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Boards of Nursing vs. Professional Nurse Associations

Boards of Nursing vs. Professional Nurse Associations

Introduction

  • There are different organizations which participate in regulating and advancing the nursing practice. Knowing each of the organizations and their roles is important to enjoy the benefits offered by the organizations.

Purpose:

  • To provide details on how the nursing practice is regulated and the roles of both BONs and professional nursing associations in regulating and advancing the nursing practice.
  • The purpose of this article is to provide details on how the nursing practice is regulated and the roles of both BONs and professional nursing associations in regulating and advancing the nursing practice.

Understanding regulation of nursing profession is important given the nature of the field. There are different organizations which participate in regulating and advancing the nursing practice, knowing each of the organizations and their roles is important. In the US, there are over 100 boards of nursing (BONs) and professional nursing associations. Understanding their roles will help nurses enjoy the full benefits offered by the organizations.

  • With the vast number of both board of nursing (BONs) and nursing associations, one can get confused about their respective roles in governing nursing practice. Both of these organizations have clear differences in terms of their mandate which are outlined as follows.

Board of Nursing

  • BONs regulate nursing practice. BONs are responsible for regulating nursing practice and protecting the public from unqualified or rogue nurses and ensuring that licensed nurses provide safe and competent care.
  • BONs do not participate in the legislative process. BONs also do not participate in legislation making including lobbying , instead they only implement the formulated legislation as pertains to nursing practice.
  • BONs are government agencies. BONs are government entities formed by the different state governments and one national board having membership picked from the other state BONs (59 state BONs and one national)

Professional Nurse Associations

  • Nursing associations advocate for nurse interests. Nursing associations are responsible for advocating for nurses interests and advancing the nursing profession (Benton et al., 2017).
  • BONs do not participate in the legislative process; nursing association do. Nursing association play an active role in representing their members in legislative process, including lobbying political players to support the interests of the nurses and the nursing practice (Milstead & Short, 2019).
  • BONs are government agencies while nurse associations are private entities  with optional membership. Nursing associations are private entities with membership requiring annual subscriptions.

Members of the Board

  • Currently chaired by Alton Shaw- FNP. The Mississippi board of nursing, currently headed by Alton Shaw (FNP).
  • Has thirteen members. It is a thirteen-member board comprising of  2 nurse educators, 3 registered nurses in clinical practice, two of which should have as basic nursing preparation an associate degree or diploma and 1 to have at least  baccalaureate nursing degree. Another board member is 1 registered nurse at large,1 Registered nursing practitioner, 4 licensed practical nurse, 1  licensed physician who shall always be a member of the State Board of Medical Licensure, 1 representative of consumers of health services
  • The membership should come from each congressional districts in the State of Mississippi. These rules are as outline in the Mississippi Nursing Practice Act amended in 2016.
  • Members in the board other than the member from the State Board of Medical Licensure are appointed by the governor. According to the Mississippi Nurse and practice Act, under the establishment of the board guidelines, for one to become a board member in the Mississippi Board of Nursing, other than the member from the State Board of Medical Licensure have to be appointed by the governor with the advice and consent of the senate.
  • A list of nominees is usually submitted to the governor for consideration by the relevant nursing boards. The list of nominees is forwarded to the governor for consideration are usually submitted by the relevant nursing associations in Mississippi with each slot in list containing three names for consideration. If such a list is not submitted to the governor, then he/she can make the appointments without nomination
  • The term for members in the board is four years with the term limit being no more than two consecutive terms.

The Impact of Federal Regulation

  • Hospital Readmissions Reduction Program (HRRP) is a federal regulation which came as part of the Affordable Care Act package. The regulation in conformance with the Medicare value-based system, requires CMS to reduce payments to health care facilities with huge numbers of patient readmissions allowing only certain conditions like cardiac failure, pneumonia, among others (McIlvennan et al., 2015).

How does this regulation influence delivery, cost, and access to healthcare?

  • The regulation links the payment of health care services to the quality of services offered. The regulation gives incentive to care facilities to enhance involvement, coordination of care and communication between patients and care providers when planning for post discharge care. The regulation focuses on patient outcomes instead of the care processes due to the fact that care givers will do their best to prevent readmissions for better pay (McIlvennan et al., 2015). With low readmissions, the overall cost of health care services will reduce.  So far, since the institution of regulation, no changes has been made to it.

