Question

what are the Professional Nursing and State-Level Regulations in California and south Dakota

Answer 1

In California, nursing practice is governed by the state nurse  

The Board of Registered Nursing has pro- mulgated regulations that require the NP to work under standardized procedures for authorization to perform overlapping medical functions

This regulation requires that NPs work under collaboration with a physician and adhere to standardized procedures developed through collaboration among administrators and health professionals, including physicians and surgeons.  

California NPs must obtain additional certification from the BRN to “furnish” (prescribe or order) drugs or devices under standardized procedures developed with the supervising physician and surgeon.8

As collaborators, physicians take legal responsibility for the NP’s practice and are expected to determine the appropriate level of supervision, communicate regularly with the NP, and oversee the NP’s practice and quality of care.

There are no rules regarding proximity of the physician

to the NP, and thus a physician can provide supervision

remotely — even from hundreds of miles away.

One specific area of regulation concerns the prescribing of buprenorphine for the treatment of opioid use disorder in office settings.

Under the Comprehensive Addiction and Recovery Act (CARA) in 2016, which allows NPs and physician assistants (PAs) to give prescription.

CARA stipulates that if a state requires physician oversight of NP/PA prescribing,the physician must be board certified in addiction psychiatry or addiction medicine, have completed training in medication-assisted therapy, or meet other specific qualifications. These restrictions may impact the potential for NPs to support treatment for opioid use disorde

Dakota: The LPN practices dependently under the supervision or direction of the registered nurse, advanced practice registered nurse, or licensed practitioner

The LPN can conduct focused assessments and assists in the care of clients whose condition is stable and predictable.

The LPN may assign nursing interventions and delegate to the Unlicensed assistive person. Note that supervision is not included in assigning nursing intervention.

RN conducts focused and comprehensive

assessments, including supervising care assigned to RNs and LPNs; and tasks delegated to UAPs.

prescriptive practices, which includes assessing need for drugs and authorizing drugs for a client, are not included in the RN standards.  

APRN functions in any setting as a member of the interdisciplinary team and provides care to fullest extent of scope of practice, which includes focused and comprehensive assessments. The APRN scope includes prescribing a therapeutic regimen, including diagnosing, prescribing, administering, and dispensing drugs and controlled substances (with prescriptive authority).

The APRN manages and supervises practice of nursing

The licensed practical nurse nor registered nurse have the authority to prescribe drug.