Care Across the Lifespan I
1. Reply/Respond to
On Being an Advanced Practice Registered Nurse in West Virginia
West Virginia advanced practice registered nurses (APRNs) have limited prescriptive authority. The state has several regulations for those wishing to practice as an APRN. These regulations serve as a means for APRNs to learn under the guidance of someone more experienced. The rules are in place to help protect the patient, yet, these regulations restrict APRNs who wish to practice independently. Recent changes to the restrictions give APRNs more authority than previously allowed.
APRN Certification and Licensing in West Virginia
To become an APRN in West Virginia, a person must already be a licensed RN. The RN must complete a master’s degree in the desired field (Nurse Practitioner License, 2022), such as a Certified Nurse Midwife or PMHNP. The graduate may apply online from the WVRNB's website. The originating school or agency sends transcripts and certifications to the WVRNB. A written account must be offered to the Board if an applicant has had criminal convictions, professional discipline, drug use, or circumstances that bring about impairment. When signing the application, the applicant attests to the knowledge of applicable state codes. The cost is $35 (Nurse Practitioner License, 2022). After receiving authority to test (ATT), the graduate must pass the certification exam to become board certified. Finally, the APRN must apply for practice authority and licensure from the West Virginia Registered Nursing Board (WVRNB). A collaborative agreement must be submitted along with applicable fees (Nurse Practitioner License, 2022).
Practice Agreements and Scope of Practice
West Virginia Code (2022) §30-7-15a states that an APRN must practice a minimum of three years in a collaborative agreement with a physician and must have completed 45 contact hours of education in pharmacology and clinical management of drug therapy under a program approved by the board. Fifteen of those hours must have been completed within the two years immediately before entering the collaborative relationship (West Virginia Registered Nursing Board [WVRNB], 2022b). After three years, the APRN may apply for authorization to prescribe without a collaborative agreement. Limitations on prescriptive authority include; APRNs cannot prescribe Schedule I drugs, with schedule II narcotics being limited to a 3-day supply (WVRNB, 2022a). There are no other limitations on APRN prescriptive authority. APRNs may order physical therapy, sign death certificates, disabled person card forms, and Physician Orders for Life-Sustaining Treatment (POLST) or similar documents (Wiesen, 2022).
West Virginia’s Prescription Drug Monitoring Program
The West Virginia Board of Pharmacy oversees West Virginia’s Prescription Monitoring Program, which employs the acronym, WV CSMP (West Virginia Controlled Substance Monitoring Program) (Prescription Drug Monitoring Program Training and Technical Assistance Center [PDMP TTAC], 2022). Prescribers and dispensers are required to register with and use the WV CSMP. They must record the patient use of any controlled substance. Before prescribing or dispensing controlled substances, the prescriber must check to see if a patient has attempted to obtain controlled substances from numerous suppliers (PDMP TTAC, 2022). This program helps prevent "doctor shopping" for controlled substances.
Conclusion
In West Virginia, APRNs are limited in prescribing drugs, namely narcotics. They must enter and remain in a collaborative agreement with a physician for three years before applying for authorization to practice independently. Many WV residents would benefit from APRNs with full prescriptive authority who could provide healthcare to those in rural areas and with limited resources.
References
Nurse Practitioner License. (2022). West Virginia nurse practitioner licensure steps – 2022. https://www.nursepractitionerlicense.com/nurse-practitioner-licensing-guides/west-virginia-nurse-practitioner-licensure-steps/ Links to an external site.
PDMP TTAC (Prescription Drug Monitoring Program Training and Technical Assistance Center). (2022). West Virginia State Profile. https://www.pdmpassist.org/pdf/state_summaries/West_Virginia_Summary_Profile.pdf Links to an external site.
West Virginia Code. (2022). §30-7-15b. Eligibility for prescriptive authority; application; fee; collaborative relationships and agreements. https://code.wvlegislature.gov/30-7-15B/ Links to an external site.
West Virginia Registered Nursing Board (WVRNB). (2022a). Board message regarding APRN prescriptive authority. https://wvrnboard.wv.gov/Pages/Board-Message-Regarding-APRN-Prescriptive-Authority.aspx Links to an external site.
West Virginia Registered Nursing Board (WVRNB). (2022b). Collaborative agreement. https://wvrnboard.wv.gov/Documents/Collaborative%20Agreement%205-24-22.pdf Links to an external site.
Wiesen, K. (2022). Nurse practitioner scope of practice by state – 2022. https://www.nursingprocess.org/nurse-practitioner-scope-of-practice-by-state.html Links to an external site.