NURS 603 DB 3.1 Scope of Practice in Your State full
board/Discussion Board 3.1: Scope of Practice
in Your State
9 9 unread replies. 62 62 replies.
Points: 20
Due: Day 3 and Day 6
Directions:
Using your assigned scope of practice scenario from this week's
media piece title "Scope of Practice" (see assignments below),
discuss how it might apply differently to the state where you will
practice. How would your state's scope affect your ability to
practice if you were placed in that scenario? Be sure to use the scope of practice from the state
where you will be employed when responding.
Scenario Assignments:
• If your last name begins in A through E, use the first scenario (Lydia).
• If your last name begins in F through J, use the second scenario (Rafe).
• If your last name begins in K through O, use the third scenario (Christopher).
• If your last name begins in P through T, use the fourth scenario (Katie).
• If your last name begins in U through Z, use the fifth scenario (Angela).
Post your original response by the end of Day 3. Then, by the end of Day 6, comment on at least
two of your classmates' posts.
Search entries or author Filter replies by unread
Reply Reply to Main Discussion
•
, Collapse Subdiscussion Taylor Young
Taylor Young
Oct 31, 2017 Oct 31 at 4:34pm
In the 5th scenario with Angela, she is a nurse practitioner who is needing to prescribe pain
medication to an adult patient, however her collaborating physicians is out of the office but can
be reached by phone. In Minnesota, the scope of practice for diagnosing and prescribing is
independent for stable patients and nurse practitioners can prescribe narcotics as long as they
have a DEA number to prescribe (Revisor of Statues, 2017). In Minnesota, Angela would not
need to be collaborating with a physician and could prescribe the pain medication as she has
been educated to do so, independently.
Reference
Revisor of Statutes. (2017). Minnesota statues 2017. State of Minnesota, 28(23-25). Retrieved
from https://www.revisor.mn.gov/statutes/?id=148&format=pdf.
Reply Reply to Comment
•
Collapse Subdiscussion Arthur Ricker
Arthur Ricker
Nov 8, 2017 Nov 8 at 4:26pm
Taylor,
This scenario would have been problematic for an APRN in Florida until earlier this year.
Although Florida was among the first states in the nation requiring nurse practitioners become
certified with the board of nursing, it was the last state to expand their authority, allowing them
to prescribe controlled substances (Miller, 2016). The passage of the Barbara Lumpkin
Prescribing Act (Florida Nurse Practice Act, 2017) in April of 2016 was the result of a hard-
fought battle of twenty years of lobbying by the Orlando nurse after whom it was named
(Miller, 2016).
As of January 1, 2017, the scenario you portrayed in your post would have played out
similarly in Florida as in Minnesota with perhaps one exception. In Florida, prescriptions written
by ARNPs for Schedule II controlled substances are limited to a 7-day supply, except for
psychiatric medications prescribed by a psychiatric nurse (Florida Nurse Practice Act, 2017).
,Florida requires a collaborative agreement between ARNPs and physicians as well as the use of
documented protocols in practice. The newly expanded prescriptive ability of APRNs in
Florida will remove another supervisory and dependent element of the physician-APRN
relationship.
Although continued limitations to ARNP prescriptive authority in Florida exist in this
legislation, they are by far outweighed by the benefits the patient population will reap from this
expansion of ARNP ability to provide quality care. Great post!
Arthur
References
Florida Nurse Practice Act, Fla. Stat. §464.01-464.012. (2017). Retrieved from http://www.leg.
state.fl.us/statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0400-0499%
2F0464%2F0464PARTIContentsIndex.html
Miller, N. S. (2016, May 13). Barbara Lumpkin, the woman behind a new prescribing bill.
Orlando Sentinel. Retrieved from http://www.orlandosentinel.com/health/os-barbara-
lumpkin- prescribing-bill-20160601-story.html
Reply Reply to Comment
Collapse Subdiscussion Marlene Wilson
Marlene Wilson
Nov 8, 2017 Nov 8 at 6pm
Taylor,
Like Minnesota, Arizona APRNs have full practice authority and can prescribe medications,
including narcotics, to patients in all settings (Arizona Nurse Practitioner Council, n.d.). We do
have a rule that an APRN must search the pharmacy database before prescribing a controlled
substance and then quarterly (Phillips, 2017). This also must be documented that it was
completed during the visit. As a psychiatric nurse, I often run the controlled substance reports
for the providers I work with and it is amazing how many medications patients are filling from
different doctors at the same time. It is usually several urgent care centers, hospitals, PCP, etc. I
know our providers check for every patient, but I wonder if this is happening everywhere since
we are still seeing over-prescribing. Do you have anything like this in Minnesota? Our
pharmacy database also searches some of our neighboring states on request just in case someone
is using pharmacies elsewhere.
