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“State practice-specific board processes are similar from state to state but vary to some extent because their laws are determined by individual state legislatures, and their regulations are determined by the specific agency” (Milstead & Short, 2019). This means once laws are cleared, and all checks and balances are performed they are then enforced by administrative agencies of each individual state. I currently practice in Virginia where some of the Advance Practice Registered Nurses (APRN) regulations are similar yet continue to have some differences from Massachusetts. Autonomous practice for nurse practitioners is not completely granted to APRNs until after five years of practice in Virginia. Currently stating that a nurse practitioner with a current, unrestricted license, may qualify for autonomous practice by completion of the equivalent of two years of full-time clinical experience as a nurse practitioner until July 1, 2022. Thereafter, the requirement shall be the equivalent of five years of full-time clinical experience to qualify for autonomous practice (Commonwealth of Virginia, 2022). This means that Physician involvement is required for diagnosis & treatment pending five years of practicing as an APRN in Virginia. Massachusetts, however, does not require the oversite of a Physician to practice within the full scope of their education and experience using full autonomy. Massachusetts Gov. Charlie Baker signed legislation that allows nurse practitioners to practice independently on Jan. 1, making it the 23rd state to adopt full practice authority (Carbajal, 2021). This allows APRNs the autonomy to practice within the full scope of their education and experience immediately after passing National Boards.

 

Prescriptive Authority for APRNs is another difference between the two states. APRNs in both Virginia and Massachusetts have the authority to prescribe both schedules II-V controlled substances. For Virginia 30 contact hours of education in pharmacology or pharmacotherapeutics (AMA, 2017). Unless a nurse practitioner has been authorized for autonomous practice, the authorization to prescribe schedules or categories of drugs will be set out in a practice agreement with a collaborating physician (e.g., working as an APRN for five years). Massachusetts does not specify a minimum number of contact hours to comply with this education requirement (Commonwealth of Massachusetts, 2022). APRNs in Massachusetts are required to schedule and use a prescription monitoring program that will electronically track prescribed medication monitoring and keep track of any drug misuse and abuse. Both states are required to obtain Drug Enforcement administration (DEA) licenses before prescribing controlled substances. 

 

Even APRNs who can practice within the full scope of their education and experience should be mindful of the regulations I have selected. In Virginia and APRNs after five years can practice within the full scope of their education and experience, however, he/she should continue to be mindful of any limitations provided against their practice (e.g., an APRN would not want to prescribe a class VI control substance when only allowed to prescribe class II – V). The ways that APRNs can adhere to these regulations would be by simply continuing to educate themselves on any changes to their scope of practice and also by becoming members of associations that would keep them informed of any changes made to their scopes of practice. 

 

 Reference

American Medical Association. (2017). State law chart: Nurse Practitioner Prescriptive Authority. https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/specialty group/arc/ama-chart-np-prescriptive-authority.pdf

 

Carbajal, E. (2021, January 4). Becker’s Hospital Review. Massachusetts 23rd state to grant nurse practitioners full practice authority. https://www.beckershospitalreview.com/nursing/massachusetts-23rd-state-to-grant-nurse-practitioners-full-practice-authority.html

 

Commonwealth of Massachusetts. (2022). Learn more about prescriptive authority requirements and practice guidelines. https://www.mass.gov/service-details/learn-more-about-prescriptive-authority-requirements-and-practice-guidelines

 

Commonwealth of Virginia. (2022). Regulations governing the Licensure of Nurse Practitioners. https://www.dhp.virginia.gov/media/dhpweb/docs/nursing/leg/NursePract.pdf

 

Milstead, J. A., & Short, N. M. (2019). Health Policy and Politics: A Nurse’s Guide. (6th edition). Jones & Bartlett Learning. 

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