Advanced Practice Registered Nurse (APRN) in Washington State

Advanced Practice Registered Nurse (APRN) in Washington State

REPLY to 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. TEXAS

 

Discussion

• How do you get certified and licensed as an Advanced Practice Registered Nurse (APRN) in your state?

Firstly, the process begins by obtaining a bachelor’s degree in nursing. As required by the state of Washington all advanced practitioners are required to be licensed and maintain their active RN license graduate from a nationally accredited graduate NP program that meets national standards for advanced didactic and clinical education and pass a national NP board certification exam. (nursing.wa.gov).

• What is the application process for certification in your state?

Application is submitted after educational requirements have been met, and graduate are expected to apply for licensure within one year of graduation (nusinglicensure.org) Application forms can be downloaded from the DOH website (http://www.doh.wa.gov/LicensesPermitsandCertificates/NursingCommission/AdvancedRegisteredNursePractitioner/ApplicationsandForms Links to an external site. Applicants are asked to request official transcripts and have them sent directly to the licensing agency.

However, DOH may accept transcripts in envelopes sealed by the institution. Certification verification is also to be provided directly by the certifying organization. The initial application fee is $92. The applicant will need to attest to having read particular portions of Washington code; links are found in the application packet. The application and fee are sent to the Department of Health. Documents that are sent later should be directed to the Nursing Commission. The licensing agency will communicate via email.

• What is your state’s board of nursing website?

 Nursing Care Quality Assurance Commission (wa.gov)Links to an external site.

• How does your state define the scope of practice of a nurse practitioner?

The nurse practitioner scope of practice in the state of Washington is full practice. Full practice authority allows the NP to practice autonomously and independently from a physician. In Washington state, the NP can be a primary care provider, order physical therapy, and has full practice to medical staff membership. They can also sign death certificates and disabled person placard forms and sign POLST or similar documents. To prescribe schedule II drugs, the NP must complete the specified educational requirements regarding prescriptive authority.

• What is included in your state practice agreement?

In the state of Washington, an advanced registered nurse practitioner may sign and attest to any certificates, cards, forms, or other required documentation that a physician may sign, so long as it is within the advanced registered nurse practitioner’s scope of practice (app.leg.wa.gov).

• How do you get a DEA license?

You will need to meet your start licensing requirements to practice medicine. Apply for a DEA registration and pay the application fees.

• Does your state have a prescription monitoring program (PMP)?

Yes, Washington state does have a Prescription Monitoring Program (PMP). RCW 70.225.020 (app.leg.wa.gov).

• How does your state describe a nurse practitioner’s controlled-substance prescriptive authority, and what nurse practitioner drug schedules are nurse practitioners authorized to prescribe?

WAC 246-840-400 ARNP prescriptive authority. An ARNP licensed under chapter 18.79 RCW when authorized by the nursing commission may prescribe drugs and medical devices pursuant to applicable state and federal laws (app.leg.wa.gov).  Upon approval by the commission, an advanced registered nurse practitioner may prescribe legend drugs and controlled substances contained in Schedule V of the Uniform Controlled Substances Act, chapter 69.50 Links to an external site. RCW, and Schedules II through IV subject to RCW 18.79.240 Links to an external site.(1) (r) or (s) (app.leg.wa.gov).

Reference.

Washington ARNP requirements: How to become a nurse practitioner in wa. NursingLicensure.org – A more efficient way to find nursing license requirements in your state. (2021, September 21). Retrieved November 29, 2022, from https://www.nursinglicensure.org/np-state/washington-nurse-practitioner/

RCW 18.79.050: “Advanced registered nursing practice” defined exceptions. (n.d.). Retrieved November 29, 2022, from https://apps.leg.wa.gov/RCW/default.aspx?cite=18.79.050

Revised code of Washington (RCW). (n.d.). Retrieved November 29, 2022, from https://app.leg.wa.gov/rcw/

Nursing commission. Nursing Care Quality Assurance Commission. (n.d.). Retrieved November 29, 2022, from https://nursing.wa.gov/nursing-commission-0

Apply for a License. Nursing Care Quality Assurance Commission. (n.d.). Retrieved November 29, 2022, from https://nursing.wa.gov/licensing/apply-license

 

 

Reply Discussion

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Reply Discussion

Hey A, I am glad to hear from you

Your post on advanced practice registered nurses provided me with insights concerning the requirements for registered nurses to be certified to practice for the role of advanced practice nursing. One of the major requirements for your post is an educational background starting from a bachelor’s degree in nursing as well as an accredited graduate NP program, which must meet the national standards.

It is also worth mentioning that Washington is one of the states that has given advanced practice registered nurses full practice authority. Full practice authority for the APRNs allows them to practice autonomously from the physicians. Unruh et al. (2018) assert that removing practice regulations among APRNs could result in an expansion of access to quality care, increased productivity for healthcare organizations as well reduced physician shortages. The fact that advanced practice registered nurses are highly trained means that they are likely to provide cost-effective and high-quality care for both rural and urban populations.

Nonetheless, despite the full authority to practice independently from the physician, from your discussion post it is evident that nurse practitioners must practice within their scope of practice as defined by the state practice Acts. It would therefore be vital for continued advocacy, education, and mentorship of the nurse practitioners to improve their knowledge of their legal provisions to practice and some of the legal parameters within their area of practice jurisdiction.

When nurse practitioners understand their scope of practice based on state agreements, they are likely to optimize both the efficiency and the quality of care provided to the patients. According to Moldestad et al. (2022), in a qualitative exploratory study they carried out, the patients were more satisfied with the care provided by the NPs compared to the physicians, Moreover, the interviewed patients asserted that the NPs provided more holistic care than the physicians. It would therefore be vital to increase advocacy by the stakeholders in the healthcare sector to advocate for states that have restricted practice for the NPs like Texas to grant them autonomous authority to practice.

References

Moldestad, M., Greene, P. A., Sayre, G. G., Neely, E. L., Sulc, C. A., Sales, A. E., … & Liu, C. F. (2020). Comparable, but distinct: Perceptions of primary care provided by physicians and nurse practitioners in full and restricted practice authority states. Journal of Advanced Nursing, 76(11), 3092-3103.

Unruh, L., Rutherford, A., Schirle, L., & Brunell, M. L. (2018). Benefits of less restrictive regulation of advance practice registered nurses in Florida. Nursing outlook, 66(6), 539-550.