Nurse Practitioner - On The Job Training?

[stefeb12]

Is there such a thing as "on the job training" for a nurse practitioner?

I'm aware of a situation in Pennsylvania where a certified graduate from a family nurse practitioner program is practicing as a neonatal nurse practitioner. The hospital's justification for allowing this is that she has received "on the job training" as a neonatal nurse practitioner.

Is this legal under PA's licensing laws?

Thank you.

[NRSKarenRN, BSN, RN]

famly nurse practioners have very broad training, including those of neonates and pediatrics, to adults and geriatrics. historically, license certification was under crnp name, while functional role was geared to the education program one attended. initially, there was no national certification requirement but as nurse practioner education programs moved from certificate education to masters or post masters education, the law was changed. with the advent of prescriptive authority, now solely under the board of nursings control, law was again changed to strengthen regulations as specific practice areas and national certification has developed.

an rn who is a family nurse practioner may function in the role of a crnp in a neonatal unit, but cannot be called a neonatal nurse practioner unless they've passed national certification corporation (ncc) neonatal nurse practitioner exam, as only one approved by pa sbon. on the job training is not sufficient. continuing education in functional area or post masters course work would help strengthen the fnp ability to work in this unit, especially as 30 hours board approved ceu needed.

karen

rnc credential as a neonatal care nurse practitioner

eligibility requirements:

• current licensure as an rn in the u.s. or canada
  
• successful completion of a formal nurse practitioner program that prepares neonatal nurse practitioners and awards either a master's degree in the specialty or a post-master's in the specialty
  

http://www.nccnet.org/public/pages/index.cfm?pageid=110

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see the article in pa sbon winter 2004/2005 newsletter pg.24-25

the importance of clinical speciality area in crnp scope of practice

by martha h. brown, equire, counsel, state board of nursingand lori lauver, dnsc©, rn, nursing practice advisor

http://www.dos.state.pa.us/bpoa/lib/bpoa/20/nurs_board/nurse_2004.pdf

one of the least-heralded but most significant changes implemented by act 206 of 2002 concerns clinical specialty areas for certified registered nurse practitioners (crnps). act 206, which was effective on february 7, 2003,provided for the regulation of crnps solely by the state board of nursing (board). act 206 defined crnp largely the same as it had been under the joint regulations of the state boards of medicine and nursing: certified registered nurse practitioner means a registered nurse licensed in this commonwealth who is certified by the board in a particular clinical specialty area. the change is the mandate in section 8.2 of the revised professional nursing law, 63 p.s. 218.2, that crnps must practice within the scope of practice of the particular clinical specialty area in which they are certified by the board. this was always assumed but never so clearly stated. all crnp practice, including acts of medical diagnosis and prescription of medical therapeutic or corrective measures, must occur within the scope of practice of the particular clinical specialty area in which the crnp is certified by the board.

presently there are 27 clinical specialty areas utilized by the board for certification in pennsylvania. they range from the general (family health, adult health, pediatric, obstetrics/gynecology, neonatal and gerontology) to the specific (adult occupational health, adult cardiopulmonary, adult renal metabolic, perinatal, pediatric critical care and pediatriconcology). currently certified nurse practitioners must be careful to practice within the scope of their certification area.

some examples are obvious: a crnp certified by the board in adult care may not treat pediatric patients. a crnp certified in women's health or obstetrics/gynecology should not be following male patients as part of aprimary care practice. less clear are the questions of whether a crnp certified by the board in a very specific specialty area such as pediatric critical care or pediatric oncology may treat general pediatric patients in a primary care practice or whether a crnp certified by the board in a more general specialty area such as adult health may practice in a very specific specialty, such as adult psych mental health, under the revised language of the professional nursing law. consequently, the board encourages crnps to examine their current job duties and current board certification. if a crnp's area of practice has changed a great deal over time and does not match the particular clinical area of certification as listed on the pennsylvania nurse practitioner certification, the crnp should consider completing the additional education necessary to obtain a second certification from the board in an area that clearly encompasses the crnp's current area of practice.

