Massachusetts is the state in focus. The region considers a psychiatric-mental health nurse (PMHNP) under Advanced Practice Registered Nurse (APRN). It has formed various agreements with APRNs, the Board of Registration in Nursing, and the Bureau of Health Professional Licensure to facilitate the certification of nursing practitioners. The agreements have advanced healthcare services that PMHNP and other nursing specialists offer clients.
Physician collaboration is not a requirement in Massachusetts since 2020. Before the onset of the coronavirus pandemic, 244 Code Mass. Regs. 4.05 policy compelled registered nurses to seek the physician’s consent before offering certain services (Japsen, 2021). Those involved in prescriptive practice had to consult the physician before pharmacotherapeutics interventions. However, during the COVID-19 pandemic, the state allowed NPs to work independently without physician collaboration. The new amendment only allowed collaboration when necessary for effective healthcare services.
Licensing of Advanced Practice Registered Nurses (APRN) in Massachusetts involves various steps. Firstly, the Massachusetts Board of Registration in Nursing provides clear observation procedures. For example, the nurse must provide an RN license, a transcript from an education program, proof of graduate-level coursework, APRN certification from the national board, and good moral character. An authorization fee of $150 is a requirement for every application (Commonwealth of Massachusetts, 2023). The board reviews the documents to ascertain one’s qualifications and can request additional written credentials when necessary. Further, it assesses applicants’ compliance with Massachusetts tax laws and other revenue policies. The procedure ensures that only qualified nurses are allowed to address patient needs.
Massachusetts allows APRNs to practice certification programs such as nurse anesthetists, midwives, and PMHNPs. Different certifying agencies handle their certification programs. For instance, American Nurse Credentialing Center (ANCC) is the certifying agency for PMHNP. The certification verification takes seven days after the applicants have mailed and paid for the accreditation.
The state’s board website is “https://www.mass.gov/orgs/board-of-registration-in-nursing.” The board defines the scope of NP to offer services such as preventive health, health promotion, diagnostic and management of chronic and acute illnesses, counselling, and health education (Commonwealth of Massachusetts, 2023). NP or CNP provides services in diverse settings, including homes, emergency departments, communities, private places, and other nursing facilities. The state practice agreement contains the independence of NPs, especially the revocation of the collaborative practice agreements. Governor Charlie Baker required Massachusetts NPs and APRNs to work without physicians’ collaboration (Japsen, 2021). The agreement guarantees advanced practitioners the independence of operations.
Acquiring a DEA license requires one to meet the Under Controlled Substances Act of 1970 requirements (U.S. Department of Justice, 2023). The applicant must provide business or personal information, state license, activity, and background information. The next step would be paying a nonrefundable fee and confirming the application details before submission.
Massachusetts also has a prescription-monitoring program (PMP) that tracks Schedule II-V prescriptions. Making the best clinical decisions, including pharmacy reporting and data submission, electronic record management, and report analysis, has been possible and more straightforward because of PMP (Commonwealth of Massachusetts, 2023). Besides, the state applies nurse controlled-substance prescriptive authority with terms and conditions of operations. The guidelines control supervised prescriptive practice and medication management. Audit Tool for Compliance with the Regulations at 244 CMR 4.00 excludes certain specialists from prescriptive practices (Commonwealth of Massachusetts, 2023). They include certified nurse midwives (CNMs) and clinical nurse specialists (CNSs). Further, MA Controlled Substance Registration (MCSR) recommends education requirements for prescribers, including pain management and overdose prevention. Thus, the PMP supported effective prescription.
The regulation barriers that might impede healthcare delivery are less focused on PMHNP, registration procedures, and prescription policies. The state should advance and expand departments for PMHNP, simplify registration procedures, and allow the prescriptive authority to CNMs and CNSs. One thing that surprises me is the revocation of collaborative practice agreements, making RNs liberal in healthcare decisions. Making necessary changes would streamline the state’s certification process.
References
Commonwealth of Massachusetts. (2023). Learn about advanced practice registered nurses (APRNs). Mass.gov. https://www.mass.gov/service-details/learn-about-advanced-practice-registered-nurses-aprn
Commonwealth of Massachusetts. (2023). Learn more about prescriptive authority requirements and practice guidelines. Mass.gov. https://www.mass.gov/service-details/learn-more-about-prescriptive-authority-requirements-and-practice-guidelines
Commonwealth of Massachusetts. (2023). Prescription monitoring program (PMP). Mass.gov. https://www.mass.gov/orgs/prescription-monitoring-program
Japsen, B. (2021). Massachusetts latest to lift hurdle to nurse practitioners as COVID-19 rages. Forbes. https://www.forbes.com/sites/brucejapsen/2021/01/04/massachusetts-latest-to-lift-hurdle-to-nurse-practitioners-as-covid-19-rages/?sh=58dcc14a600f
U.S. Department of Justice. (2023). Application for registration under the Controlled Substances Act of 1970. https://apps.deadiversion.usdoj.gov/webforms2/spring/main?execution=e1s1
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