reply to this discussion with two references  Professional Nursing and State-Level Regulations Boards of nursing are equipped to regulate nursing in each state in the United States. It is however important to note that the regulations vary from one state to another. Over the years, there have been reforms in different states with the view of lifting restrictions to practice. It should be noted that expanded state NP practice regulations have come to be associated with greater NP supply and improved access to care among rural and underserved populations without decreasing care quality (Yang et al., 2021). Indeed, there is enough evidence supporting the lifting of restrictive practice. Thus, it is important that APRNs should be aware and understand existing regulations for the specific states where they practice in order to not only practice within their scope but to also identify opportunities for advocating for independent practice. This discussion will compare regulations as they apply to APRNs in the state of Maryland and Georgia. Maryland Versus Georgia In the state of Maryland, it is important to note that the board of nursing licenses qualified APRNs to full scope of practice. The regulations therefore allow a licensed and certified APRN to practice without supervision from a physician by carrying out duties such as evaluating the patient, diagnosing and treating the patient (American Association of Nurse Practitioners, 2021). On the other hand, the board of nursing of Georgia State allows restricted scope of practice for APRNs who are licensed and certified to practice within the state. This means that the licensure laws and regulations provided by the board of nursing restrict the APRN’s ability to be involved in at least one nursing practice’s element. The law requires supervision, delegation or management of team by another healthcare provider for the nurse practitioner to provide care for the patient (American Association of Nurse Practitioners, 2021). In both states, the APRN is required to register with the prescription drug monitoring program (PDMP) in order to prescribe opiates. However, in the state of Georgia, the regulations allow the APRN to only practice under a physician’s prescriptive authority (Georgia Department of Public Health, 2018). This regulation also applies for prescription of controlled substances. In the State of Maryland, the APRN has to get a DEA number and after that, they can independently prescribe schedule II to V of controlled substances. In the State of Georgia, the APRN can only be involved in prescribing schedule III to V control substance under the prescriptive authority of a physician (American Medical Association, 2017). APRNs with Full Practice Authority These regulations apply to advanced practice registered nurses with legal authority to practice within the full scope of their experience and education. For example, the prescriptive authority of APRNs in Maryland allows them to prescribe ...

1. reply to this discussion with two references
Professional Nursing and State-Level Regulations
Boards of nursing are equipped to regulate nursing in each state
in the United States. It is however important to note that the
regulations vary from one state to another. Over the years, there
have been reforms in different states with the view of lifting
restrictions to practice. It should be noted that expanded state
NP practice regulations have come to be associated with greater
NP supply and improved access to care among rural and
underserved populations without decreasing care quality (Yang
et al., 2021). Indeed, there is enough evidence supporting the
lifting of restrictive practice. Thus, it is important that APRNs
should be aware and understand existing regulations for the
specific states where they practice in order to not only practice
within their scope but to also identify opportunities for
advocating for independent practice. This discussion will
compare regulations as they apply to APRNs in the state of
Maryland and Georgia.
Maryland Versus Georgia
In the state of Maryland, it is important to note that the board of
nursing licenses qualified APRNs to full scope of practice. The
regulations therefore allow a licensed and certified APRN to
practice without supervision from a physician by carrying out
duties such as evaluating the patient, diagnosing and treating
the patient (American Association of Nurse Practitioners, 2021).
On the other hand, the board of nursing of Georgia State allows
restricted scope of practice for APRNs who are licensed and
certified to practice within the state. This means that the
licensure laws and regulations provided by the board of nursing
restrict the APRN’s ability to be involved in at least one

2. nursing practice’s element. The law requires supervision,
delegation or management of team by another healthcare
provider for the nurse practitioner to provide care for the
patient (American Association of Nurse Practitioners, 2021). In
both states, the APRN is required to register with the
prescription drug monitoring program (PDMP) in order to
prescribe opiates. However, in the state of Georgia, the
regulations allow the APRN to only practice under a physician’s
prescriptive authority (Georgia Department of Public Health,
2018). This regulation also applies for prescription of
controlled substances. In the State of Maryland, the APRN has
to get a DEA number and after that, they can independently
prescribe schedule II to V of controlled substances. In the State
of Georgia, the APRN can only be involved in prescribing
schedule III to V control substance under the prescriptive
authority of a physician (American Medical Association, 2017).
APRNs with Full Practice Authority
These regulations apply to advanced practice registered nurses
with legal authority to practice within the full scope of their
experience and education. For example, the prescriptive
authority of APRNs in Maryland allows them to prescribe
medications, including schedule II to V controlled substances
independently or without supervision of physicians. This is
however not the case for the APRNs in Georgia. In cases where
there is need for supervision, the required agreements should be
signed and NPs in Georgia will have to practice only within the
scope that is allowed by the law. Notably, full scope of practice
for NPs has come to be associated with improved access to care
(Kandrack et al., 2021). It is unfortunate that nurses that are
able to provide safe and quality care just like physicians do are
restricted from doing so by state laws. Access to quality care
has always been negatively impacted when NPs that are willing
to deliver cost-effective, safe and quality care become restricted
and this calls for an update in health policies in such states

3. (Peterson, 2017).
Adherence to the Regulations
The APRNs have the responsibility and role to make sure that
they are conversant with the regulations as per the specific state
they work in. In order to adhere to the set regulations, it is very
important for the APRN to be familiar with the state’s
regulating board and ensure that the Nurse Practice Act for that
particular state is read and understood. Notably, the APRN
should be aware of the process and regulations put in place
concerning licensing and authorizing them to practice. In
conclusion, it is very important for every nurse practitioner to
be well equipped and knowledgeable about the regulations of
the state’s board of nursing and the scope of practice of that
particular state and what it means. It is clear that each state is
unique and different.
References
American Association of Nurse Practitioners. (2021). State
practice environment.
https://www.aanp.org/advocacy/state/state-practice-environment
American Medical Association. (2017). State law chart: Nurse
practitioner prescriptive authority. AMA.
https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-
browser/specialty%20group/arc/ama-chart-np-prescriptive-
authority.pdf
Georgia Department of Public Health. (2018). Prescription Drug
Monitoring Program. DPH.
https://dph.georgia.gov/pdmp
Kandrack, R., Barnes, H., & Martsolf, G. R. (2021). Nurse
practitioner scope of practice regulations and nurse practitioner

4. supply.
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(3), 208-217.
Peterson, M. E. (2017). Barriers to practice and the impact on
health care: A nurse practitioner focus.
Journal of the Advanced Practitioner in Oncology
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8
(1), 74.
Yang, B. K., Johantgen, M. E., Trinkoff, A. M., Idzik, S. R.,
Wince, J., & Tomlinson, C. (2021). State nurse practitioner
practice regulations and US health care delivery outcomes: A
systematic review.
Medical Care Research and Review
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78
(3), 183-196.