Need a discussion post in reply to both posts below Length: A minimum of 150 wor

Need a discussion post in reply to both posts below
Length: A minimum of 150 words each post, not including references
Citations: At least one high-level scholarly reference in APA 7th edition from within the last 5 years
Post #1 The
AANP’s live State Practice Environment map outlines the workings of
nurse practitioners in all 50 states, Washington, D.C., and US
territories. There are three main levels of practice authority: full
(green), limited (yellow), and restricted (red). Full practice level
states allow nurse practitioners to work independently, while reduced
practice laws restrict their autonomy. Restricted practice states
require nurse practitioners to work under physician supervision, with
some states relaxing limits as experience increases (“State Practice
Environment,” 2022).
California
comes in a red color. It means it’s at a restricted level. California
is one of the twenty-two states in the United States that imposes
limitations on nurse practitioners (NPs) by mandating their
collaboration with physicians for oversight. Notably, California stands
as the sole state in the western region to enforce such regulations
(Spetz, 2019).
In
2020, Governor Gavin Newsom signed Assembly Bill 890 into law, creating
two new categories for nurse practitioners. The first category allows
practitioners to apply for it if they have completed 4,600 hours or
three years of full-time clinical practice in California. After
completing this level, they can work without contractual medical
supervision in specific locations with a minimum of one physician or
surgeon (Ibarra, 2022). For nurse practitioners (NPs), California is
more restrictive, setting most scope criteria and restricting their
practice beyond what is often expected of RNs. When engaging in
concurrent medical activities, NPs must adhere to standardized
protocols—but only in certain circumstances and with specific
authorizations (Keeley, 2020).
In
the state of California, nurse practitioners have the authority to
write prescriptions for medications that are associated with their field
of practice. However, to write prescriptions for medications that are
classified as Schedule II or Schedule III, they must first obtain
authorization from the doctor who is monitoring them (“Prescriptive
Authority for Nurse Practitioners,” 2021). Furthermore, in California,
for an NP to have prescribing power, a doctor must be involved. NPs are
allowed to recommend controlled substances on schedules III through V.
NPs are allowed to write prescriptions for drugs on Schedule II. For an
NP to be able to write prescriptions, they must also complete a
pharmacology course, a course on Schedule II controlled substances, and
six months of training under the supervision of a doctor. For each NP
who has prescribing power, the Board gives them a “furnishing number,”
which the Board also keeps track of. To recommend IIs, NPs need to
continue learning (“State Law Chart: Nurse Practitioner Prescriptive
Authority,” 2017).The
Board of Registered Nursing and the Division of Allied Health
Professions of the Board of Medical Quality Assurance are working to
establish standard procedures in healthcare systems to ensure patient
safety and uniformity. These rules include written instructions, clear
instructions for trained nurses, and requirements for education,
training, and experience. They also outline supervision levels, unique
situations requiring consultation with doctors, settings where standard
processes cannot be performed, and the need for patient records. Regular
reviews of these rules are also necessary (“Standardized Procedure
Guidelines,” 2019).
Post #2
According to the State Practice Environment Map on the American Association of Nurse Practitioners (AANP) website (2022), Arizona, which is the state I practice in, is classified as a “green” state. This means that nurse practitioners in Arizona have full independent practice (Arizona State Board of Nursing, 2019). After licensure, for registered nurse practitioners (RNPs) to have prescriptive and dispensing authority in Arizona, they must apply for these privileges on the application for RNP certification, as well as showing at least 45 education hours in pharmacology or clinical management of medication therapy within the previous three years. Prescriptive and dispensing authority allows the RNP to prescribe medications and devices to patients in their clinical focus, including providing refills of non-controlled substances for up to one year. RNPs can also dispense drugs and devices to patients, including sample medications (Arizona State Board of Nursing, 2019).
Once
prescriptive and dispensing authority is granted, a Drug Enforcement
Administration (DEA) registration number must be obtained by the RNP if
they wish to prescribe controlled substances. An RNP with a DEA
registration number in Arizona may prescribe a schedule II controlled
substance but may not provide refills (Arizona State Board of Nursing,
2019).
There
are prohibited acts that go with privileges of prescribing and
dispensing. Examples of these acts are prescribing controlled substances
for self, family, or other persons that are not in a professional
patient-provider relationship with the RNP. Other restrictions are
prescribing or dispensing to a population outside of the RNP’s education
and certification, or with patients that have not been personally
evaluated and established under the RNP’s care (Arizona State Board of
Nursing, 2019). These prohibitions are ethical and I do not see these
are barriers to practice.