this article is not requiring that any crnp obtain additional certification from the board at this time. the objective is to notify all nurse practitioners that they are required to practice within the scope of practice of the particular clinical specialty area in which they are certified by the board. the board is working on regulations which will address the issue and provide clear guidance to licensees on how to comply with the requirements of the law. interested parties should monitor the "special notices" link on the board's website for any further developments or advisories from the board.

all crnps initially certified by the board after february 7, 2005, will be certified in a particular clinical specialty area if they have completed a board-approved master's or post-master's nurse practitioner program and hold certification as crnp from a board-recognized national certification organization which requires the passing of a national certifying examination in the particular clinical specialty area in which the crnp is seeking certification by the board....

only general certifications will be available to nurse practitioners initially certified by the board after february 7,2005. all crnps who were already certified by the board in a particular clinical specialty area before february 7, 2005, will retain that clinical specialty area of certification without the need to obtain national certification or pass a national certifying examination.

for more information, see the state board of nursing website at

www.dos.state.pa.us/nurse or contact the board at p.o. box 2649, harrisburg, pa 17105-2649, or at [phone]

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certified registered nurse practitioners ... 21.251

http://www.pacode.com/secure/data/049/chapter21/subchapctoc.html

the certification of crnp has changed in pa as ammeded by law below.

(8 amended june 29, 2002, p.l.651, no.99)

section 8.1. certified registered nurse practitioners; qualifications.--(a) the board may certify a licensed registered nurse as a certified registered nurse practitioner in a particular clinical specialty area if the nurse satisfies the requirements established by this act and regulations promulgated by the board. certification of a nurse by the board shall expire on the same date as the license of that nurse expires.

(b) (1) beginning on the effective date of this section, a nurse shall not qualify for initial certification by the board under subsection (a) unless the nurse:

(i) is a graduate of an accredited, board-approved master's or post-master's nurse practitioner program; and

(ii) holds certification as a certified registered nurse practitioner from a board-recognized national certification organization which required passing of a national certifying examination in the particular clinical specialty area in which the nurse is seeking certification by the board

(ii) would otherwise qualify for certification as a certified registered nurse practitioner under section 7(b).

(3) in order to provide a transition period for persons who completed or were enrolled in an approved educational program on the effective date of this section and to permit those persons to apply for certification under the rules in existence immediately prior to the effective date of this section, the board shall issue initial certification to any person who, within two (2) years of the effective date of this section:

(i) submits evidence of having completed or been enrolled in an approved educational program on the effective date of this section; and

(ii) fulfills all administrative requirements of the board and possesses all of the other qualifications for certification in effect immediately prior to the effective date of this section.

© as a condition for biennial renewal of certification by the board, a certified registered nurse practitioner must, in the two (2) years prior to renewal, complete at least thirty (30) hours of continuing education approved by the board. in the case of a certified registered nurse practitioner who is prescribing medical therapeutic or corrective measures pursuant to section 8.3, that continuing education must include at least sixteen (16) hours in pharmacology in that two-year period.

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updated special notice for crnps on continuing education

special notice for crnps on continuing education

act 206 of 2002, effective february 7, 2003, established the requirement of at least 30 hours of continuing education biennially for all certified registered nurse practitioners (crnps) holding certification by the pennsylvania state board of nursing (board). crnps must complete at least 30 hours of board-approved continuing education in order to renew their pennsylvania certification. crnps with prescriptive authority approval must complete at least 16 of the 30 hours in the area of pharmacology.

[stefeb12]

Famly Nurse Practioners have very broad training, including those of neonates and pediatrics, to adults and geriatrics. Historically, license certification was under CRNP name, while functional role was geared to the education program one attended. [/Quote]

Karen: Thank you so much for taking the time for answering my question. You have helped a great deal.

I do have one more question: The hopsital in question aso has a midwife functioning as a neonatal nurse practitioner. The same logic applies, that of "on the job training."

Is this also allowed under PA law? Seems to me there has to be some sort of educational cut off point.

Thanks again. Please forgive the additional question. I do not want to impose upon your kindness.