NRS 430 Topic 4 DQ 1 Outline the process for the development of nursing standards of practice for your state

NRS 430 Topic 4 DQ 1 Outline the process for the development of nursing standards of practice for your state

Topic 4 DQ 1

Outline the process for the development of nursing standards of practice for your state, including discussion of the entities involved in developing the standards of practice and how the standards of practice influence the nursing process for your areas of specialty.

REPLY TO DISCUSSION

The addition of compact licensure to the nurse licensure process allows nurses to practice in other compact partner states. In your opinion, would it be beneficial to have national professional practice standards versus state oversight? Why or why not?

I believe the compact licensure has been very helpful. It allows the holder to practice in all participating states in the US. Considering the recent pandemic, nurses were able to move from one locatiion to another to care for severely sick. This i believe was possible because of the compact license to practice.

Having a national professional practice standard or state specific standard has its cons and pros.

The advantage of a federal standard of practice is uniformity in practice and licensure. For instance, in my home country, there is just one board of nursing referred to as the nursing council and they help in maintaining standard of care in all states of the federation as well as issuance of liscenses. Hence, a professional nurse in one state can practice in all the 36 states of the country.

The downside of this system could be delay in processes and procedures such as registration, verification and issuing of liscenses.

Coming to the US, i think having a centralized system might be a bit cumbersome to maintain because of the ever growing population size and changing system in healthcare. Also, it would be easier to manage the ever growing population and nursing practice within the state level.

You bring up a valid point of a national council to regulate the practice. Larger numbers of nurses to oversee would be a challenge. Perhaps the national council could have state committees to oversee the practices using the national standards.

In my country, there is one board of nursing called the ‘Nursing council’, and they help in monitoring the standard of care in all states of the federation. The nursing council will verify where I studied and the state health authority will issue the license to practice nursing in any state. So a professional nurse can practice nursing in all states of the country. The Nursing council will register, verify and issue licenses. And it is renewed every five years. To practice outside the country, a special authorization is required. In the United states, each state allows nursing practice after verifying the nursing certificate and allowing to practice as an RN nurse.

Thank you, Rose. In your opinion, since you have licensure in your home country as well as the U.S. is one better?

If one can meet the competencies of the NCLEX, safe practice should be the same everywhere. In nursing, basic study is the same, but teaching methods can be different. Although the studies and practice are similar, tradition, culture and people are different. And one should have dedication and compassion to nursing job. Only then can one be sincere to their patients.

In my opinion I think absolutely it would be more stream line and beneficial to all those involved (patients, nurses, and the state legislators) to have national professional practice standards versus state oversight. For example, looking at the pandemic, different

states needed nurses at different times through the waves of COVID, having a nursing license that had the same scope of practice and nationally standardized would help streamline nurses to work around the country at any given time. This can also help nurses when moving states or location if they decide to relocate they don’t have to go through the hoops of getting an RN license that permits them to practice in whatever state they are going to. I think overall its better to have one golden standard across the country versus having different scopes of practices, rules and regulations for RN’s in different states. Having a national professional practice standard would make for safer better regulated conditions and overall better patient outcomes across the country.

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Thank you, Cassidy. COVID provides a great example of why it would be beneficial to support national standards.

Billie, yes I do believe it would be beneficial to have a national standardization in certain instances. Especially in times like we have seen with the pandemic. So maybe an emergency compact licensure would be more ideal. This would still give each state oversight ability and responsibility, not to mention autonomy.

Safe practice should be the same everywhere. If one meets the competencies of the NCLEX, then it would be ideal that one be granted the ability to do use that licensure consistently across the states.

In my opinion, I think that it would be benficial for there to be a national licensure for nurses. I think this could be both helpful for the nurse and patient. Quality of standards being universal across the states will allow the nurse flexibility to travel or move states without delay in work. Being able to move from state to state working with the same scope of practice and standard of care can also be beneficial in a state of emergency or even in a pandemic. This also insures and equally in care nation wide through the nursing profession, so patients can expect the same great care wherever they are in the country. On the other hand, I do feel that it is important to have nurses and health care professionals from various fields to have input on the nursing scope of practice and standard of care.

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The practice of nursing is in a constant state of motion and in an effort to create guidelines for standards of practice, a “list of competencies to help nurses better understand the expectations…these include assessment, diagnosis, planning, coordination of care, health teaching consultation, prescriptive authority, and evaluation” (Dean, 2018). The National Council of State Boards of Nursing (NCSBN) assists all fifty states, including Oklahoma, in developing guidelines for standards of care for its Board of Nursing (BON) (ncsbn.org). These guidelines set forth by the NCSBN encourage the state of Oklahoma to use evidence-based practice in its Nurse Practice Act (NPA) which promotes patient safety and outcomes (Huynh, 2021).

With all states using the NCABN, a sense of continuity and standardization can be felt in the profession of nursing. With developments in medicine and other interventions, it is vital in the nurse role to understand what his/her role is in regards to patient safety and outcomes. By using the standards of practice put forth by the state of Oklahoma’s BON, the safety of patients is in the forefront of the care that is provided.

In the post-anesthesia care unit (PACU), the five components of the nursing process are utilized (Dean, 2018). An example of this would be a patient who presents to the PACU after a shoulder arthroscopy. An initial assessment of the patient shows the patient to be moaning, wincing, as well as tachycardia and hypertensive; this is the first step in the nursing process. The second step would be to provide a diagnosis. What is the problem? The patient reports pain (as 8 on a scale of 0-10) as a result of surgery as seen by increased heart rate and blood pressure as well as pain score. The third step is planning/outcomes, what can the nurse implement as far as interventions and possible pharmacologic strategies to alleviate the patient’s pain and what could the outcomes of said implementations be? The fourth step is implementation. The nurse carries out the intervention that was previously evaluated, in this case the nurse decides to dim the lights, quiet the room, and provide the patient with pain medication per orders given by provider. The last step is evaluation. Did the intervention work? Is the patient’s pain alleviated? This step often requires another assessment to determine the effectiveness of the intervention. The Standards of Practice set forth by the BON guides this nurse process in that the nurse is able to evaluate the problem, consider options for implementing interventions then evaluating the outcomes, all based on the appropriate standards of care put in place.

Dean, Julie. (2018). Practice and Competency Development. Dynamics in Nursing Art & Science of Professional Practice Ch.3. https://www.gcumedia.com/digital-resources/grand-canyon-university/2018/dynamics-in-nursing_art-and-science-of-professional-practice_1e.php

Huynh, A.P., Haddad, L.M. (July 22, 2021). Nursing Practice Act. Stat Pearls. ncbi.nlm.nih.gov/books/NBK559012/

ncsbn.org/decision-making-framework.htm

Thanks for the insightful discussion. From your discussion, I have learned that the National Council of State Boards of Nursing (NCSBN) assists all fifty states, including Oklahoma, in developing guidelines for standards of care for its Board of Nursing (BON) (National Council of State Boards of Nursing, 2021). My state is Arizona and the process of developing standards for nursing practice is almost similar to that of Oklahoma. The development of nursing standards of practice for the state of Arizona is a collaborative effort that involves various entities, including nurses, nurse educators, and nurse practitioners (Dean, 2018). The first step in the process is the identification of areas that need clarification or standardization. Nurses and other healthcare professionals then develop evidence-based clinical practice guidelines to address these areas (Bradley et al., 2019). These guidelines are then submitted to the Arizona State Board of Nursing for review and approval. Finally, the guidelines are published on the board’s website and become part of the nursing standards of practice for the state.