Responses

Response 1

Here in California, we have been making a big push for Nurse Practitioners to have more autonomy. Laws recently changed in the past year, making a step towards the direction of not requiring oversight from an overseeing physician after completing certain prerequisites. In order to get certified/licensed in the state of California, you must complete a graduate degree, earn a certification by passing one of the board-certified tests, and then apply for your licensure through the California State Boards of Registered Nursing (Advanced Practice and Certification, n.d.). The California State Board of Registered Nursing is also the primary resource offered for information on step-by-step instructions and the primary website for information. Another resource that is very useful for resources and staying up to date on the latest campaigning for push for Nurse Practitioner autonomy is the California Association for Nurse Practitioners. CANP was responsible for the push of bill AB890, which now allows for full independent practice for Nurse Practitioners after completing 3 years of full-time oversight by a physician (California Association for Nurse Practitioners, n.d.). The steps to how to do this is also explained on the California Board of Registered Nursing website, as all official applications including furnishing licensure is to be completed through them. One challenge I have heard from my peers at CANP, however, is getting the overseeing physician to fill out the required paperwork, as it is an extensive application.

Further details on how California defines the Nurse Practitioner’s scope of practice can also be found on the board’s website, including details of the corresponding bills that have been passed through legislature, if you want to read more in depth (General Information: Nurse Practitioner Practice, 2019). Legal details on billing, treating sexually transmitted diseases for partners here in California, and expected supervision of lower-level staff is also outlined according to California regulations (General Information: Nurse Practitioner Practice, 2019). Specifics on fines and citations can also be found regarding not following state laws along with other state practice agreements that you are legally agreeing to when applying for licensure (General Information: Nurse Practitioner Practice, 2019). One of the things that California details very specifically in the laws is the specifics with furnishing of drugs. There are many specifics for scheduled drugs that must be adhered (General Information: Nurse Practitioner Practice, 2019).

A Nurse Practitioner can obtain a DEA license through the Department of Justice website, where you can fill out an application (How to Get Information About Obtaining a Dea Number, n.d.). You also have the option of calling their 1800 number where you can find an office site near your city that you can go to in person, or request a paper form that you can fill out and send in (How to Get Information About Obtaining a Dea Number, n.d.). Once you obtain your furnishing number as an NP, you can prescribe

scheduled II-V drugs, however, this must be in collaboration with an overseeing physician, unless you have applied for your NP 103, which grants you full autonomy, including writing for all prescription drugs (Afarouk, 2017).

It is an exciting time to be a Nurse Practitioner in California, as the state has been slow to recognize the expertise of the valued clinician, but has made recent progress. Although there has been pushback from organization such as The American Medical Association and physicians here in California in general, with AB890 passing and being put into effect in 2022, this was a huge step in the right direction. The California Association for Nurse Practitioners have been highly involved in the highest forms of advocacy in terms of trying to get further legislation passed and push beyond the red tape of bureaucracy. Their monthly newsletters do a great job of outlining their current agendas that they are working on each month and how us as individuals can support our main mission of pushing for further autonomy and being recognized for our valued role in the medical field. I have also found facebook groups through CANP a great way to connect and be a part of the large push for autonomy for Nurse Practitioners as well.

Response 2

Licensure and Application

To get licensure in the state of Kentucky, you must complete an application through the Kentucky Board of Nursing that consists of a background check, official transcripts, report any criminal convictions, and apply for a license through the nurse portal. You must also submit your certification that you acquire through a board’s exam, such as the ARNP. Once all is submitted a license will be issued within 14 business days.

Scope of Practice and KBN

The primary nurse licensure office resource website in my state is the Kentucky Board of Nursing (KBN). KBN is associated and involved with the American Nurses Association (ANA) and the National Council of State Boards of Nursing (NCSBN). My state defines the scope of practice of a nurse practitioner as An APRN “is licensed to engage in advance practice registered nursing pursuant to KRS 314.042

Links to an external site.

and certified in at least one population focus. Throughout the statutes and regulations relating to APRNs, the four APRN roles are: certified nurse practitioner, certified registered nurse anesthetist, certified nurse midwife, and clinical nurse specialist,” (KBN, 2023).

Drug Enforcement Agency (DEA) license

To apply for a DEA number, you must submit an application through the Drug Enforcement Administration website

Links to an external site.

. “The online DEA application has six sections to complete. These sections require information regarding your personal and practice information, business activity and prescribing schedules, state license, background, and payment,” (Tolbert, 2022)

Controlled-substance prescriptive authority and Drug Authority

“In Kentucky, APRNs have been able to prescribe controlled substances since 2006 under a “collaborative agreement for prescriptive authority-controlled substances,” or CAPA-CS. They are allowed to prescribe a 72-hour supply of a Schedule II drug,” (AL CROSS, 2022).

“KRS 314.042 provide the only statutory requirements for physician involvement; requiring an APRN enter into a collaborative agreement for prescriptive authority (CAPA) with a physician prior to prescribing drugs. The APRN is individually responsible and accountable for his or her acts and decisions independent of the physician signing the APRN’s CAPA,” (KBN, 2023).