California Certification and Licensure Plan

Discussion: Certification and Licensure Plan 

An advanced practice nurse holds a higher level of training and is more skilled than a registered nurse, though they still have the same responsibilities and rules when it comes to medical practice. The NPA is developed by the board of nursing of a specific state to ensure the quality of care and safety of patient. It is also designed to help nurses develop their knowledge and skills in order to meet the expectations of the profession. Becoming an APRN allows nurses to take on more leadership roles, which include making more decisions regarding policy and delegation, and resolving conflicts. This paper will discuss the various expectations necessary to become an effective and efficient NP. 

How do you get certified and licensed as an Advanced Practice Registered Nurse (APRN) in California? 

California RNs must have a valid California license and have been working in the field of psychiatric/mental health nursing for at least 1 year while completing the master’s degree in nursing. They also need 2 years of supervised clinical experience in providing mental health counseling services (California Board of Registered Nursing, 2019). 

What is the application process for certification in California? 

Becoming a nurse practitioner in California requires the completion of an associate or bachelor’s degree in nursing. This step is followed by the application for and passing the National Council Licensure Exam. The next step is choosing an accredited graduate school that has an NP program accepted by the California board of registered nurses. As an APRN, you must have a master’s degree in nursing or related field of study in order to become a certified NP. To become an NP, you must pass the national certification exam (California Board of Registered Nursing, 2019). 

What is your state’s board of nursing website? 

The Board of Registered Nursing is an organization by the state government created by law to safeguard as well as advocate for the public’s health and safety by regulating registered nurse practice and assuring the best quality registered nurses in California. 

The BRN website for California state is http://www.rn.ca.gov. 

How does your state define the scope of practice of a nurse practitioner? 

“The nurse practitioner (NP) is a registered nurse who possesses additional preparation and skills in physical diagnosis, psycho-social assessment, and management of health-illness needs in primary health care, who has been prepared in a program that conforms to Board standards as specified in California Code of Regulations, CCR, 1484 Standards of Education” (Buppert, 2021)  

In California, nurse practitioners have limited scope of practice. They can’t practice alone, thus they’ll need to be supervised, delegated, or managed by a physician throughout their careers. They can’t sign death certificates since they don’t have the legal authority to do so They can, however, work as a primary care practitioner, fill out handicapped person placard applications, and sign POLST or equivalent paperwork. After six months of physician supervision, completion of a pharmacology course, and completion of a particular pharmacology course regarding schedule II prohibited substances, they can prescribe schedule II pharmaceuticals independently. 

What is included in your state practice agreement? 

NPs are required to maintain a standard procedure agreement with a physician when they are practicing in a certain setting. One physician may not enter into supervisory agreements with more than four NPs. NPs can provide Physical therapy and refer to other treatments. They are also allowed to provide proof of disability for certain parking permits (American Association of Nurse Practitioners, 2020). 

How do you get a DEA license? 

After passing the exam, you must apply for the DEA. The online application has six sections, and it takes about four weeks to get a DEA number. After you apply it takes 4-6 weeks to get a DEA number (DEA: Diversion Control Division, n.d.). 

Does your state have a prescription monitoring program (PMP)? 

California does have a PMP, it is called Cures, Controlled Substance Utilization Review and Evaluation system (Bonata, 2021). In my current practicum, we look at this for our patients monthly.  

How does your state describe a nurse practitioner’s controlled-substance prescriptive authority, and what nurse practitioner drug schedules are nurse practitioners authorized to prescribe? 

As a nurse practitioner, a person who is a licensed professional with the US Drug Enforcement Administration can order controlled substances through V controlled substances without having to go through the Board of Registered Nurse’s continuing education course. In order to obtain a license to do so, the NP must meet a variety of educational requirements California Board of Registered Nursing, 2019). 

References  

American Association of Nurse Practitioners. (2020, October 15). California State Policy Fact  

Sheet. In American Association of Nurse PractitionersRetrieved from https://www.aanp.org/advocacy/state/state-practice-environment/state-policy-fact-sheet 

Bonata, R. (2021). Controlled Substance Utilization Review and Evaluation System. In State of California Department of Justice. Retrieved from https://oag.ca.gov/cures  

Buppert, C. (2021). Nurse practitioner’s business practice and legal guide (7th ed.). Jones & Bartlett Learning.  

