Discussion: Understanding Scope of Practice in relation to Certification and Licensure
The National Council of State Boards of Nursing (NCSBN) is a non-profit organization comprised of members from each state board of nursing in the U.S., the District of Columbia, and the four U.S. territories. Their role is to provide a platform for all state boards of nursing to convene, discuss, and ensure all state boards work together to provide the appropriate regulation to ensure that public health, safety, and welfare is the primary focus. A key element of NP licensure is understanding the components of Scope of Practice and subsequent practice within the parameters of the educational program completed and appropriate national certification.
Consider the differences in certification exams options for your specialty
Consider whether primary care NP graduates are qualified to seek employment in acute care settings such as ER, OR, or hospitalist/intensivist
Review and select one of the following case studies to research in depth:
Case Study One: Selecting the Certification Exam for your specialty.
Mary is in the last two months of her program of study. She is trying to decide whether to take the American Association of Nurse Practitioner Credentialing Exam or the American Nurses Credentialing Exam.
Case Study Two: Obtaining initial licensure post matriculation.
Amy, FNP-BC has recently graduated from an accredited Family Nurse Practitioner Program. She decides to relocate from her home state of Tennessee to Missouri and practice in a rural area. She is very excited about her new role and new position.
By Day 3
Post the National Certification Exam you plan to take, a brief explanation for why you chose this exam, and an outline of your plan for passing the National Certification Exam you selected. Then, provide an explanation of the professional and/or clinical practice issues the new Nurse Practitioner will need to consider and address with the certification, licensure, credentialing, or relocation process. Compare Scope of Practice between the Acute Care, Family Practice, and Adult Gerontology Primary Care Nurse Practitioner and how practice may differ from state to state. Then, identify and explain at least two types of settings that are appropriate for FNP and AGPCNP graduates to practice
Nursing: Scope of Practice, Certification, and Licensure
Against the backdrop of the significance of certification and licensure as may be dictated by nursing scope (according to specialty), the exam I plan to take is the American Association of Nurse Practitioner Credentialing Exam. I chose this exam because I believe it will be crucial to the validation of my ability, skills, and knowledge as a nursing practitioner. Importantly, it will be an important step towards confirmation of my competence and credibility in the nursing field, an element that consumers of nursing care need to be assured of in the face of today’s complex healthcare needs. Additionally, I believe subsequent certification and accreditation will boost my confidence in this field and deliver much-needed personal satisfaction as far as a career in nursing is concerned. My plan to pass this exam entails familiarizing myself with test content outlines that are usually issued by the examining body and making use of the recommended reference lists during my preparation. I am also considering purchasing additional review material (mainly online) or digging in databases where such materials are free. Last yet important in this respect, I think an online/electronic certification review course will help me a great deal as I prepare for the exam.
Some of the professional and/or clinical practice issues the new Nurse Practitioner will need to address with the certification, licensure, credentialing, or relocation process include patient assessment, patient education, diagnosis, intervention, planning, response evaluation, disease prevention (health promotion), nursing leadership, and ethics. Imperatively, these will need to be congruent with the overall healthcare objectives of bodies such as the National Council of State Boards of Nursing and the American Nursing Association. Certification, licensure, credentialing, and relocation processes vis a vis these professional/practice issues have to be congruent with best evidence and specified quality standards (ANCC, 2013; Dickerson & Chappell, 2011).
The scope of practice for Primary Care Nurse Practitioners in Acute Care, Family Practice, and Adult Gerontology Primary can best be understood based on the framework developed by ANCC (2008), called the Consensus Model for APRN Regulation: Licensure, Accreditation, Certification, and Education. This model defines practice on the basis of role and population-based competencies. Whereas Acute Care and Family Practice Nurse Practitioners have certification to deliver care for patients across the life span, those in Adult Gerontology are limited to practice with (thus deliver care) to older adults. Importantly, all categories of practitioners might be employed in EDs emergency departments) to offer emergency care but because those in Adult Gerontology have limited educational preparation that does not usually cover all populations, their practice is population-specific (they handle only children or older adults). The categories of patients (based on age) and the settings in which these Nurse Practitioners can practice are the likely points of difference as one moves from one state to another.
Lastly, FNP and AGPCNP graduates can practice in a variety of settings, examples being: 1) Hospital inpatient setting and 2) Private group practice. The former would give them exposure in Acute care (for instance clinical focus could be on surgical care) whereas the latter would be focusing on family as the population being given Primary Care.
American Nurses Credentialing Center. (2008). Consensus model for APRN regulation: Licensure, accreditation, certification and education. Retrieved December 1, 2019 from http://www.nursecredentialing.org/APRN-ConsensusModelReport.aspx
American Nurses Credentialing Center (ANCC) (2013). American Nurses Credentialing Certification-ENP-BC. Author.
Dickerson, P., & Chappell, K. (2011). Addressing innovation: Changes in the American Nurses Credentialing Center accreditation system. Journal of Continuing Education in Nursing, 42(10), 441–445.