The issue of APRNs practicing without adhering to the requirements is critical. This is because once caught, the consequences are severe, and it can lead to suspension from work. Commonwealth requires that APRNs should have a valid registered nurse license, good moral character, and a graduation certificate from an approved institution (Commonwealth of Massachusetts, 2012). The BORN tutorial has two authorization requirements that concern practice after certification and payment of the required fees for the processing of applications (Cherry, 2008).
According to the case study, James violated the standard of conduct concerning practice after the loss of authorization, controlled registration, and certification of advanced practice nurses (Commonwealth of Massachusetts, 2012). On the other hand, James complied with some of the APRN requirements for prescriptive practice that include authorization from the board, minimum hours in pharmacotherapeutics service, and the scope of works. Finally, APRN prescribers require training about effective and efficient pain management techniques, substance abuse, and rational drug use.
Board Authorization Requirements
Commonwealth requires the following Board Authorization Requirements for APRN: A valid registered nurse license, good moral character, and graduation certificate from an approved APRN institution (Commonwealth of Massachusetts, 2012). Sullivan (2010) explains that a valid registered nurse license is up to date. This means that it is current and thus, a person possessing it can lawfully perform nursing duties. According to Caho (2007), a nurse obtains the license after training and attaining an excellent performance in the final examination. Once in possession of the license, the nurse should adhere to the professional standard of conduct (Feldman, 2010). For instance, good moral behaviors like honest and hard work.
According to the requirement of Board Authorization, the nurse should portray a good moral character like honesty, integrity, reliability, accountability, and trustworthiness (Commonwealth of Massachusetts, 2012). The nurse should be trustworthy in that he can handle the hospital resources with minimal supervision. Caho (2007) explains that accountability means that the nurse should take charge of any action. For example, the nurse should take care of the hospital equipment and the patients in a responsible manner. In addition, honesty means that the nurse should give correct information. On the other hand, reliability means that the nurse should be there for the patient when the need arise (Feldman, 2010). Lastly, the nurse should be able to make the right decision and treat patients and staff with fairness.
It is required that the nurse should have a graduation certificate from an approved APRN institution (Commonwealth of Massachusetts, 2012). An accredited nursing body should verify the certificate. This is important because it proves that the nurse has received the required training and is eligible to practice. It is also helpful when it comes to the eradication of quack nurses (Sullivan, 2010). For instance, a quack nurse does not have a verified certificate.
The BORN tutorial requires that the nurse should practice after certification by a certifying body that is nationally recognized (Cherry, 2008). Additionally, the nurse should pay the required fees for the processing of the application forms in time to avoid inconveniences (Cherry, 2008). This is because a nurse can only receive a valid license after the processing of application forms.
Standard of conduct that James violated
James violated a standard of conduct concerning practice after the loss of authorization. According to this standard, one should not practice as an advanced nurse after suspension or voluntary withdrawal from an Authorization Board (Commonwealth of Massachusetts, 2012). James violated this conduct by working without authorization. He worked in several health facilities after he had withdrawn from practice as APRN. This shows that he was working without authority from the Authorization Board.
Additionally, the investigations proved that James had violated a standard of conduct that concerned controlled registration. This standard of conduct requires that one should notify the authority in writing after surrendering to work as an APRN (Commonwealth of Massachusetts, 2012). Moreover, Caho (2007) adds that APRN should submit the notice to the authorization board within thirty days and he should not practice as a nurse thereafter. James violated this standard by not notifying the authorization board that he had stopped working as a registered nurse.
Finally, James violated the standard of conduct that entails certification of advanced nursing practice. According to this standard, a nurse should not practice without a valid license (Commonwealth of Massachusetts, 2012). The analysis of the case study shows that James was practicing without current certifications. Additionally, he had not done the nursing exams, thus, he was practicing illegally.
