Ohio Atty Gen opinion on non-ACNP working inpatient

[DizzyJ DHSc PA-C]

The Ohio Attorney General (AG) issued his opinion on July 19, 2017 to the Ohio Board of Nursing on the issue of non-certified acute care nurse practitioners working in acute care environments. The AG did not find sufficient statutory guidelines to make a definitive opinion.

From the opinion:

… If the Board of Nursing intends to generally and uniformly apply and enforce a requirement that a certified nurse practitioner shall be nationally certified in acute care in order to provide services for acute illnesses, the board should adopt a rule that expressly states that qualification standard. In promulgating such a rule under R.C. Chapter 119, the board may receive comments from interested parties and consider whether a grace period or an exception to the requirement of national certification in acute care based upon particular post-graduate clinical experience or advanced certification is appropriate…

Conclusions

Based upon the foregoing, it is my opinion, and you are hereby advised that:

1. Pursuant to R.C. 4723.43©, an advanced practice registered nurse designated as a certified nurse practitioner may provide services for acute illnesses, so long as the services are consistent with the nurse's formal education, clinical experience, and national certification, and the services are provided in accordance with rules adopted by the Board of Nursing.
   
2. Whether a certified nurse practitioner who is not nationally certified in acute care may engage in acute care practice based upon post-graduate clinical experience obtained in the course of employment and training incident to that employment shall be determined by the Board of Nursing.
   
3. The Board of Nursing may require a certified nurse practitioner to obtain national certification in acute care if the Board of Nursing determines that the certification is necessary to document that the certified nurse practitioner has the requisite education, knowledge, skills, and abilities to engage in acute care practice”.
   

It would seem before the OBON would move in the direction of restriction of NP care in acute care environments, if still desired, a rule would need to be enacted before enforcement could be placed in effect. It is unknown what the OBON will do with this opinion as it has been most recently received. OAAPN will update members as more information is known.

Attorney General Issues Opinion on Non-ACNPs Working in Acute Care | OAAPN

[traumaRUs, MSN, APRN]

Yep IL is heading that way also. The hospitals in my area will only hire FNPs for ER and FastTrac areas only.

[shibaowner, MSN, RN, NP]

I just graduated from Johns Hopkins as a Primary Care AGNP. Our professors told us that many hospitals would still want to hire us, but warned us not to take any acute care jobs unless we were provided with adequate training.

[birdie22]

Sorry if this sounds silly, but what does all that legal jargon actually mean? He didnt actually give his opinion and make a decision correct? I'm studying to be an ACNP but dont really see myself in the ICU. I get it that the trend is for only ACNPs to work in the ICU. But what about the opposite situation....for example can an ACNP work in a specialty outpatient clinic like cardiac?

[DizzyJ DHSc PA-C]

Sorry if this sounds silly, but what does all that legal jargon actually mean? He didnt actually give his opinion and make a decision correct? I'm studying to be an ACNP but dont really see myself in the ICU. I get it that the trend is for only ACNPs to work in the ICU. But what about the opposite situation....for example can an ACNP work in a specialty outpatient clinic like cardiac?

My interpretation is that if the OBN is going to require NPs to have acute care certification to work inpatient, then they OBN needs to develop a rule stating as such. They can't enforce the requirement if it is not clearly stated in a rule that there is such a requirement.

[ghillbert, MSN, NP]

Sorry if this sounds silly, but what does all that legal jargon actually mean? He didnt actually give his opinion and make a decision correct? I'm studying to be an ACNP but dont really see myself in the ICU. I get it that the trend is for only ACNPs to work in the ICU. But what about the opposite situation....for example can an ACNP work in a specialty outpatient clinic like cardiac?

An acute care NP can work anywhere the patient population is acutely ill adults. So yes, if you are taking care of patients with acute issues in an outpatient clinic, that is permitted. Many ACNPs work for cardiology practices and both cover both inpatient and outpatient patients. What you should NOT do it work in primary or preventative care with stable/chronic issues. Because you're not trained for that.