Maryland Certified and licensed Advanced Practice Registered Nurse (APRN)

To get certified and licensed as an Advanced Practice Registered Nurse (APRN) in Maryland, one must complete four main steps. The first step is completing an educational program of your choice, which can be BSN, LPN, ADN, or any other degree that has been approved by one of the United States Department of Education (USDE) nursing program accreditation agencies. The next step is earning a national certification in one’s speciality of choice (For Students and New Graduates, n.d). The third step is applying for the certificate.  The application is verified under federal law, and in applying, one must provide their US social security number, attach official sealed graduate transcripts from the institutions they too graduate classes and there has to be a copy of the current national certification, a copy of the current registered nurse (RN) license, whether for Maryland or another state; pay $50 application for the first NP certification and $25 each for the subsequent certifications.  Finally, the nurse must provide an attestation form that has been filled and signed by the collaborator or physician with whom the nurse consult and collaborate (For Students and New Graduates, n.d). The final stage is certificate renewal which must be done annually.

The Application Process For Certification

In Maryland, applicants first need to register for a nurse portal account on the website. There are three main steps in the application process. Initial steps include choosing an APRN role and population focus area for which licensure is desired. The nurse will then be asked to enter their name, gender, race, and other personal information. Also, the online application process entails an eligibility check. To determine whether one is eligible for the permit, the applicant must answer a series of questions. The nurse must have the registered nurse license number and details about their education, including the school, state, specialization, review board that accredited the program, level of degree, and year of completion. The next level will be determining the area of specialization and proof of national certification, preferably a copy of current certification (For Students and New Graduates, n.d). The nurse will provide details on their mentor, who must sign and provide their legal name, license number to affirm the information. The last step of the process is providing a declaration of residence, filling a form, and providing proof of residence with two documents, preferably a national ID or driver’s license and a voter’s registration card.

Maryland State’s Board of nursing

The website is https://mbon.maryland.gov/Pages/default.aspx

Scope Of Practice Of A Nurse Practitioner

In Maryland, a nurse practitioner (NP) can practice independently without supervision from a physician. The Nurse Practitioner Full Practice Authority Act was signed in 2015 by the governor and allows nurse practitioners to their full potential, including prescribing medication without attestation agreement with a physician (Maryland allows nurse practitioners to practice independently of a physician, 2015). In addition to being free from the collaborative agreement, an NP can own a clinic.

Getting a DEA license in the state

To be licensed by the Drug Enforcement Administration (DEA), a nurse must first have completed an accredited master’s degree program and pass their certification exam. A completed online application will be required from the applicant. To apply, the nurse will have to provide personal and contact details. This application requires the submission of a controlled substance license from the applicant. Wherever a Maryland address is required, there must be proof of that location. Medical Staff Services Department may require applicants to sign a paper in the event of pending federal DEA registration (Credentialing and Approval Process – Medical Staff Services, n.d).

Prescription Monitoring Program (PMP)

The state has a prescription monitoring program (PMP), which was established to enhance the safety and effectiveness of prescription drugs through the support offered to patients and healthcare providers. The program collects and stores information on drugs with controlled elements provided to patients in Maryland (Maryland Prescription Drug​ Monitoring Program, n.d.). The information is supposed to promote the provider’s ability to manage the risks and benefits of controlled medication.

Nurse Practitioner’s Controlled-Substance Prescriptive Authority

The Nurse Practitioner Full Practice Authority Act gives nurses the authority to prescribe schedule II, III-V controlled substances. However, the NP must have a Maryland Drug Control Number.

Barriers On Nurse Practitioner Independent Practice

There are no regulations in Maryland on nurse practitioner independent practice. Maryland is among the 21 states that give nurse practitioners full anatomy; a nurse practitioner can provide full care, including diagnosing and treating a health issue. The only barriers identified affect their independent practice is lack of positive APRN/physical relations, poor administration, and poor understanding of the APRN role (Schirle et al., 2018).