California Board of Registered Nursing . (2019, January). In State of California Department of  Customer Affairs. Retrieved from https://www.rn.ca.gov/pdfs/applicants/pmh-app.pdf  

California Board of Nursing. (2019a, February). Nurse Practitioner Schedule II Controlled  

Substance and Risk of Addiction . In State of California Department of Customer Affairs  

Retrieved from https://www.rn.ca.gov/pdfs/regulations/npr-b-59.pdf  

California Board of Nursing . (2011, April 3). General Information: Nurse Practitioner Practice. In State of California Department of Customer Affairs. Retrieved from https://www.rn.ca.gov/pdfs/regulations/npr-b-23.pdf  

DEA: Diversion Control Division. (n.d.). Chemical Control Program. In US Department of Justice Drug Enforcement Administration. Retrieved from https://www.deadiversion.usdoj.gov/online_forms_apps.html  

 I live in California and will be applying for a California PMHNP license upon completion of this program. I enjoyed reading your insight on the scope of practice and process for licensing in California. PMHNPs are seen as valuable providers who increase access to care and usually provide medication management as part of their practice (Phoenix et al., 2016). Through my research, I found that many steps need to be completed to get licensed, and I can see how it can be a complex process at times. Along with passing the national certification exam and applying for a nurse practitioner certification in California, applicants must complete a separate application to receive a furnishing license number to allow the nurse practitioner to prescribe medications. This furnishing license number is also needed to obtain a Drug Enforcement Administration (DEA) registration number so that the nurse practitioner can prescribe controlled substances (California Board of Registered Nursing, 2021). It will be essential for us to ensure we apply for our furnishing license number so that we can incorporate medication management into our practice.

References

California Board of Registered Nursing. (2021). Advanced practice and public health nurse certification. https://www.rn.ca.gov/applicants/ad-pract.shtml#npf

Phoenix, B. J., Hurd, M., & Chapman, S. A. (2016). Experience of Psychiatric Mental Health Nurse Practitioners in Public Mental Health. Nursing Administration Quarterly, 40(3), 212–224. https://doi.org/10.1097/NAQ.0000000000000171

I found it very interesting what is included in your state practice act. As you stated NPs are required to have a standardized procedure agreement. I was unaware what was involved in a standardized procedure agreement coming from a independent practice state. This is what I found out. A standardized procedures agreement is a legal mechanism for RNs, NPs and PAs to perform functions which would otherwise be considered the practice of medicine. They must be collaboratively by nursing, medicine, and administration (Board of Registered Nursing, n.d.). It is exciting to see that California is joining other states that permit independent practice. California is starting a new law where the NP can practice independently or they can continue their current agreement if they do not meet the qualifications to practice independently (Montague, 2020). It is great to see that California joined the full practice authority states and will be effective in 2023. This is a huge win for the state.

References

Board of Registered Nursing. (n.d.). Retrieved from An Explanation of Standardized Procedure Requirements for Nurse Practitioner Practice: www.rn.ca.gov

Montague, A. (2020). Expanding Scope of Practice for Nurse Practitioners in California: AB 890 Compromises to Permit Independent Practice. The Source.

An excellent discussion there you have! I have learned quite a lot from the discussion posts this week. Your insights into the registration process, licensing board, scope of practice, the prescriptive authority of scheduled drugs for nurse practitioners in California state is no exception. I currently live in New Jersey State and purpose to practice within upon licensure as an APRN. Therefore, I have been keen on the scope of practice and basic requirements for NPs in NJ and across the United States to understand our practice’s possible benefits and limitations in the various states. California is a local practice state for NPs must collaborate with physicians. In New Jersey (NJ), a Joint Protocol is signed by the NP and the collaborating nurse to facilitate the prescription of medications.

Both parties should sign the Joint Protocol every year, but the physician does not necessarily need to be with the NP (Cadmus et al., 2020). They only need constant communication on the phone or through the mail for consultations as the collaborative agreement requires. The NP can prescribe schedule two and four controlled substances. They may request, receive, and dispense pharmaceutical samples as well. According to Cimiotti et al. (2019), prescriptions must contain information for both the NP and collaborating physician. Additionally, NPs in NJ can pronounce death, but the physician declares the cause of death.

References

Cadmus, E., de Cordova, P. B., Weaver, S., & Ravichandran, A. (2020). Access to Care in New Jersey: Making the Case for Modernizing Legislation. Journal of Nursing Regulation, 11(1)

 Cimiotti, J. P., Li, Y., Sloane, D. M., Barnes, H., Brom, H. M., & Aiken, L. H. (2019). Regulation of the nurse practitioner workforce: implications for care across settings. Journal of nursing regulation, 10(2), 31-37., 36-41

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