Marlene
, References:
Arizona Nurse Practitioner Council. (n.d.). Frequently asked questions. Retrieved from
https://arizonanp.enpnetwork.com/page/15741-what-is-the-scope-of-practice-for-nurse-
practitioners-in-arizona-is-there-a-requirement-for-physician-supervision-or-collaborative-
practice-agreement-may-nurse-practitioners-in-arizona-own-their-practice
Phillips, S. J. (2017). 29th annual APRN legislative update. The Nurse Practitioner, 42(1), 18-46.
doi:10.1097/01.NPR.0000511006.68348.93
Reply Reply to Comment
Collapse Subdiscussion Theresa Stenmark
Theresa Stenmark
Nov 9, 2017 Nov 9 at 9:38am
Taylor, In this scenario in the state of Oklahoma, the Advanced Practice Nurse are authorized
by the Board of Nursing to prescribe as Advanced Registered Nurse Practitioners, Clinical
Nurse Specialists, or Certified Nurse Midwifes subject to the medical direction of a supervising
physician. They have prescribing authority and may obtain a mid-level DEA number to
prescribe CDS. Schedules III, I and V, limited to a seven day supply. The nurses have an
Exclusionary Formulary (a list of drugs they cannot prescribe). The name of the Advance
Practice Nurse will be placed on the prescription label ("Oklahoma Medical Board," 2017). So
in scenario 5, Angela the family nurse practitioner working in a walk-in-clinic providing
primary services does have authority in the state of Oklahoma to prescribe "something for back
pain".
The first line of therapy for lower back pain would not be a narcotic. He may receive Motrin,
Ketorolac (Toradol) or Prednisone in this case scenario. Prescribing a narcotic would require a
written prescriptions from the physician in the state of Oklahoma ("Oklahoma Medical Board,"
2017).
http://www.okmedicalboard.org/download/348/19990301MD.htm (Links to an external
site.)Links to an external site.
Reference
Oklahoma Medical Board. (2017). Okmedicalboard.org. Retrieved 9 November 2017, from
http://www.okmedicalboard.org/download/348/19990301MD.htm
Reply Reply to Comment
board/Discussion Board 3.1: Scope of Practice
in Your State
9 9 unread replies. 62 62 replies.
Points: 20
Due: Day 3 and Day 6
Directions:
Using your assigned scope of practice scenario from this week's
media piece title "Scope of Practice" (see assignments below),
discuss how it might apply differently to the state where you will
practice. How would your state's scope affect your ability to
practice if you were placed in that scenario? Be sure to use the scope of practice from the state
where you will be employed when responding.
Scenario Assignments:
• If your last name begins in A through E, use the first scenario (Lydia).
• If your last name begins in F through J, use the second scenario (Rafe).
• If your last name begins in K through O, use the third scenario (Christopher).
• If your last name begins in P through T, use the fourth scenario (Katie).
• If your last name begins in U through Z, use the fifth scenario (Angela).
Post your original response by the end of Day 3. Then, by the end of Day 6, comment on at least
two of your classmates' posts.
Search entries or author Filter replies by unread
Reply Reply to Main Discussion
•
, Collapse Subdiscussion Taylor Young
Taylor Young
Oct 31, 2017 Oct 31 at 4:34pm
In the 5th scenario with Angela, she is a nurse practitioner who is needing to prescribe pain
medication to an adult patient, however her collaborating physicians is out of the office but can
be reached by phone. In Minnesota, the scope of practice for diagnosing and prescribing is
independent for stable patients and nurse practitioners can prescribe narcotics as long as they
have a DEA number to prescribe (Revisor of Statues, 2017). In Minnesota, Angela would not
need to be collaborating with a physician and could prescribe the pain medication as she has
been educated to do so, independently.
Reference
Revisor of Statutes. (2017). Minnesota statues 2017. State of Minnesota, 28(23-25). Retrieved
from https://www.revisor.mn.gov/statutes/?id=148&format=pdf.
Reply Reply to Comment
•
Collapse Subdiscussion Arthur Ricker
Arthur Ricker
Nov 8, 2017 Nov 8 at 4:26pm
Taylor,
This scenario would have been problematic for an APRN in Florida until earlier this year.