References

Credentialing and Approval Process – Medical Staff Services. (n.d.). Www.umms.org. Retrieved July 14, 2021, from https://www.umms.org/ummc/pros/medical-staff-services/credentialing-approval-process

For Students and New Graduates. (n.d.). Www.umms.org. Retrieved July 14, 2021, from https://www.umms.org/ummc/pros/nurse-practitioners/students-graduates

Maryland allows nurse practitioners to practice independently of a physician. (2015, May 14). Modern Healthcare. https://www.modernhealthcare.com/article/20150514/NEWS/150519928/maryland-allows-nurse-practitioners-to-practice-independently-of-a-physician

Maryland Prescription Drug​ Monitoring Program. (n.d.). Health.maryland.gov. https://health.maryland.gov/pdmp/Pages/Home.aspx

Schirle, L., Norful, A. A., Rudner, N., &Poghosyan, L. (2018). Organizational facilitators and barriers to optimal APRN practice. Health Care Management Review45(4), 1. https://doi.org/10.1097/hmr.0000000000000229

Thank you for updating me on the initial $50 application for the first NP certification and $25 each for the subsequent certifications in the state of Maryland.  I am also a resident of Maryland, and this is what I would like to your post after my research. The recently graduated student from an accredited NP program who holds a valid RN license and is certified by a nationally accredited body (ANCC) would apply to DEA for a license and pay an application fee of $888. (DEA, 2020). Additionally, must register with the Prescription Drug Monitoring Program and apply for a CDS registration number; a social security number is necessary, and prior approval is required for CE 2 units for dangerous drug distribution. The CDS application fee is $120 and is valid for three years. The Maryland Department of Health’s Office of Controlled Substances Administration maintains the following website: https://egov.maryland.gov/mdh/cds#registration. Requirements

Legislative authority: Under Maryland law, the appropriate licensed NP is granted prescriptive authority by the state board of nursing. According to MD.Regs.Code 10-27.07.07, the PMHNP is authorized to prescribe and dispense medications, including Schedule II–V controlled narcotics. The Drug Enforcement Administration (DEA), in partnership with the Maryland Board of Nursing, confirms this action and maintains a record of prescriptions through the PDMP.

References

Drug Enforcement Administration Diversion Control Division (2020). Registration. https://www.deadiversion.usdoj.gov/drugreg/index.html

 Prescription Drug Monitoring Program (2020.) https://www.crisphealth.org/applications/prescription-drug-monitoring-program-pdmp/

The full exercise of PMHNP is permitted under Maryland state practice and licensure. Under the exclusive license authority of the Maryland nursing board, nursing practitioners are regarded as main caregivers with complete ability to make client assessments, diagnoses, and establish treatment regimens. I reside in  MA which had been the most restrictive practice setting in the United States and was the only state in the New England area that did not allow it’s APRNs to practice with full authority Massachusetts Coalition of Nurse Practitioners, till recently. The inability to have full authority limits the APRN and makes it difficult to have full autonomy in the care of patients. According to an article by Ward (2015), full practice authority for APRNs has many benefits such as increased access to health care for communities. By lifting restrictions on full authority of practice for APRNs, it gives patients the option to obtain high quality health care

          During my research, I noticed that only PDMP-registered PMHNPs can prescribe controlled medications to patients. This regulation was put in place to help the state limit the usage of opioids. In order to participate in active nursing practice in Maryland, NPs must complete education and certification. To become a registered nurse practitioner in the state, a nurse must complete an authorized nursing education program that complies with the Board’s regulations and obtain a certificate of approval from the Board of Nursing (Doherty et al., 2020). After their licenses, education, and certification have been verified through the credentialing procedure, PMHNPs are free to begin working. PMHNPs must also submit all of their academic credentials to a certification organization for proper examination and approval during the relocation procedure to practice in another state.

References

Doherty, C. L., Fogg, L., Bigley, M. B., Todd, B., & O’Sullivan, A. L. (2020). Nurse practitioner student clinical placement processes: A national survey of nurse practitioner programs. Nursing Outlook68(1), 55–61. https://doi.org/10.1016/j.outlook.2019.07.005   

Fitzgerald, M. A. (2017). Nurse practitioner certification examination and practice preparation. F.A. Davis Company.

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