Discussion 2
Colorado VS maryland
Respond to at least two of your colleagues on 2 different days in one or more of the ways listed below.
- Share an insight from having viewed your colleagues’ posts.
- Suggest additional actions or perspectives.
- Share insights after comparing state processes, roles, and limitations.
- Suggest a way to advocate for the profession.
- Share resources with those who are in your state.
Maryland
Summary of Certification and Licensure Requirements for Advanced Practice Registered Nurses (APRNs) in Maryland
Maryland is a full practice state for nurse practitioners (NPs), granting them the authority to evaluate, diagnose, treat, and prescribe without requiring physician collaboration or supervision. The Maryland Board of Nursing (MBON) regulates NP licensure and provides detailed guidelines for certification, licensure, and practice agreements (Maryland Board of Nursing, 2024).
Certification and Licensing as an APRN in Maryland
To practice as an APRN in Maryland, candidates must pass a national certification exam, such as the Psychiatric-Mental Health Nurse Practitioner (PMHNP) certification offered by the American Nurses Credentialing Center (ANCC). Certification is essential to begin the application process for state licensure (CGFNS International, 2024).
Application Process for Certification and Licensure
Education Requirements: Candidates must graduate from an accredited nursing program approved by MBON.
Official Transcripts: Applicants must arrange for their official transcripts to be sent to MBON through a digital credentialing service. These transcripts should include verification of all nursing education and transferred credits (Maryland Board of Nursing, 2024).
Background Check: Both in-state and out-of-state applicants must complete fingerprinting through the Criminal Justice Information System (CJIS). Fingerprinting must adhere to MBON’s specific authorization and ORI numbers.
License Verification: Verification of an existing RN license must be completed through Nursys.com or directly from non-participating state boards.
Endorsement Application: Applicants must provide a digital passport photo, proof of an active RN license, and pay application fees. The permanent license fee is $100, while a temporary license costs $40.
Scope of Practice and Practice Agreements
Maryland defines the scope of practice for NPs as inclusive of independent evaluation, diagnosis, ordering of diagnostic tests, and prescribing medications. The state’s full-practice designation means that NPs can function without physician collaboration or supervision, with the Maryland Board of Nursing regulating all aspects of their practice (CGFNS International, 2024). This autonomy empowers NPs to establish independent practices and deliver comprehensive patient care.
DEA License and Prescriptive Authority
To prescribe controlled substances, NPs must apply for a Drug Enforcement Administration (DEA) number after obtaining state licensure and certification:
DEA Application Process: The DEA requires applicants to complete an online application and pay the associated fees (American Association of Nurse Practitioners, 2020).
Controlled-Substance Schedules: Maryland NPs are authorized to prescribe medications in Schedules II–V.
Prescription Monitoring Program (PMP): Maryland mandates NP participation in the PMP, which tracks controlled-substance prescriptions to prevent misuse.
Barriers to Independent Practice
While Maryland provides full-practice authority, certain barriers persist:
Administrative Complexity: The multi-step endorsement process, including detailed transcript verification and background checks, can delay licensure (Maryland Board of Nursing, 2024).
Financial Burden: Application, credentialing, and DEA registration fees can be costly, particularly for out-of-state applicants.
PMP Compliance: Although essential for patient safety, the PMP introduces additional administrative responsibilities, potentially reducing time for direct patient care.
Surprises and Insights
One notable finding was Maryland’s streamlined process for nurses with compact multistate licenses. These individuals can practice under compact rules while awaiting permanent state licensure, demonstrating Maryland’s support for workforce mobility (CGFNS International, 2024). Another surprising detail was the stringent transcript and English proficiency requirements for foreign-educated nurses, underscoring Maryland’s commitment to maintaining high standards of patient care (Maryland Board of Nursing, 2024).
Conclusion
Maryland fosters a supportive environment for APRNs by offering full-practice authority and reducing the need for physician oversight. While administrative and financial barriers exist, the state’s progressive stance on NP independence makes it an appealing option for advanced practice nurses. By meeting Maryland’s licensure requirements, NPs are well-positioned to deliver high-quality, patient-centered care.
References
American Association of Nurse Practitioners. (2020). How to Get Information About Obtaining a DEA Number. American Association of Nurse Practitioners; AANP Website. https://www.aanp.org/practice/practice-management/business-resources-for-nurse-practitioners/how-to-order-a-dea-number
CGFNS International, Inc. (2024). Maryland licensure & registration info. Retrieved from https://www.cgfns.org/licensure/maryland/#:~:text=Maryland%20is%20a%20Nurse%20Licensure,Registered%20Nurse%20EndorsementLinks to an external site.
Maryland Board of Nursing. (2024). RN/LPN licensure by endorsement process. Retrieved from https://mbon.maryland.gov/Pages/licensure-by-endorsement.aspxLinks to an external site.
Colorado
Introduction
A practice agreement guides the scope, independence, and collaborative needs of nurse practitioners (NPs). In Colorado, these agreements aim to ensure the delivery of quality healthcare while balancing autonomy with regulatory oversight. Below are key aspects of NP practice in Colorado.
Certification and Licensure as an APRN in Colorado
To become an APRN in Colorado, candidates must hold a valid registered nurse license in good standing and complete a graduate-level NP program accredited by a recognized body, such as the Commission on Collegiate Nursing Education (CCNE) (Berry, 2019). National certification in a specific NP population focus is also required.
Certification Application Process
The application process involves submitting an online application to the Colorado Board of Nursing through the Department of Regulatory Agencies (DORA), including proof of RN licensure, national certification, and official transcripts from an accredited NP program (Berry, 2019).
Colorado Board of Nursing Website
The Colorado Board of Nursing’s official website is dpo.colorado.gov/Nursing, where detailed information on licensure and regulations is provided.
Scope of Practice for Nurse Practitioners
Colorado is a full-practice state, meaning NPs can evaluate, diagnose, treat, and manage patients independently without mandatory physician supervision, provided certification and licensing requirements are met (Hudspeth & Klein, 2019).
State practice agreement requirements New NPs with fewer than 1,000 hours of clinical practice must enter into a mentorship agreement with a physician or experienced NP to ensure competence. After completing this requirement, NPs can practice independently.
Obtaining a DEA License
To obtain a DEA license, NPs must first secure state licensure and prescriptive authority (Martin, 2023). They can then apply directly through the DEA’s website, completing the application and associated fee.
Prescription Monitoring Program (PMP)
Colorado’s Prescription Drug Monitoring Program (PDMP) allows NPs to monitor and manage patients’ controlled substance prescriptions, helping to prevent misuse (Martin, 2023).
Controlled-Substance Prescriptive Authority
Colorado NPs can prescribe medications, including controlled substances in Schedules II-V, upon obtaining prescriptive authority and DEA registration. Completing pharmacy coursework is a prerequisite.
Summary of Findings
Colorado supports NP autonomy through full practice authority, fostering improved patient access to care. The mentorship requirement for new NPs promotes skill development and ensures patient safety.
Regulations and Barriers to Independent Practice
Regulations include initial mentorship agreements and adherence to prescriptive authority requirements. However, barriers such as the limited availability of mentors for new NPs may delay independent practice.
Surprising Findings
The mentorship agreement requirement was surprising, as it strikes a balance between independence and safety, ensuring new NPs are well-prepared before practicing autonomously.
