The Georgia Board of Nursing (GBN) is the legal body with the statutory authority to formulate rules that regulate and define the nursing professional requirements and limitations of the nursing practice within the state of Georgia. After reviewing the scope of work as an advanced practice registered nurse (APRN) in the state of Georgia, it is evident licensed providers are not aware of certain areas constituting their scope of work as listed below.
The first area entails having limited prescriptive authority over control substances under the laws of the state. Notably, the State of Georgia is among the top restrictive states, which only allow the APRNs limited authority to prescribe Schedule III-V drugs (Georgia Watch, 2015) Prescription drugs classified under Schedule II are extremely regulated since they are prone to addiction and are highly likely to be abused (Andreae et al., 2016). As such, the state law in Georgia mostly requires physicians to prescribe Schedule II drugs. Essentially, this limited prescriptive authority to independently prescribe Schedule III-V drugs was implemented recently, and it is conducted with great caution since there must be a protocol agreement. The protocol agreement connotes a written consent document where the physician assigns the APRN the authority to conduct selected medical acts. In Georgia, the physicians are required to supervise the APRN by reviewing their charts and also seeing the APRN’s patient on quarterly basis (Georgia Watch, 2015). However, APRNs are not allowed to write prescriptions for Schedule II drugs.
As noted above, Georgia is generally a restrictive state where APRNs are not allowed to practice to the full scope of their training. However, despite the restrictions, the APRNs can still be allowed to independently order for critical radiographic imaging tests including CT scans, MRIs scans, and PET without necessarily involving the physicians. However, even this authority is a limited one as it can only be ordered in life-threatening circumstances (Georgia Watch, 2015). Here, the APRNs are still subject to the supervision of the physician and these imaging tests must be forwarded to the physician for interpretation. Inherently, the limited authority for APRNs to order radiographic imaging tests is also subject to a protocol agreement. Nonetheless, there are some imaging tests such as an ultrasound testing and examination that the APRNs are permitted to order without necessarily requiring the signature of the physician.
The third area of APRN practice that advance practice nurses may not be aware of includes the role to influence health care through policy and legislative arena. In the state of Georgia, the health care environment contains numerous complex policies, regulations, and laws imposed by the state. Therefore, nurses should acknowledge that the health care system is in dire need of change and there is need to take advocacy roles to promote change in policies, laws, and regulations to better the health care system (McGuire, Goldstein, Claywell & Patton, 2017). Regarding this policy advocacy role, many nurses are not aware that they need to step into the unfamiliar arena of politics and policy, an arena that many of them feel unprepared to operate in effectively. Essentially, nurses are the health care professionals that most associate with patients and their families, making them better placed to notice when the health care does not meet the needs of patients (McGuire, Goldstein, Claywell & Patton, 2017). As such, nurses can provide comprehensive policy changes to tackle these myriad health-related concerns.
References
Andreae, M. H., Rhodes, E., Bourgoise, T., Carter, G. M., White, R. S., Indyk, D., … & Rhodes, R. (2016). An ethical exploration of barriers to research on controlled drugs. The American Journal of Bioethics, 16(4), 36-47.
Georgia Watch. (2019). Retrieved 4 September 2019, from https://www.georgiawatch.org/wp-content/uploads/2015/01/APRN01072015WEB.pdf
McGuire, M., Goldstein, C., Claywell, L., & Patton, R. (2017). Analysis of student reflections of experiential learning in nursing health policy courses. Nurse educator, 42(2), 95-99.
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