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Advanced Practice Registered Nurse FAQ

Initial Licensure

How soon after graduation can I practice as an APRN? 

You must apply for initial licensure and receive a temporary permit to practice until you take and receive the results of your certification examination.  The temporary permit expires after 90 days.

How can I qualify for the temporary permit? 

You must apply for licensure, complete the criminal history record check requirements, and apply as a first-time candidate for the certification examination or awaiting certification results.

Are continuing education hours required for initial licensure?

Yes. Initial APRN with prescriptive Authority must have 30 hours of pharmacology specific CE in the past 3 years.  Only certificates which itemize pharmacology CE will be accepted.  If the applicant recently graduated from an education program, the pharmacology courses apply to the required CE.  UpToDate activity certificates do not meet the requirement for Pharmacology specific CE for Prescriptive Authority. 

Applicants applying for APRN licensure without prescriptive authority do not require CE if RN licensure is current.

What certification examinations does the North Dakota Board of Nursing recognize?

See the approved listing

What information does the North Dakota Board of Nursing need when I pass my certification examination? 

When you apply for the certification examination, indicate on the form that you would like the results sent to the board office.  The Board must have primary source verification of your successful passing of the certification examination.

Can I apply for licensure as an Advanced Practice Registered Nurse if my population foci do not have a certification examination at the post-graduate level?

No, As of January 1, 2005 you must have taken a certification examination.

When will I receive full licensure as an APRN? 

After you pass the certification examination and notification has been received in the board office that you have passed the certification examination, full license will be issued if you have met all the other requirements.

What happens if I fail the certification examination?

If you fail the first certification examination for which you are eligible you must notify the board. Your temporary permit will be inactivated upon notification to the board. You may practice as an RN during the time you must wait to reapply to retake the certification examination.

Practice

Am I restricted to the client population identified in my certification examination?

Yes.  You must also verify that your Scope of Practice is consistent with your education, certification, and NDAC section 54-05-03.1-03.2. The Board recognizes the National Association of Pediatric Nurse Practitioners’ (NAPNAP) position state on Age parameters. NAPNAP broadly defines the pediatric population care for the PNP’s as all children from birth through 21 years of age and, in specific  

Can a Nurse Practitioner work in an Emergency Room?

Yes, if the NP has the knowledge, skills, and abilities to work in the ER, that is an acceptable work environment. 

Can a Nurse Practitioner also fill the position of director of nurses?

Yes, if they meet the requirements for the position.

How many continuing education hours are required for renewal of prescriptive authority?

You must have 15 contact hours of education in pharmacology related to the scope of practice within the two-year renewal cycle.  For example, if you are renewing in 2015 for the 2016-2017 cycle, the contact hours must have been obtained in 2014 or 2015. 

Section 54-05-03.1-11(4) Provide evidence of completion of fifteen contact hours of education during the previous two years in pharmacotherapy related to the scope of practice. These contact hours may fulfill the registered nurse renewal continuing education requirement. The education or its equivalent as approved by the board may include academic credits, attendance at approved seminars and courses, or participation in approved correspondence or home study continuing education courses.

When can I apply for prescriptive authority or a DEA number?

You can apply for prescriptive privileges after you have passed your certification examination and meet the requirements listed in Section 54-05-03.1-09.  Once you have been approved by the board for prescriptive authority, you can apply for a DEA number.

Can I write prescriptions for myself or a family member?

According to Section 54-05-03.1-10 (7) you may not prescribe to oneself, spouse, or child any drug legally classified as a controlled substance or recognized as an addictive or dangerous drug.  The Board discourages writing prescriptions of any kind to family members.

In regards to the hospitalized patient, are there any ND laws, rules or regulations which require physician oversight or involvement when an APRN admits, follows, discharges?

According to the Administrative Rules and Regulations Section 54-05-03.1-01 Statement of Intent, the scope of practice for a registered nurse with advanced licensure is based upon an understanding that a broad range of health care services can be appropriately and competently provided with validated knowledge, skills, and abilities in specific practice areas.  Section 54-05-03.1-12 Change in Physician Collaboration Regarding Authority was repealed effective October 1, 2011.  Organizational bylaws regarding the APRN practice and hospitalized patient may vary throught the state.

Is it within ND law/rules for the APRN with prescriptive authority to assign or delegate prescribing to an LPN or RN?

According to NDAC 54-05-02-07, the nurse professional can assign to another only those nursing interventions that are included within that nurse’s scope of practice, education, experience, and competence. Prescribing practice is not within the LPN or RN standards or scope. Additionally, NDAC 54-02-07-01.1 includes inappropriate or inconsistent assigning or delegating interventions as potential grounds for discipline.

Is it within ND law and rules for the APRN to prescribe therapeutic regimen, including prescribing drugs, without assessing the client or establishing a client-provider relationship?

In ND, the APRN standard and scope includes performing a comprehensive assessment of client and synthesis and analysis of data, as well as prescribing a therapeutic regimen of health care, including diagnosing, prescribing, administering, and dispensing drugs. In addition, prescriptive practice means assessing the need for drugs and writing a prescription to be filled by a licensed pharmacist. Additionally, the NDBON, ND Board of Pharmacy, and ND Board of Medicine revisited a prior consensus of a “legitimate prescription”, which states that a prescription written without a valid patient/practitioner relationship, where there is not an actual physical examination of the patient, is not a valid prescription. The consensus also states that prescribing based on internet mail or telephone questionnaires is not appropriate medical care.

Is it within ND law/rules for an APRN with prescriptive authority prescribe to themselves or their family?

The NDAC 54-05-03.1-10 states that the APRN with prescriptive authority may not prescribe, sell, administer, distribute, or give to oneself or to one’s spouse or child any drug legally classified as a controlled substance or recognized as an addictive or dangerous drug. In addition, the NDBON refers to the ND Board of Pharmacy statement titled, “Dispensing prescriptions for a practitioner or their family” available at https://www.nodakpharmacy.com/pdfs/DispensingPrescriptions_Physician_or_family.pdf

Reimbursement

What billing capabilities are available for FNP?

You must apply for a NPIN number to bill for services.

Can I be reimbursed for services prior to passing the certification examination and becoming fully licensed?

No.  You and your employer will need to make other arrangements for billing for services.

Certification 

Am I required to have a current national certification to be licensed as an APRN in ND?

Yes.  An APRN must hold a current certification in an advanced nursing role and population foci by a national organization.  If your certification expires, you will no longer meet the requirements for licensure in ND.  It is the licensee's responsibility to maintain current certifications.  Licensee shall notify the Board office if certification expires/lapses (NDCC 43-12.1-09 and ND Administrative Code 54-05-03.1-04 (3); 54-05-03.1-06 (3)).

What is the correct title for me to use once I have received certification?

According to 54-05-03.1-02 Board Authority -Title-Abbreviation - The Board shall authorize advanced nursing practice to a registered nurse who has submitted evidence of advanced knowledge, skills, and abilities in a defined area of nursing practice. Individuals are licensed as advanced practice registered nurses in the roles of nurse midwife, nurse anesthetist, clinical nurse specialist, or nurse practitioner and in the population foci of family across the lifespan, adult-gerontology, neonatal, pediatrics, women’s health or gender related or psychiatric mental health. Each advanced practice registered nurse shall use the designation APRN and applicable role designation for purposes of identification and documentation. No person may use the advanced practice registered nurse (APRN) title plus the person’s respective role title without the express authority of the board of nursing to do so.

 

Revised:  01/19