Although Florida was among the first states in the nation requiring nurse practitioners become
certified with the board of nursing, it was the last state to expand their authority, allowing them
to prescribe controlled substances (Miller, 2016). The passage of the Barbara Lumpkin
Prescribing Act (Florida Nurse Practice Act, 2017) in April of 2016 was the result of a hard-
fought battle of twenty years of lobbying by the Orlando nurse after whom it was named
(Miller, 2016).
As of January 1, 2017, the scenario you portrayed in your post would have played out
similarly in Florida as in Minnesota with perhaps one exception. In Florida, prescriptions written
by ARNPs for Schedule II controlled substances are limited to a 7-day supply, except for
psychiatric medications prescribed by a psychiatric nurse (Florida Nurse Practice Act, 2017).
,Florida requires a collaborative agreement between ARNPs and physicians as well as the use of
documented protocols in practice. The newly expanded prescriptive ability of APRNs in
Florida will remove another supervisory and dependent element of the physician-APRN
relationship.
Although continued limitations to ARNP prescriptive authority in Florida exist in this
legislation, they are by far outweighed by the benefits the patient population will reap from this
expansion of ARNP ability to provide quality care. Great post!
Arthur
References
Florida Nurse Practice Act, Fla. Stat. §464.01-464.012. (2017). Retrieved from http://www.leg.
state.fl.us/statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0400-0499%
2F0464%2F0464PARTIContentsIndex.html
Miller, N. S. (2016, May 13). Barbara Lumpkin, the woman behind a new prescribing bill.
Orlando Sentinel. Retrieved from http://www.orlandosentinel.com/health/os-barbara-
lumpkin- prescribing-bill-20160601-story.html
Reply Reply to Comment
Collapse Subdiscussion Marlene Wilson
Marlene Wilson
Nov 8, 2017 Nov 8 at 6pm
Taylor,
Like Minnesota, Arizona APRNs have full practice authority and can prescribe medications,
including narcotics, to patients in all settings (Arizona Nurse Practitioner Council, n.d.). We do
have a rule that an APRN must search the pharmacy database before prescribing a controlled
substance and then quarterly (Phillips, 2017). This also must be documented that it was
completed during the visit. As a psychiatric nurse, I often run the controlled substance reports
for the providers I work with and it is amazing how many medications patients are filling from
different doctors at the same time. It is usually several urgent care centers, hospitals, PCP, etc. I
know our providers check for every patient, but I wonder if this is happening everywhere since
we are still seeing over-prescribing. Do you have anything like this in Minnesota? Our
pharmacy database also searches some of our neighboring states on request just in case someone
is using pharmacies elsewhere.
Marlene
, References:
Arizona Nurse Practitioner Council. (n.d.). Frequently asked questions. Retrieved from
https://arizonanp.enpnetwork.com/page/15741-what-is-the-scope-of-practice-for-nurse-
practitioners-in-arizona-is-there-a-requirement-for-physician-supervision-or-collaborative-
practice-agreement-may-nurse-practitioners-in-arizona-own-their-practice
Phillips, S. J. (2017). 29th annual APRN legislative update. The Nurse Practitioner, 42(1), 18-46.
doi:10.1097/01.NPR.0000511006.68348.93
Reply Reply to Comment
Collapse Subdiscussion Theresa Stenmark
Theresa Stenmark
Nov 9, 2017 Nov 9 at 9:38am
Taylor, In this scenario in the state of Oklahoma, the Advanced Practice Nurse are authorized
by the Board of Nursing to prescribe as Advanced Registered Nurse Practitioners, Clinical
Nurse Specialists, or Certified Nurse Midwifes subject to the medical direction of a supervising
physician. They have prescribing authority and may obtain a mid-level DEA number to
prescribe CDS. Schedules III, I and V, limited to a seven day supply. The nurses have an
Exclusionary Formulary (a list of drugs they cannot prescribe). The name of the Advance
Practice Nurse will be placed on the prescription label ("Oklahoma Medical Board," 2017). So
in scenario 5, Angela the family nurse practitioner working in a walk-in-clinic providing
primary services does have authority in the state of Oklahoma to prescribe "something for back
pain".
The first line of therapy for lower back pain would not be a narcotic. He may receive Motrin,
Ketorolac (Toradol) or Prednisone in this case scenario. Prescribing a narcotic would require a
written prescriptions from the physician in the state of Oklahoma ("Oklahoma Medical Board,"
2017).
http://www.okmedicalboard.org/download/348/19990301MD.htm (Links to an external
site.)Links to an external site.
Reference
Oklahoma Medical Board. (2017). Okmedicalboard.org. Retrieved 9 November 2017, from
http://www.okmedicalboard.org/download/348/19990301MD.htm
Reply Reply to Comment
