Maryland Registered Nurse Certification and Licensure
Regulation is the exercise of authority over various aspects that stem from the broad spectrum of legislation (Milstead & Short, 2019). Different states have distinct rules and requirements for certification and licensure of advanced practice registered nurses, all aimed at protecting public safety by regulating the activities of healthcare professionals. These regulations, based on the Nurses Practice Act, are enacted by the board of nursing to safeguard the community, ensuring that healthcare practitioners meet the qualifications to practice (Bosse et al., 2017). Additionally, they are responsible for maintaining and continuously updating appropriate practice standards in Maryland Registered Nurse Certification and Licensure.
In Maryland, my home state, the primary requirement for becoming a certified nurse practitioner is to complete an approved nurse practitioner program and pass a board-sanctioned examination (Maryland Board of Nursing, 2019). The Maryland Board of Nursing provides a list of approved NP programs nationwide, including institutions like Walden University. If a program is not on the list, NPs can seek approval as long as it is recognized by the US Department of Education or the Council for Higher Education Accreditation. MBON has designated four approved organizations for board certification, namely, the American Nurses Credentialing Center, the American Academy of Nurse Practitioners, the Pediatric Nursing Certification Board, and the National Certification Corporation. To apply for a Maryland NP license, MBON requires several documents, including a copy of the current RN license, a certification application, a declaration of residency form, a sealed official transcript, a copy of the current national certification, or a letter confirming eligibility for the certification exam. Effective October 2015, an additional requirement mandates that applicants have a mentor for 18 months from the date of application. The mentor must be a Maryland licensed Nurse Practitioner or Physician with a license in good standing (Maryland Board of Nursing, 2019) Maryland Registered Nurse Certification and Licensure.
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NURS 6512 Discussions and Assignments: Advanced Health Assessment and Diagnostic Reasoning
Concerning the scope of practice, NPs in Maryland are recognized as primary care providers after completing 18 months of mentorship with a physician or experienced NP and successfully passing the licensure exam. Maryland NPs have full practice authority without the need for physician supervision, allowing them to perform functions authorized by law, including patient assessments, diagnoses, and ordering and interpreting laboratory tests (Maryland Board of Nursing, 2019).
To obtain a Drug Enforcement Administration (DEA) license in Maryland, NPs can apply for a Maryland State Controlled Dangerous Substances (CDS) license through the Office of Controlled Substances Administration (OCSA). The NP must complete the CDS application form and mail it to the Maryland Department of Health- Public Health Services Office of Controlled Substances Administration. Nurse practitioners in Maryland have full prescriptive authority without physician involvement and can prescribe drugs classified under Schedule II, III, IV, and V (Maryland Board of Nursing, 2019).
The Nurse Practitioner Association of Maryland (NPAM) is one of the NP organizations in Maryland with a robust legislative committee responsible for monitoring NP practice issues governed by state laws and regulations. This legislative committee comprises members from various regions of Maryland, engaged in legislative and advocacy activities such as assessing legislative and regulatory issues affecting NP practice, formulating plans, educating legislators, and advocating for necessary changes Maryland Registered Nurse Certification and Licensure. The organization also develops a legislative agenda, collaborates with NPAM lobbyists to draft legislation, promotes these legislative initiatives to members, legislators, and the public, reviews health-related bills introduced by other groups in the legislature, and provides recommendations to NPAM regarding support or opposition. Furthermore, NPAM builds relationships with other healthcare stakeholders representing nursing, medicine, education, government, business, and the community (Nurse Practitioner Association of Maryland, n.d.).
Most regulations in Maryland favor NP independent prescriptive and practice authority. However, the regulation effective since October 2015, which mandates that newly certified NPs have a physician mentor for 18 months before they can practice independently, is the only potential barrier impacting independent practice in Maryland (Maryland Registered Nurse Certification and Licensure).
It is intriguing to observe how different states vary in terms of NP independent practice authority. What is surprising is the range of independent functions that Maryland NPs can perform, in addition to prescribing drugs and ordering diagnostic and therapeutic measures. I discovered that Maryland NPs can complete death certificates for patients under their care, certify individuals with specific health needs for the Department of Transportation, and witness advance directives (Maryland Board of Nursing, 2019). Knowing about these additional independent functions has further motivated me to consider serving my community in the future, given the extensive scope of practice available to NPs in Maryland.
In summary, full practice authority for APRNs plays a significant role in providing high-quality, accessible, and cost-effective healthcare services to the public (Bosse et al., 2017). As noted by Michael et al. (2019), the aging population in the United States is expected to more than double in the next four decades, leading to increased demand for healthcare providers, particularly primary care practitioners. Additionally, the high number of individuals gaining insurance coverage due to the Affordable Care Act has led to reports of reduced access to healthcare services due to a shortage of physicians (Bosse et al., 2017). These factors underscore the importance of granting APRNs full practice authority in all states to meet the growing healthcare needs of the population. APRNs are highly qualified healthcare professionals with extensive education and training, and eliminating restrictions on their practice will enable nurse practitioners to fully address the increasing healthcare demands in the country. Maryland Registered Nurse Certification and Licensure.
References
Bosse, J., Simmonds, K., Hanson, C., Pucini, J., Dunphy, L., Vanhook, P., & Poghosyan, L. (2017). Position statement: Full practice authority for advanced practice registered nurses is
necessary to transform primary care. Nursing Outlook, 65(6), 761–765. https://doi.org/10.1016/j.outlook.2017.10.002
Buppert, C. (2021). Nurse practitioner’s business practice and legal guide (7th ed.). Jones & Bartlett.
Maryland Board of Nursing. (2019). Nurse practitioner: Scope and standards of practice. https://mbon.maryland.gov/Documents/proposed-regs-for-20171113-md-register.pdf
Milstead, J. A., & Short, N. M. (2019). Overview: Economics and finance of healthcare. In Health policy and politics: A nurse’s guide (6th ed., pp. 171–211). Jones & Bartlett Learning.
Nurse Practitioner Association of Maryland. (n.d.). Maryland legislative districts and NPAM
legislative committee. https://www.npamonline.org/page/35 Maryland Registered Nurse Certification and Licensure.
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