Scope of Practice for APRNs in New York and California: A Legislative Review - Free Paper Example

SUBJECT: A memorandum summarizing the scope of practice acts and regulations for APRNs in New York and California

Senator Swanson is on the verge of proposing legislation that defines the scope of practices and regulations for APRNs in New York and California. This memorandum summarizes the scope of practice acts and regulations for APRNs in New York and California. The memorandum highlights key differences between regulations and statutes in both states and proposed the recent proposal. Finally, a recommendation of which of the two statutes would serve as a model for the Setonia Act and a discussion of whether to recommend the endorsement of the new legislation.

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Background

Advanced practice registered nurses (APRNs) are American clinicians who are licensed as Nursing Practitioners (NPs), Clinical Nurse Specialists (CNS), Certified Registered Nurse Anesthetists (CRNAs), or even Certified Nurse-Midwives (CNMs). All these groups of patients are trained up to the postgraduate level to help them diagnose, prescribe medications, and further medications of complex medical conditions. Most of APRNs practice their services in emergency medical settings, including both in-hospital and even at home-based medication (American Nursing Association, 2010). APRNs have operated for the past 50 years and have been established as the most reliable emergency members serving in major states of America among these including New York and California.

Summarization of the scope of practices acts and regulations for APRNs in New York

APRNs in New York operates under New York's Practitioner Supervision. Under these guidelines, APRNs practices its operations through set regulations and practices acts. The following are a summary of the Practices Acts and Regulations:

New York’s APRNs acts do not allow nurses to operate under complete independence, and therefore, they have to operate in collaboration with a physician. According to the New York State Board of nursing, NP's collaboration with physicians does not mean that they are under the supervision of the physician. The practices act also gives nurses full responsibility for their actions (Emergency Nurses Association, 2016). The act also highlights clearly the role of physicians in reviewing nurse’s patient records timely in not less than three months duration.

Decisions involving extended and number of charts to be reviewed are left under the care of a collaborating physician. The act also requires nurses to be well experienced and have amassed enough knowledge to operate in New York hospitals.

APRNs operating in New York are required to have a written practice agreement and practicing protocol that is written. If the APRNs are operating in more than one facility, regulations require him or her to collaborate in only one practicing agreement.

The overall Act regulating APRNs in New York is the "New York Board of Nursing.’’

Summarization of the scope of practices acts and regulations for APRNs in California

In California, APRNs are governed under the state nurse practice act. The California Board of Registered Nursing promulgates a set of regulations that all NPS operating in California are required to follow. These regulations require the following;

The California nursing regulations require APRNs who are working under collaboration with physicians should adhere to all procedures and standards that have been developed by collaboration amongst administrators, and professionals including surgeons and physicians (Spetz, 2018).

Regulations also require Californian APRNs to have an additional certification by BRN to activate their ability to prescribe patients with devices and drugs with standardization procedures that are developed through the supervision of surgeons and other physicians.

Under the collaboration, physicians have a full legal responsibility to practice APRNs and determine the level of supervision that is appropriate (Spetz, 2018). They are also required to have constant communication with APRNs to oversee the practices of NPs and care quality.

The regulations in California have no rules that control the proximity under which the physicians can give their supervisions. This enables them to supervise even in remote areas even if they are in hundreds of miles away.

Differences of Acts and Regulations in New York and California

Although in the two states requires the collaboration of APRNs with the physician, there exist differences in how they are supervised. In New York, APRNs' practices are not in complete supervision of the physicians. However, in California, physicians have the overall mandate to supervise all APRNs under collaboration with them.

Another difference exists on the two sets of APRNs responsibilities. In New York, APRNs have the freedom to operate independently. However, they are responsible for their own acts. However, in California, physicians have a legal responsibility to set standardized regulations and procedures that are under the strict supervision of physicians and other professionals as they are responsible for APRNs acts.

APRN’s supervisors in New York need to have additional certification and can only offer close supervision. However, in California, physicians can offer their supervision even in remote areas that are 100 miles away.

Recent New York Proposal "advanced home health aides.''

The recent proposal by New York State concerning Nursing practice is to advance the home health aide program. The program is believed that it will effectively enable home health aide that will enable clinicians to offer patients with advanced tasks as long as they follow all designated training under the supervision of Registered Nurses. The regulation under this program is that home care agencies will address the diversion of drugs to help the clinicians perform specified tasks that are related to the administrative medication. Under this proposal, agencies will be performed aided tasks to patients whose health is stable and are aware that they will receive the program.

According to Roger Noyes, who is the director of the communication for Home Care Association (HCA) in New York, "the new regulations that are highlighted in the program will mostly deal with medications.'' (Holly, 2018) Therefore, advanced tasks will concentrate on home health aides that will be performed to residing patients in a nursing home or even to the hospitals, clinics, and Outpatient Health Care facilitation. Therefore, the model will enhance more flexibility of health practitioners. However, the cost associated with the model is not yet established.

Recommendation for the appropriate statute to include in the Setonia Act

From the discussion above, there are two statutes that Senator Swanson can incorporate in the Setonia Act. The first Act is the New York Board of Nursing and Nursing Practice Act of California. From the summarization done above, I can recommend Senator Swanson to consider incorporating the New York Board of nursing in Setonia Act. The reason for this is that the New York statute allows the practitioners to seek extra certification as a guarantee of their experience and knowledge. Also, the act gives the practitioners some freedom to explore hence expanding their chances of increasing professionalism. Therefore, by incorporating this statute in the proposed Setonia Act, it will give the nurses more chance to expand their professionalism and serve patients of the state to full satisfaction.

Conclusion

Personally, I would endorse the proposed "Advanced home health aides.'' This model will extend clinical services to patients at home. Through this, more patients will be served even at their homesteads, reducing congestion in the hospitals.

References

American Nursing Association. (2010). APRN State Law and Regulation. ANA. https://www.nursingworld.org/practice-policy/advocacy/state/aprn-state-law-and-regulation/

Emergency Nurses Association. (2016). Advanced Practice Registered Nurses in the Emergency Care Setting. https://www.ena.org/docs/default-source/resource-library/practice-resources/position-statements/advpracticeernursing.pdf?sfvrsn=e4186f66_22

Holly, R. (2018, July 5). New York Considering Advanced Home Health Aide Designation. Home Health Care News. https://homehealthcarenews.com/2018/07/new-york-considering-advanced-home-health-aide-designation/

Spetz, J. (2018). California’s Nurse Practitioners: How Scope of Practice Laws Impact Care. https://www.chcf.org/wp-content/uploads/2018/09/NursePractitionerScopePracticeLaws.pdf