Advanced Practice Registered Nurse Legislation

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Minnesota Nurses Association




                          Advanced Practice
                           Registered Nurse
                             Legislation




                                 Minnesota Nurses Association        Revised September, 2005
                                 1625 Energy Park Drive, Suite 200
                                 St. Paul, MN 55108
                                 Phone: (651) 646-4807
                                 Fax:       (651) 647-5301
                                 Web:       www.mnnurses.org
                                 E-Mail: [email protected]




Advanced Practice Registered Nurse Legislation                                        Page 1 of 8
                                           Minnesota Nurses Association Mission Statement

The Minnesota Nurses Association (MNA) is the professional organization for Registered Nurses and
speaks for our members and for nursing to:

      Promote the professional, economic, and personal well-being of nurses.

      Uphold and advance excellence, integrity and autonomy in the practice of nursing.

      Advocate for quality care that is accessible and affordable for patients and consumers.



                                                               Goals

      Ensure that the Minnesota Nurses Association thrives by preserving and enlarging membership
       and resources, increasing member activism, and mastering threats and opportunities in the
       environment.

      Promote and defend the practice of nursing, for the benefit of the public, by educating and
       mobilizing members to exert power and influence within the profession and in the public arena.

      Prepare Minnesota Nurses Association members to design their own professional futures.




Advanced Practice Registered Nurse Legislation                                                   Page 2 of 8
Background
1999 was an historic year at the legislature for MNA with the passage of the Advanced Practice
Nurse Act of 1999. What made this legislative effort particularly gratifying was the manner in
which MNA, the Minnesota Board of Nursing and advanced practice registered nurses from
throughout the state joined to build consensus on the content of the legislation and the legislative
strategy.


Overview
Advanced Practice Registered Nursing (APRN) is an umbrella term for registered nurses with
advanced education, usually a master's degree, who provide complex, specialized health care, and
are certified by a national nurse certification program. These highly trained nurses are able to do
60 to 80 percent of primary and preventive care traditionally done by physicians.

The law specifies the following groups of registered nurses as APRNs: Clinical Nurse Specialist
(CNS), Nurse Practitioner (NP), Certified Registered Nurse Anesthetist (CRNA) and Certified Nurse
Midwife (CNM). APRNs diagnose and treat, consult, coordinate care and collaborate with other
health care providers.

The Advance Practice Registered Nurses legislation of 1999 was signed into law by Governor
Ventura on May 17, 1999. This legislation defines the scope of practice for each category of
advanced practice nurses. Although prescriptive authority for Nurse Practitioners, Nurse Midwives
and Clinical Nurse Specialists in psychiatry is unchanged, these APRNs no longer need to apply to
the Board of Nursing to secure this authority. As of July, 1999, Clinical Nurse Specialists in
Psychiatric and Mental Health Nursing may now have a prescriptive agreement with any physician,
rather than only with a psychiatrist. In addition, Clinical Nurse Specialists and Nurse Anesthetists
are now authorized to prescribe.

Advanced Practice Registered Nurses have their own scopes of practice under the law. As long as
APRNs practice within their own scopes of practice, they are practicing independent advanced
practice registered nursing functions. The APRN must practice within a health care system that
provides for consultation, collaborative management and referral as indicated by the health status
of the patient.

With regard to prescribing, APRNs (with the exception of CNMs) have a written agreement that
conforms to the memorandums of understanding between the Minnesota Nurses
Association/Minnesota Medical Association and the Minnesota Psychiatric Association. If APRNs
wish to write prescriptions, that is a function delegated to the APRN through the written
prescriptive agreement from a physician.

Employers may place additional restrictions on APRNs through the employment relationship, as long
as these restrictions do not conflict with state law and accepted standards of care. For example, a
clinic may hire an APRN to do only diabetic care. The nurse's scope of practice in the law is
actually much broader, but the employer hires the nurse to carry out only a part of their total
scope of practice. This has always been the prerogative of the employer.

Advanced Practice Registered Nurse Legislation                                                Page 3 of 8
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