As I enter my final quarter at Walden, I am incredibly excited at the prospect of finally becoming a nurse practitioner. Unfortunately, the regulations for APRN’s can be very confusing, as each state sets its own laws with regard to the practice authority of NP’s. It is important that every aspiring NP understands the regulations of their state and has a clear outline of the next steps regarding licensure and practice.
Certification and Licensing in Pennsylvania
To become a certified and licensed nurse practitioner in Pennsylvania, one must first achieve a master’s degree from an accredited university (Pennsylvania Department of State, 2021). Next, the prospective NP must pass a certification exam from a recognized organization, such as the AANP or ANCC. 3 hours of CE training on child abuse is also required, along with a $100 or $140 licensing fee, depending on whether the student was educated within or outside of Pennsylvania. Once all of the requirements have been met, nurses can apply for licensure with the state through Pennsylvania’s online licensing system, PALS (State Board of Nursing, 2019). PAL’s is the primary licensure office website for Pennsylvania, and allows nurses to apply and renew licenses, file complaints, and conduct mandatory reporting.
Practice Restrictions
Pennsylvania limits nurse practitioners to collaborative practice, in which they are bound to a collaborative agreement between themselves and a physician (Commonwealth of Pennsylvania, 2021). This agreement is to define the details of what the nurse practitioner is authorized to do and which medications he or she is authorized to prescribe. The physician must also be immediately available for communication while the NP is practicing, a plan for emergency care must be laid out, and the physician must regularly review the NP’s protocols, records, and practices.
This is the area of my research that I found most surprising, as the exact definition of “communication” and “supervision” is never clearly outlined. I have looked into these questions in the past, as this sort of gray area is also very prevalent in my industry of aesthetics. The level of supervision required seems to be left up to the physician’s comfort level and what can be justified as standard practice, but as someone who likes clear rules, I definitely wish these regulations were more clearly defined.
Prescriptive Authority
Nurse practitioners must obtain a DEA number through the DEA’s Diversion Control Division website in order to prescribe controlled substances (Drug Enforcement Agency, 2021a). The registration costs $888 and is valid for three years. In Pennsylvania, NP’s are allowed to prescribe schedule II drugs for up to a 30 day supply and schedule III, IV, and V drugs for up to a 90 day supply, so long as this is also authorized in their collaborative agreement (Drug Enforcement Agency, 2021b, p.8; Commonwealth of Pennsylvania, 2021).
Nursing Organizations in Pennsylvania
There are multiple large organizations in Pennsylvania that advocate for APRN’s and push for more autonomy. These groups include the Alliance of Advanced Practice Nurses (The Alliance), the Pennsylvania Coalition of Nurse Practitioners (PCNP), and the Pennsylvania State Nurses Association (PSN) (Carthon et al., 2016, p. 103). All three currently advocate for and ask members and supporters to contact their legislators to encourage them to vote for legislation that promotes APRN autonomy. For Pennsylvania specifically, the PCNP has been strongly backing bill SB25, which would allow for full practice authority (Pennsylvania Coalition of Nurse Practitioners, 2021).
References
Carthon, J., Wiltse Nicely, K., Altares Sarik, D., & Fairman, J. (2016). Effective strategies for achieving scope of practice reform in pennsylvania. Policy, Politics, & Nursing Practice, 17(2), 99–109. https://doi.org/10.1177/1527154416660700
Commonwealth of Pennsylvania. (2021). Chapter 21: Subchapter C: Certified Registered Nurse Practitioners. http://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/049/chapter21/subchapCtoc.html&d=reduce
Drug Enforcement Agency. (2021a). Application for registration under Controlled Substances Act of 1970. https://apps.deadiversion.usdoj.gov/webforms2/spring/main?execution=e1s1#
Drug Enforcement Agency. (2021b). Mid-level practitioners authorization by state. https://www.deadiversion.usdoj.gov/drugreg/practioners/mlp_by_state.pdf
Pennsylvania Coalition of Nurse Practitioners. (2021). Breaking: Senate committee passes SB25. https://www.pacnp.org/news/570100/Breaking-Senate-Committee-Passes-SB25.htm
Pennsylvania Department of State. (2021). Certified Registered Nurse Practitioner: Pennsylvania licensure requirements. https://www.dos.pa.gov/ProfessionalLicensing/BoardsCommissions/Nursing/Pages/Certified-Registered-Nurse-Practitioner-Licensure-Requirements-Snapshot.aspx
State Board of Nursing. (2019). Apply online for certified registered nurse practitioner certification. https://www.dos.pa.gov/ProfessionalLicensing/BoardsCommissions/Nursing/Documents/Applications%20and%20Forms/CRNP%20App%20Online%20Instructions.pdf