Board of Registration in Nursing

1. Board of Registration in Nursing

2. Module 3: Preparing for Practice as an Advanced Practice Registered Nurse (APRN): Board Authorization

3. Prohibition of Practice • Board authorization to practice must be obtained prior to: • Engaging in practice as an Advanced Practice Nurse (APRN) • Using any APRN credentials • Identifying self as APRN by signs, name tag, stationary and similar devices

4. APRN Authorization Written authorization granted by the Massachusetts Board of Registration in Nursing to a Registered Nurse, under authority of M.G.L. C. 112, s. 80B to engage in advanced practice nursing as defined in 244 CMR 4.00

5. Graduation from formal education program which has as its objective the preparation of nurses to practice in a defined advanced practice role Current, unencumbered MA Registered Nurse (RN) licensure Determination of Good Moral Character (GMC) Attainment of certification from a nationally recognized accrediting body approved by the Board in a category recognized in regulation Payment of fees Becoming Authorized to Practice as an APRN

6. Board Authorization Requirements for APRN • Compliance with the requirements of 244 CMR 4.00, as evidenced by documentation filed with and acceptable to the Board • Applications available at www.pcshq.com • Read and follow instructions carefully to avoid delay

7. Educational Preparation • Satisfactory completion of a formal educational program which has as its objective the preparation of registered nurses to practice in the advanced role • Program must be Board recognized • Advanced physical assessment • Advanced pathophysiology • Advanced pharmacology (minimum 24 hours beyond generic RN education)

8. Education • Advanced nursing knowledge and clinical skills acquired through an Board recognized program • Advanced skills including evaluation, diagnosis, and treatment • Not considered the generic practice of registered nurse

9. CNS Grandfather Clause • Effective until December 31, 2016 • the Board will accept current CNS certification granted by a Board-recognized certifying organization as equivalent to the requirements for inclusion of pathophysiology, advanced assessment and pharmacology in educational curricula • the CNS who is authorized by the Board on the basis of this equivalent competency will be eligible to renew his or her authorization

10. RN license • Current, unencumbered • Has met good moral character requirements

11. Application Process • Obtain instructions and application from Professional Credentialing Services (PCS) • www.pcshq.com • Read, complete in entirety, follow directions to avoid delay

12. Each application for initial, additional or reciprocal authorization must be received by PCS, fully completed and legible, with all required documentation, before it will be reviewed.

13. Good Moral Character Licensed nurses in Massachusetts who fulfill the Good Moral Character requirement are honest, trustworthy, accountable, reliable, have integrity, and are able to distinguish between right and wrong. They also avoid aggression to self and others, and avoid injustice and deceit. • Review Module 2: Standards of Practice for detailed GMC information

14. Right to Review • If you are denied license based on the Good Moral Character requirement, you have the right to review your denial. • You will be required to provide documentation which can reasonably substantiate the existence of specific areas of factual dispute relevant to the issue.

15. Review Module 4: Competence: A Legal Requirement to Advanced Registered Nursing Practice for detailed certification information Must have completed requirements and attained certification from Board approved, national, professional certifying organization Certification in Board recognized category in regulations at 244 CMR 4.00 (CNP, PCNS, CRNA, CNM, CNS) Certification

16. Prescriptive Practice Guidelines • With the exception of CNM, APRN’s with prescriptive authority must have guidelines • CNS do not have prescriptive practice • Review Module 5: Legal Scope of APRN Practice for detailed guideline information

17. Legal Documentation • In all records required by federal and state laws and regulations and accepted standards of nursing practice • Must be accurate, complete, legible • Sign name and initials as they appear on your license (CNP, PCNS, CRNA, CNM, CNS) • May use certification credentials on business cards, stationary, advertisements, and other similar correspondence

18. Authorization Documentation • Once authorized, the Board will send you written notification of your authorization approval • You will receive a wallet sized document soon after indicating your APRN Board approved category • Your Board authorization will appear on the Board’s website under “Check a License” and is considered the most “up to date” information and is primary source verification

19. Authorization Renewal Requirements • Due on your birthday in the even numbered years • Current MA registered nurse licensure • Determination of GMC • Current certification from a nationally recognized accrediting body approved by the Board • Signature attesting to compliance with Board laws and regulations. READ WHAT YOU SIGN!! • Payment of fees

20. On-line renewal is recommended • Fast • Secure • Provides for immediate verification via the Board’s website

21. Certification Renewal • A requirement for Board authorization • Certification must be current to continue authorization • You are responsible to fulfill the requirements of the certifying organization • You are responsible to know when your certification renewal is due

22. Wallet size documentation • You will receive two wallet sized documents when you renew • Your RN license • Your APRN authorization

23. Scope of Practice Category vs. Specialization • Board authorizes APRN practice by category, not by specialization within the category • Category competency determines: • Ages of population served • Characteristics of population served • Medical conditions of population served • Activities performed

24. Demonstration of Competency • Certification • Experience • On the job training • On-going education • Attendance at educational session • Formal course work

25. Scope of Practice • An APRN’s scope of practice is determined by the knowledge, skills and abilities attained • Able to demonstrate competency in the activity • Responsible for own practice

26. No longer practicing? • Should you want to rescind your APRN authorization, complete the Board’s form at http://www.mass.gov/Eeohhs2/docs/dph/quality/boards/nursing_aprn_resign_letter.pdf • Remember!! Once you rescind your authorization you will be required to meet the current authorization requirements to make authorization as an APRN current

27. Review 4.00 and 9.00 • Go to the Board’s website to review: • 244 CMR 4.00: Massachusetts Regulations Governing Advanced Practice Registered Nursing • 244 CMR 9.00: Standards of Conduct

28. Get into the habit of Checking the Board’s Website www.mass.gov/dph/boards/rn • News and Updates • Practice Issues • Alerts • Regulatory Guidance • Advisory Rulings • Newsletters

29. Board of Registration in Nursing239 Causeway Street2nd Floor, Suite 200Boston, MA 02114 On-Line Renewal www.mass.gov/dph/boards/rn (go to On Line Services in right margin)