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In Tennessee it is required by the board of nursing that the physician overlooking the APRN’s practice meet with the APRN once every thirty days, however, it is not required that the physician be on site of the facility.  This is different compared to Missouri which requires no physician meetings; however, the Missouri board of nursing requires that a physician be continuously present for the first thirty days of the APRN’s practice at a facility (National Nurse Led Care Consortium, 2017).

            The NCSBN has been working continuously towards the goal of making the APRN’s scope of practice universal for all states.  The APRN campaign for consensus is trying to alleviate differences between states so that there is less confusion when APRNs practice in different states or can work in states that need APRNs (Litchman et al., 2018).  One area of the APRNs scope of practice that differs a lot from state-to-state is the ability to prescribe medications and how this process is regulated.  In Tennessee the board of nursing requires that the APRN follows written protocol by the physician they are working under, it is also required that they register with the DEA and Controlled Substance Monitoring Data (CSMD).  In Missouri APRNs are required to have a Collaboration Practice Agreement (CPA) with their physician and 300 hours of guided pharmacological experience (National Nurse Led Care Consortium, 2017).