Nursing Regulatory Bodies (NRBs), as stated by the NCSBN, 2021, were established more than 100 years ago with the goal of being in all 50 states and responsible for the regulation of nursing practice. The mission of NRBs is to protect the publics health and welfare by overseeing safe practice of nursing around the country. In each state, when someone is licensed as a nurse, the NRB of that state monitors their compliance to laws and acts if any regulations are broken. Enforced by the NRB is the Nurse Practice Act which entails the qualifications for nursing licensure, titles, scope of practice, and reprimandable actions (National Council of State Boards of Nursing, 2021).
However, even though NRBs are established in all 50 states, there are variables within each NRB depending on their state or jurisdiction. For example, in the state of Massachusetts the NRB has no set regulations or policies regarding telehealth. But, in the state in Rhode Island their NRB does in fact have set regulations or policies regarding telehealth for nurses (regulatoryatlas.com, n.d.).
In Massachusetts, the Board of Medicine allows for anyone who can practice medicine in person to be allowed to practice medicine via telehealth. If conducting telehealth services, there is no requirement to have a face-to-face encounter between the provider and the patient prior to the telehealth visit. Massachusetts telehealth includes audiovisual, audio-only, and email. On the other hand, Rhode Island telehealth does not include audio-only or email communication. The Board of Medicine in Rhode Island also does not allow just anyone with a medical license to practice telehealth in their state, but rather they require a Rhode Island license. (Sessions, L., & Novick, J., n.d.). This affects APRNs in both states because the states border each other. Currently with the Covid19 pandemic telehealth has become very popular and patients are keener on using these services. This makes it difficult for APRNs practicing in RI under an emergency license to fulfill their duties and provide telehealth visits to RI residents since they do not have a true RI medical license and RI only allows the emergency license to be used for telehealth for 7 days (Sessions, L., & Novick, J., n.d.).
Another difference in regulations affecting APRNs in MA vs RI is that regarding autonomous practice. The latest updates regarding the scope of practice for APRNs in the United States can be found by Barton Associates, last updated on June 16, 2021. In Massachusetts APRNs have full practice, meaning they are allowed to evaluate, diagnose, and prescribe medications to patients. However, an APRN cannot be treated as a sole provider, meaning their autonomous practice is restricted; they must have a collaborative agreement with physicians to gain the benefits of having full practice. In Rhode Island, APRNs also have full practice but this is authorized by the state, not by a collaborating physician. This means that in Rhode Island, APRNs have full autonomous practice; APRNs can independently diagnose and treat patients without physician involvement. (Barton Associates, 2021).
The state of Rhode Island seems to be going down the right path. As stated in an article found by NPnow, 2018, there are many benefits to having APRNs as independent practitioners. Some benefits include lower healthcare costs, higher patient satisfaction, increased patient education, increased participation in research, and better quality of patient care. Therefore, allowing APRNs to have full autonomous practice would benefit the public and allow patients to have more access to healthcare.
References:
About U.S. Nursing Regulatory Bodies. (n.d.). NCSBN. https://www.ncsbn.org/about-nursing-regulatory-bodies.htm
Jurisdiction Comparison. (n.d.). Www.regulatoryatlas.com. Retrieved from: https://www.regulatoryatlas.com/jurisdiction-comparison?Jurisdiction=Massachusetts
National Council of State Boards of Nursing (NCSBN). (n.d.). Retrieved from: https://www.ncsbn.org/index.htm
Nurse Practitioner Autonomy: A Shift to More Independent Practice – NP Now The Nurse Practitioner Search Firm. (2018, April 5). NP Now the Nurse Practitioner Search Firm. Retrieved from: https://www.npnow.com/nurse-practitioner-autonomy-a-shift-to-more-independent-practice/
Nurse Practitioner Scope of Practice Laws. (2021). Barton Associates (En-US). Retrieved from: https://www.bartonassociates.com/locum-tenens-resources/nurse-practitioner-scope-of-practice-laws
Sessions, L., & Novick, J. (n.d.). Beazley. U.S. Telehealth Laws Interactive Map. Retrieved from: https://www.beazley.com/beazley_academy/interactive_map.html?msclkid=2e0c814b5feb155bb3a2e00549087c47&utm_source=bing&utm_medium=cpc&utm_campaign=Beazley%20Virtual%20Care%20%7C%20US%202020&utm_term=%2Btelehealth%20%2Blaws&utm_content=Telehealth%20Regulations