Understanding Scope of Practice about Certification and Licensure

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Every nursing program has a specific scope of practice about its certification and licensure by the State regulations. The role of the National Council of State Boards of Nursing (NCSBN) is to provide a platform for all the state boards of nursing. They need to meet, discuss, and ensure that all the state boards work together to provide an appropriate regulation for public health, safety, and welfare as the main focus (American Nurses Association, n.d.). The Essay provides a discussion of the clinical practice issues required to be considered and addressed by a new Nurse Practitioner with the certification, licensure, credentialing, or relocation process. Also discussed is a comparison of the scope of practice of the Acute Care, Family Practice, and Adult-Gerontology Primary Care Nurse Practitioner and the differences in practice from state to state.

Primary care Nurse Practitioner graduates can seek employment in the acute care settings such as ER, OR, or the hospitalist since they are fully qualified with substantial and appropriate training. There is an overlap of the acute care and primary care competencies, and wording only distinguishes the few unique competencies that exist. Thus, the distinction in the role of primary care and acute care is only made at the population level served by the Nurse Practitioner. The acute care and primary care distinctions exist within the adult-gerontological and pediatric aspects. The NP competencies are not setting-specific in which acute care NP only serves in the hospital, and the primary care NP only serves within a community setting. The setting boundaries usually overlap in practice (National Organization of Nurse Practitioner Faculties, 2011).

From Case study one; Mary tries to decide whether to take the American Association of Nurse Practitioner Credentialing exam or the American Nurses Credentialing Exam. For the American Association of Nurse Practitioner Credentialing exam, Mary requires completing the competency-based examination for nurse practitioners. It helps to reflect on nurse practitioner knowledge and expertise for her specialty. Next is to take the computer-based examinations and receive a preliminary result of Pass/Not Pass status during testing. A certification with authorization to use the NP-C credentials follow and she will be qualified to use the credential Nurse practitioner-Certified. The certification runs for five years upon which it is renewed.

For the American Nurses Credentialing Exam, Mary requires to access the certification web page to access the eligibility criteria, have an online application, and acquire the exam preparation resources. After taking the certification exam, she requires seeking for the primary accreditation that uses evidence-based criteria to organize, implement, and assess the highest quality continuing nursing education activities.

In Maryland, the scope of practice for Acute Care, Family Practice, and Adult-Gerontology Primary Care Nurse Practitioner have similarities in their practice. However, there exist some crucial educational, clinical, and environmental differences between the different specialties. It is inappropriate to regulate the acute and primary care scope and practice based on the practice settings but should have a basis for the educational preparation (National Organization of Nurse Practitioner Faculties, 2011). The practice from one state to another differs by the relative scope of practice due to the legal, ethical, and safety issues that arise whose responsibility lies in the nurse practitioner (Barton Associates, n.d.).

The appropriate practice settings for FNP graduates are providing primary care across the lifespan in the hospitals and the Emergency departments when a need arises. The appropriate practice settings for AGPCNP graduates are the community clinics, health maintenance organizations, long-term care settings, and continuing care retirement community settings. They work in various clinical settings and also in independent practices.

In conclusion, it is essential to understand the components of the scope of practice and other practices within the parameters of the educational program completed and the appropriate national certification. Every state has particular guidelines on the scope of practice, but the components of the specialties overlap in practice. 


American Nurses Association (n.d.). American Nurses Association;

Retrieved from http://www.nursingworld.org/EspeciallyForYou/AdvancedPracticeNurses

Barton Associates (n.d.). Nurse practitioner scope of practice laws;

Retrieved from http://www.bartonassociates.com/nurse-practitioners/nurse-practitioner-     scope-of-practice-laws/

National Organization of Nurse Practitioner Faculties (2011) Statement on acute care and             primary care nurse practitioner practice: Consensus Model for APRN Regulation:        Licensure, Accreditation, certification, and education.

Retrieved from             http://c.ymcdn.com/sites/www.nonpf.org/resource/resmgr/imported/NPPrimaryCareAcut            eCarePracticeFINAL.pdf

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