Maryland Nursing Practice Certification and Licensure

Maryland Nursing Practice Certification and Licensure

How to Obtain Certification and Licensure in Your State?

I reside in the State of Maryland, which grants full practice privileges to qualified Nurse Practitioners (NPs) meeting the state’s requirements. According to the American Association of Nurse Practitioners (AANP) (2020), states with full practice and licensure laws empower NPs to assess patients, make diagnoses, order and interpret diagnostic tests, and initiate and manage treatments. In Maryland, NPs also have the authority to prescribe medications and controlled substances, regulated exclusively by the Maryland Board of Nursing (MBON). This means that NPs in Maryland can offer comprehensive care.

Comparison Between Pennsylvania and Texas APRN Board of Nursing Regulations

Advanced practice status in Maryland hinges on education and certification. To become licensed as a qualified NP in this state, certain prerequisites must be met. These prerequisites include holding a current and unencumbered Maryland RN license or having a multistate licensure privilege as an RN, graduating from a Master’s-level or higher nurse practitioner program approved by the Board, passing a board-certified NP examination, obtaining national certification from a recognized body like the American Academy of Nurse Practitioners National Certification Board (AANPNCB), submitting a complete application for NP certification, and demonstrating proficiency in written and oral English (Advance Practice Registered Nurse License Requirements in Maryland, 2021).

What is the Certification Application Process in Your State?

To practice as an NP in Maryland, certification must be obtained from the Maryland Board of Nursing. The application process involves several key steps:

1. Providing a Maryland RN number or a valid Compact Current State RN License.
2. Completing the certification application accurately and thoroughly.
3. Submitting the Declaration of Residence form, confirming Maryland residency.
4. Supplying sealed official transcripts from your NP program.
5. Providing a copy of your current national certification or eligibility to take the certification exam (Maryland Board of Nursing, 2021).

What is the Primary Nurse Licensure Office Resource Website in Your State?

The primary resource website for nurse licensure in the State of Maryland is: https://mbon.maryland.gov/Documents/np_application.pdf

How Does Your State Define the Scope of Practice of a Nurse Practitioner?

In Maryland, the scope of practice for Nurse Practitioners is extensive. It includes performing comprehensive physical assessments, certifying individuals with special health considerations to the Department of Transportation, determining pregnancy or childbirth, completing birth and death certificates, diagnosing common short-term and chronic stable health conditions, issuing “do not resuscitate orders” (DNR) on Maryland Emergency Medical Services forms, ordering and interpreting laboratory and diagnostic tests, prescribing medications, providing emergency care, making referrals to appropriate licensed healthcare providers, certifying clients with serious illnesses or needing life-support equipment, and witnessing advance directives (Maryland Board of Nursing, 2021).

What is Included in Your State’s Practice Agreement?

Maryland is part of the National Nurse Licensure Compact (NLC), allowing nurses licensed in compact states to practice across state lines without obtaining a separate license. This compact ensures that nurses with a multistate license can fully practice in any of the 25 participating NLC states (Maryland Board of Nursing, 2021).

How Do You Obtain a Drug Enforcement Agency (DEA) License?

Nurse Practitioners in Maryland have the responsibility to administer, prescribe, and dispense controlled substances. To do so legally, they must register with the Drug Enforcement Administration (DEA). Here’s the process:

1. Apply for a Maryland State Controlled Dangerous Substances Registration (CDS) with the Office of Controlled Substances Administration (OCSA). Prior to this, applicants must register with the Prescription Drug Monitoring Program (PDMP) on the CRISP website at https://crisphealth.org/ (Maryland Department of Health-Public Health Services-Office of Controlled Substances Administration, 2021).

2. Once the CDS registration is approved, NP applicants can apply for a Federal DEA license using their State license number. This can be done online through the U.S. Department of Justice website or by mailing in the application (U.S Department of Justice Drug Enforcement Administration, 2021).

How Does Your State Describe a Nurse Practitioner’s Controlled-Substance Prescriptive Authority and What Nurse Practitioner Drug Schedules Are They Authorized to Prescribe?

In Maryland, qualified and approved NPs can independently prescribe and dispense drugs, devices, and controlled substances classified as Schedule II-V. For the first 18 months of practice, physician involvement is required for NP prescriptive authority. To prescribe controlled substances, NPs must have a Maryland Drug Control Number (American Medical Association, 2021).

What Legislative and Advocacy Activities Are Your State Nurse Practitioner Organizations Involved In?

Nurse Practitioner organizations in Maryland are actively involved in legislative and advocacy activities. They work to influence positive actions taken by the legal authorities to advance the role of NPs and increase access to healthcare. For instance, the Nurse Practitioner Association of Maryland (NPAM) advocates for comprehensive policies and regulatory foundations that enable NPs to provide high-quality healthcare to the fullest extent of their scope of practice (Nurse Practitioner Association of Maryland, 2021).

Additionally, organizations like the National Association of Pediatric Nurse Practitioner – MD – Chesapeake monitor pediatric health-related bills introduced at the state and local levels during the Maryland General Assembly session. They provide support or opposition to bills based on the National Association of Pediatric Nurse Practitioners (NAPNAP) National Health Policy Agenda (National Association of Pediatric Nurse Practitioners MD: Chesapeake, 2021).

In summary, Maryland provides a favorable environment for Nurse Practitioners, allowing full practice and prescribing authority. However, the requirement for a mentor during the initial 18 months of practice may pose challenges for some NPs. The state’s NP organizations are actively engaged in legislative efforts to promote and protect the profession, making it an exciting time for aspiring NPs in Maryland.

