Maryland and Georgia APRN State-Level Regulations

Maryland and Georgia APRN State-Level Regulations

Boards of nursing (BON) are present in all states to oversee nursing practice licensure. They evaluate license applications to either approve or decline (National Council of State Boards of Nursing, n.d.). According to Neff et al. (2018), BON approves registered nursing (RN) education programs to ensure that they comprehensively cover the skills and knowledge required to operate as a licensed RN (Neff et al., 2018). Despite the overall functions of BONs, each state has its set of regulations for licensing advanced practice registered nurses (APRNs). The laws determine the scope of APRNs in the states (Milstead & Short, 2019).

APRN board of nursing regulations in Maryland

The Advanced Practice Registered Nurse regulations in the state of Maryland stipulate various elements of practice, including certification, renewal of certification, education, practice before certification, and other nursing administration elements. The APRN regulations in Maryland stipulate that nurses can independently perform a wide range of clinical functions, including comprehensive physical assessment of patients (Maryland Board of Nursing, 2020). Nurses are also empowered to establish a medical diagnosis for short-term and chronic health problems as well as order, perform, and interpret laboratory results and diagnostic tests for patients.

Nurse practitioners in Maryland are also equipped to perform advanced therapeutic measures, such as performing diagnostic, therapeutic, and corrective measures on patients, including prescribing drugs and providing emergency care (Rubenfire, n.d.). However, the performance of these nursing responsibilities is defined and coordinated under various regulatory foundations, including the General Health Article §4-212 (Maryland Board of Nursing, 2020). Nurses may also refer patients to appropriate licensed physicians for purposes of coordinating the acquisition of advanced or specified clinical procedures or actions. Psychiatric nurse practitioners may also coordinate with other physicians to administer treatment on mental disorders on a voluntary basis as well as when the clinical intervention is warranted Maryland and Georgia APRN State-Level Regulations.

However, practicing nurses in the state of Maryland are only mandated to specialize the practice to their specific area of professional training for which they were certified. Nurses are also offered the leeway to refuse delegated tasks in cases where their individual judgement or assessment of the delegated task shows some element of professional doubt, gaps, ethical concerns or lack of observation of safety procedures or standards. Lastly, all practicing APRNs in the state of Maryland are subject to additional relevant regulatory measures, including disciplinary action in accordance with the Health Occupations Article §8-316 (Maryland Board of Nursing, 2020).

APRN board of nursing regulations in Georgia

In the state of Georgia, regulations of Advanced Practice Registered Nurses are quite strict and restrictive in terms of what nurses are allowed to do in practice. The scope of practice of APRN nurses in Georgia limits the nurses from offering prescription drug orders, especially for schedule I or II controlled substances. APRN nurses are also limited from offering any drug refills if the date of the initial drug prescription order was more than 12 months before. Nurses are, however, allowed to carry out drug refills for oral contraceptive drugs, hormone replacement therapy drugs, and prenatal vitamins for a duration of up to 24 months after the initial drug order (Advanced Practice Legal Issues, n.d.).

When it comes to actual practice, APRN nurses in the state of Georgia are restricted from providing advanced patient care unless a physician supervises the APRN nurse and proper stipulations of responsibility delegation are explained. This includes diagnosing patients, ordering tests, or even writing prescriptions. The practice limitation for APRN nurses in Georgia also extends into the issue of supervision of licensed APRN nurses by a licensed physician (“Practitioner Scope of Practice,” n.d.). To stipulate the terms of working, the two parties are required to establish a protocol agreement, which is a written document that allows licensed physicians to delegate responsibilities to APRN nurses. The state requirements regarding delegation of responsibilities define that if a physician delegates prescriptive authority to an APRN, then the nurse involved in the delegation cannot exercise protocol agreement with more than four other APRN nurses. In general, the strict restrictive practice regulations in the state of Georgia has limited the number of nurses willing to practice in the state (Rules and Regulations of the State of Georgia, n.d.) Maryland and Georgia APRN State-Level Regulations.

Practicing as an APRN nurse in Maryland and Georgia is significantly different. In Maryland, for example, APRN nurses can exercise the full scope of authority, including prescribing drugs and ordering tests on patients. This makes it substantially easy for APRN nurses to consider private practice. In the state of Georgia, however, APRN nurses are very limited in terms of their authority, and it is virtually impossible for them to focus on private practice, especially since they do not have the authority to attend to patients individually without physician supervision (Clement, 2018).

Reference

Advanced Practice Legal Issues. (n.d.). 
Nurse practitioner scope of practice: Georgia
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https://thriveap.com/blog/nurse-practitioner-scope-practice-georgia
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Clement, D. M. (2018). Factors Influencing Georgia Legislators’ Decision-Making on Nurse Practitioner Scope of Practice. 
Policy, Politics, & Nursing Practice
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Maryland Board of Nursing. (2020). 
Advanced practice registered nursing: Nurse practitioners
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https://mbon.maryland.gov/Pages/adv-prac-nurse-practitioner-index.aspx
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Milstead, J. A., & Short, N. M. (2019). 
Health policy and politics: A nurse’s guide
 (6th ed.). Jones & Bartlett Learning.

National Council of State Boards of Nursing (NCSBN). (n.d.). 
Nurse Licensure Guidance. 
https://www.ncsbn.org/index.htm
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Neff, D. F., Yoon, S. H., Steiner, R. L., Bumbach, M. D., Everhart, D., & Harman J. S. (2018). The impact of nurse practitioner regulations on population access to care. 
Nursing Outlook
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Practitioner Scope of Practice
. (n.d.). Scope of Practice Policy. 
https://scopeofpracticepolicy.org/states/ga/
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Rubenfire, A. (n.d.). 
Maryland allows nurse practitioners to practice independently of a physician
. Modern Healthcare. 
https://www.modernhealthcare.com/article/20150514/NEWS/150519928/maryland-allows-nurse-practitioners-to-practice-independently-of-a-physician
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Rules and Regulations of the State of Georgia. (n.d.). 
Chapter 410-11 Regulation of Advanced Practice Registered Nurses
. rules.sos.state.ga.us/nllxml/georgiacodesGetcv.aspx?urlRedirected=yes&data=admin&lookingfor=410-11.  Maryland and Georgia APRN State-Level Regulations