nurse Practitioners (Committee Bill) was placed in Florida State fights to alter the name from ARNP to APRN, provide aptitude to apply for status of independent practice after 2000 hours of post graduate experience in a period of three years, provide DEA licensure, enact international signature authority, provide involuntary commitment signature authority and finally provide the aptitude to sign death certificates. The second bill is the 2014 SB 1352 Healthcare Practitioners (Senator Grimsley) bill. This bill advocates for title change from ARNP to APRN, provision of DEA Licensure to APRNS, and providing psychiatric NPs the aptitude to release a Baker act. This bill has been referenced to rules, judiciary and health policy. ARNPs have also been added in the SB 1646 Telemedicine (Committee bill) need ARNPs to be allowed to provide telemedicine services. The same aspect is also addressed in HB751 Telemedicine services (Cummings and Jones) bill that fights to permit APRNs to offer telehealth services. The Baker act bills section CS/HB 829 and SB 1544 also push to ensure that APRNs nurses are provided the authority to sign the involuntary examination. All these legislatives were provided to change the role of APRNs in the Florida state (Flap.Org, 2014a).
Conclusion
APRN has highly been embraced in Florida by ensuring all the APRN aspects are certified by all individuals wishing to join and remain under APRN regulations. However, besides employing all this effort to acquire all the requirements, APRN nurses in Florida are denied the independency and authority to act in absence of a physician. In this regard, there have been a number of legislatives employed by the Florida state to ensure that ARPNs nurses acquire more independence and authority in their operation (Brassard & Smolenski, 2011).
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