References

American Medical Association (2021). State law chart: Nurse Practitioner Prescriptive Authority. Retrieved from https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/specialty%20group/arc/ama-chart-np-prescriptive-authority.pdf

Nurse Practitioner Association of Maryland (2021) The Legislative and Clinical Practice Environment in Maryland. Retrieved from https://www.npamonline.org/page/34

American Association of Nurse Practitioners (2020). Practice Environment Details. Retrieved from https://www.aanp.org/advocacy/state/state-practice-environment

Advance Practice Registered Nurse License Requirements in Maryland (2021). Retrieved from https://www.nursinglicensure.org/np-state/maryland-nurse-practitioner/#education

Maryland Board of Nursing (2021).  Criteria for Nurse Practitioner Certification & Instructions for the applicant. Retrieved from https://mbon.maryland.gov/Documents/np_application.pdf

Maryland Board of Nursing (2021).  Nurse Practitioner — Scope and Standards of Practice. Retrieved from https://mbon.maryland.gov/Pages/adv-prac-nurse-practitioner-index.aspx

University of Maryland. Division of Research (2021). DEA License Information. Retrieved from https://research.umd.edu/dea-license-info Maryland nursing practice Certification and Licensure

Maryland Board of Nursing (2021) Nurse Licensure Compact. Retrieved from https://mbon.maryland.gov/Pages/msl-compact-states.aspx

U.S Department of Justice Drug enforcement Administration (2021). Registration Procedures (University of Maryland Division of Research, 2021).

Maryland Department of Health-Public Health Services-Office of Controlled Substances Administration (2021). Practitioner Instructions. Retrieved from https://health.maryland.gov/ocsa/Documents/Applications%20Instructions%20(Pra.Revised%209-25-2018).pdf

National Association of Pediatric Nurse Practitioners MD: Chesapeake (2021). Legislation. Retrieved from https://community.napnap.org/marylandchesapeake/legislation Maryland nursing practice Certification and Licensure

Nurse Practitioner Certification and Licensure in Maryland

Nurse practitioners play a vital role in healthcare, with responsibilities encompassing the diagnosis, treatment, and management of acute and chronic health conditions, along with a strong emphasis on health promotion and disease prevention (AANP, n.d.). In my journey to explore the requirements for nurse practitioner licensure in Maryland, my home state, I discovered essential information that pertains specifically to the state’s regulations. Maryland’s nursing sector falls under the governance of the Maryland Board of Nursing (MBON), which offers a dedicated website containing valuable resources for Certified Registered Nurse Practitioners (CRNPs) in Maryland.

Application and Regulations

To attain certification as a nurse practitioner in Maryland, applicants must hold a current RN license issued by Maryland or a compact state and have completed a Master’s level or higher program recognized by the MBON (Division of State, n.d.). The application process for Maryland involves completing a CRNP application provided by the MBON, which must be typed. Applicants are also required to submit a copy of certification from either the American Association of Nurse Practitioners (AANP) or the American Nurses Credentialing Center (ANCC), sealed official transcripts, and a declaration of their state of residence, supported by a copy of their driver’s license.

Maryland is considered a full practice state, which means that nurse practitioners here have the authority to evaluate and manage patients, make diagnoses, order and interpret diagnostic tests, and initiate and manage treatments. This authority extends to prescribing medications and controlled substances, all under the exclusive licensure jurisdiction of the state board of nursing (AANP, 2019). As of October 2015, the Maryland Board of Nursing mandates that new CRNPs have a mentor for a duration of 18 months after certification. This mentor can be either a medical doctor or another CRNP (MBON, 2015).

While Maryland’s regulations are generally conducive to nurse practitioner practice, some barriers may exist. The state’s requirement for a mentor could present a challenge for new NPs if they struggle to find a suitable provider willing to commit to mentoring for the specified duration. Although the state does not outline specific responsibilities for the mentor, their availability and commitment to supporting a new NP may vary, potentially posing challenges.

During my research on NP requirements, I was particularly surprised by the significant variation in practice levels allowed by each state. I am grateful to live and work in a full practice state like Maryland, where nurse practitioners have a comprehensive scope of practice.

Prescribing Medications

In Maryland, nurse practitioners are authorized to prescribe and dispense medications classified as class II, III, IV, and V. The practitioner must obtain a Drug Enforcement Administration (DEA) registration from the United States Department of Justice using form 224. This certification information must then be provided to the state office of controlled substances administration. Additionally, NPs are required to register for the prescription drug monitoring program (PDMP), and Maryland utilizes the CRISP system to monitor patients who may be misusing or addicted to prescription medications. All prescriptions issued by nurse practitioners must be thoroughly documented in the patient’s chart, including any samples provided to the patient.

Conclusion

Becoming a Certified Registered Nurse Practitioner is a rigorous process that demands a substantial investment of time and effort, including extensive coursework and clinical experience. Having a comprehensive understanding of state regulations and requirements is essential for students aspiring to become CRNPs, as it greatly contributes to their success in the certification process.

References

– American Association of Nurse Practitioners (n.d.-a). Nurse practitioners in primary care.
– American Association of Nurse Practitioners (2019). State practice environment.
– Division of State (n.d.). Maryland Board of Nursing.
– Maryland Board of Nursing (2015). Nurse Practitioner Application.