APRN requirements for prescriptive practice
According to the case study, James complied with several APRN requirements for prescriptive practice. To begin with, he had authorization from the board to practice as an APRN. Cherry (2008) explains that APRN nurses who engage in prescriptive practice should have authority from the authorization board. According to the case study, between 1998 and 2008 when James was practicing as a nurse in an outpatient clinic, he had authorization from the board.
Commonwealth of Massachusetts (2012) states that a nurse is required to have a minimum of twenty-four hours in pharmacotherapeutics practice apart from an education program. James fulfilled this condition. This is because he had worked with Dr. Smith in the outpatient clinic for many days. For instance, James used to review prescriptions within seventy-two hours. Additionally, he used to review his prescriptive practice with Dr. Smith every three months. This scenario shows that James had worked more than twenty-four hours in pharmacotherapeutics.
APRN requirement for prescriptive practice states that the physician and the nurse should determine the scope of nursing practice (Feldman, 2010). The scope of nursing practice entails issues concerning prescriptions and ordering of tests (Sullivan, 2010). James complied with this requirement by discussing and agreeing with Dr. Smith about the scope of prescriptive services. For example, Dr. Smith used to review James general and prescriptive practice once in three months in a scheduled meeting with him. Additionally, James used to document all the cases concerning medications so that he could review them with Dr. Smith. This shows that Dr. Smith and James had an understanding about what James should do and what he should not.
Lastly, the APRN requirement for prescriptive practice states that when a nurse prescribes, the prescription should include the physician’s name but the signing should be upon mutual agreement (Sullivan, 2010). According to the case study, it is evident that James complied with this requirement by acting as a designee when Dr. Smith was absent. This shows that Dr. Smith had granted him the authority of signing prescriptions.
Educational requirements for APRN prescribers
Caho (2007) explains that APRN prescribers must train about effective and efficient pain management techniques. This is because most of the diseases and conditions present with pain. Additionally, patients go to the hospital because they experience pain (Feldman, 2010). Therefore, a nurse prescriber must know about pain management because it will help him manage patients well. For example, an APRN prescriber who knows how to manage acute pain will provide quality care to the patient than one who does not.
Grouping of patients according to their susceptibility to substance abuse is the second education requirement for APRN prescribers (Cherry, 2008). This means that the APRN nurse should have adequate knowledge that enables him to identify patients at risk of substance abuse and provide prompt intervention. Therefore, APRN nurses require training about substance abuse and patients’ presentations. This will help them in the quick identification of patients at risk.
Finally, the APRN prescriber requires training about rational drug use (Commonwealth of Massachusetts, 2012). It should involve the side effects of medications, dosages, storage, and prescriptions (Sullivan, 2010). The knowledge about the side effects of the medication will assist the APRN prescriber to counsel patients about the undesired outcome of drugs. On the other hand, knowledge about prescription and dosage will assist the APRN prescriber to dispense the right amount of drugs. This will ensure that there is a minimization of wastage that usually occurs when patients are given more medications than they require.
In conclusion, a nurse needs to adhere to the practicing requirement. This is because it will save him from the consequences of breaking the law. According to the case study, James did not adhere to the standards concerning authorization, registration, and certification. As a result, the Authorization Board reprimanded him. On the other hand, he did not face the law because he complied with APRN requirements for prescriptive practice. Finally, APRN prescribers should receive training about pain management techniques, rational drug use, and substance abuse. The training will enable them to provide quality services to the patients.
Caho, J. (2007). How to Meet the Most Challenging Joint Commission Requirements for Nursing Care. Philadelphia: Elsevier.
Cherry, B. (2008). Contemporary Nursing: Issues, Trends and Mangement. Philadelphia: Elsevier.
Commonwealth of Massachusetts. (2012). Preparing for Advance Practice Registered Nursing. Web.
Feldman, R. (2010). Nursing Leadership: A Concise Encyclopidia. New York: Springer.
Sullivan, M. (2010). Nurse Practitioner: The Evolution and Future of Advanced Practice. New York: Springer.