The Impact of State Regulation

  • State regulation – Chapter 41 Minimum Standards of Operation for Mississippi Hospitals, Subchapter 30 on nursing
  • The regulation stipulates hospitals to maintain organized nursing staff to provide  quality care
  • Nursing service will be under qualified RN
  • Sufficient number of RNs on duty at all times
  • The nurses working in hospitals are required to provide quality care
  • Leadership role for nursing service rests on the nurses
  • The regulation mandates hospitals to safeguard quality services to patients.
  • The regulation if properly implemented will have a reduction on cost incurred by patients due to quality care offered
  • Restriction caused by the legislation has affected access especially in the underserved areas
  • Lower efficiency due to the current regulation
  • Increased costs due to duplication and unnecessary physician oversight

According to Chapter 41 Minimum Standards of Operation for Mississippi Hospitals, Subchapter 30 on nursing, the regulation stipulates that hospitals to maintain an organized nursing staff to provide quality care to patients. The regulation also requires the nursing service to be under qualified RN with sufficient of RNs on duty at all times

The state regulation selected first requires that nurses working in a hospital provides high quality services when tending to patient needs and that the mandate to regulate professional conduct of nurses lies squarely on the hospitals. This regulation also put the nurses to be in charge of the nursing service. Therefore, the leadership role of nurses rests on nurses themselves and not other professional. By implementing this regulation, hospitals will be required to employ competent nurses who will in turn provide quality care to patients. similarly, with quality care enhanced with proper nursing leadership, patient readmissions, and adverse outcomes will be reduced making the overall cost incurred by patients to go down (Salmond & Echevarria, 2017).

Due to the regulation as outlined in the Mississippi Nursing Practice Law §73-15-20(3), the access to care, especially in the underserved rural and urban areas is restricted (Neff et al., 2018). This is due to lack of utilization of APRNs to full scope of their abilities. Due to duplication of roles between APRNs and physicians, lower efficiency in delivery of care is observed. The costs of health care have also remained high because of the unnecessary oversight by physicians and duplication of roles (Milstead & Short, 2019). Therefore, it is high time that the relevant organs consider amending the regulation to allow full practice of nurse practitioners in Mississippi.

Conclusion

  • The article has focused on;
  • BONs and associations and their differences
  • Composition of Mississippi BON
  • Regulation of nursing practice
  • Regulation of APRNs
  • The outlined aspects play a pivotal role in dictating the scope of nursing practice

This article has covered different areas including BONs and associations and their differences. The presentation has also described the composition of the Mississippi BON. The presentation has also talked about how regulation of the nursing practice is conducted from the federal to the state level including regulation of APRNs. From the collected information, it can be concluded that the outlined aspects play a pivotal role in dictating the scope of nursing practice.

References

■Benton, D. C., Thomas, K., Damgaard, G., Masek, S. M., & Brekken, S. A. (2017). Exploring the differences between regulatory bodies, professional associations, and trade unions: An integrative review. Journal of Nursing Regulation8(3), 4-11. https://doi.org/10.1016/S2155-8256(17)30154-0

■Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning. Chapter 4, “Government Response: Regulation” (pp. 57–84)

■McIlvennan, C. K., Eapen, Z. J., & Allen, L. A. (2015). Hospital readmissions reduction program. Circulation, 131(20), 1796–1803. https://doi.org/10.1161/CIRCULATIONAHA.114.010270

■Neff, D. F., Yoon, S. H., Steiner, R. L., Bumbach, M. D., Everhart, D., & Harman J. S. (2018). The impact of nurse practitioner regulations on population access to care. Nursing Outlook, 66(4), 379–385. doi:10.1016/j.outlook.2018.03.001

■Nursing Practice Act, MS, ST, § 73-15-9 (2016)

■Salmond, S. W., & Echevarria, M. (2017). Healthcare Transformation and Changing Roles for Nursing. Orthopedic nursing36(1), 12–25. https://doi.org/10.1097/NOR.0000000000000308

Boards of Nursing vs. Professional Nurse Associations

 

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