Introduction
The Nurse Practice Act of California provides a reference point for the scope of activities for registered nursing practice. It also offers an overview of the dependent and independent functions of registered nurses, in addition to interdependent functions. The following discussion evaluates the roles of the California Board of Registered Nursing to provide a comprehensive reference for the nursing practice in the state.
The Governor of the State of California makes an appointment to the Board of Registered Nurses, which in turn manages the nursing affairs within the state as stipulated by its authority that is prescribed in the Nurse Practice Act. Besides the governor, The Senate Committee and the Speaker of the Assembly make the other appointments of public members to the board. The power of the board, therefore, comes from the constitution, specifically for the legislative offices of the Senate, the Governor, and the Speaker of the Assembly. These are elective positions that serve the citizens. Therefore, the people of California provide the ultimate power to the board. The governor is in a position to terminate someone’s term on the board if they do not abide by the regulations that govern the board. Removal can also happen due to poor professional conduct. Incompetency and dishonorable conduct are also grounds for removal. Having an understanding of the way the board’s appointment occurs is necessary because it leads to an appreciation of its role in facilitating nursing practice for improving health services to the people of California.
Governance Structure of BRN
The board in California has nine members, with four of them being members of the public and five being registered nurses including two direct patient care nurses. The three other registered nurses are a nurse administrator, a nurse educator, and an advanced practice nurse.
License and Regulation
The BRN issues licenses to the applicants who meet the requirements for the nursing practice. Once issued with a license, an applicant can practice for two years before applying again for the same license. One has to meet the educational qualifications needed, in addition to being allowed to practice by the licensing board. Moreover, one should not have committed a crime that is considered grave enough to make one unfit for licensure. Licensing is part of the regulation, and it covers the registered professional nurses (RNs) and the advanced practice nurses (APNs).
Approval of Schools, Nursing Programs and Licensure for Registered Nurses
The BRN has to approve all the nursing schools in California before they can be recognized. Any person graduating from a school that is not approved is not eligible for licensure. The authority ensures that all schools in the state operate within the requirements for approval set by the board. The board also has the authority to issue a “cease” letter for any nursing program identified as not meeting the requirements of the board. Any entity may set up a nursing school and enroll nursing students in different programs. However, the authority to approve the programs in a school and recognize the certification obtained by a particular student rests with the board.
Cases of programs that have not been authorized are common. It is upon the potential nursing students to countercheck with the board about the approval status of a program that interests them. Common indicators for a program that is unapproved or not suitable for approval include the following: A school or program may lack proof of BRN approval from the state. It may also lack a course syllabus for the units taught as part of the program. Other indicators include the lack of information about the credentials of every instructor in the school. The school may also have a dubious representation online and claim that its transcripts, degrees, and other qualification certifications come from an internal program, instead of programs and organizations recognized in California.
The board only considers qualifications for programs that it has approved under its role of granting licenses for registered nurses to practice in California. At the present, there is no approval for ‘out of state’ qualifications. The board does not recognize any distance-learning program or internal qualification program, as long as it does not include the National Council Licensing Examination (NCLEX). The board qualifies applicants to take the NCLEX only when they have participated in its approved nursing programs. The board is also not responsible for any representation by a program or school on its qualification when such information is false. The student nurse has to confirm the status of a school or program before proceeding to seek qualifications at any level of the nursing study.
Discipline
The board runs an online system for consumers to verify the license status of a person as a way of regulating the nursing practice. Consumers are also able to see any BRN certificates that a person has and the history of disciplinary action. The BRN has the power to take disciplinary action. It does so by revoking or suspending the license of the nurse. One may be disciplined if one engages in acts that have the potential to harm the patients. The seriousness of the case determines the action taken by the board.
Scope of Registered Nursing Practice in California
The scope of practice for registered nurses includes independent functions, dependent functions, and interdependent functions. Here, nurses and the board follow the Nurse Practice Act, Subsection (b) (1) (2) (3), and (4) of Section 2725. It allows the provision of direct and indirect patient care services, which lead to improved patient safety and satisfaction. It also covers disease prevention and restorative measures. In addition to these direct services, indirect services of nursing practice in California include delegation and supervision of subordinates as they deliver patient care. Nurses can delegate and supervise patient care; they are authorized to observe signs of an illness and a patient’s reaction to treatment. They also look at the general behavior and physical condition and confirm whether these are abnormal characteristics. They then report and make referrals or proceed with emergency procedures. Nurses also implement the orders given by physicians, dentists, pediatrics, or clinical psychologists that are within the scope of the nurse licensure. Some activities overlap with the practice of medicine and require nurses to conduct standard procedures or changes in treatment regimes, based on their observational feedback (Bailey, 2011).
Nurses are required to different situations that require standardized procedures and those that allow common nursing practices that may not qualify as standardized procedures. Such knowledge acquired by experience and education permits nurses to avoid behaviors that can lead to disciplinary actions by the board (Bailey, 2011).
Graduating from a Nursing Program
Registered nurses qualify after completing an associate’s degree in nursing, which takes two years in a community college. The applicant may also complete a Bachelor of Science in Nursing, which takes four years in a university. APNs have higher qualifications and may advance their careers by specializing in different areas of their nursing practice, such as research, healthcare management, education, or consultancy roles (Harrington & Terry, 2008).
Certified Nursing Assistants (CNAs) work under nurse supervision in California. They are required to have a diploma qualification, a social security card, and proof of employment authorization before they are qualified for a CNA exam. However, the regulation of this profession falls under the California Board of Vocational Nursing, which has a different mandate compared to the BRN (Harrington & Terry, 2008).
Reciprocity Issues
The board also requires nurses to join a professional association, usually the California Nurses Association at a state level and the American Nurses Association at the national level. At present, no reciprocity arrangement allows a licensee from California to practice elsewhere. However, countrywide recognition of NCLEX allows nurses to move from one state to another and apply for a license without having to retake NCLEX. Foreign educated nurses have to ensure that any documentation they present as part of their qualification is in English so that the board can accept it (Harrington & Terry, 2008).
Other Remarks
The California BRN allows applicants for licenses to reapply for the NCLEX when they fail. However, an applicant has to wait for 90 days. Applicants from other states have to undertake a program recognized by the California BRN before they can get a recommendation by the board for taking the NCLEX. The board has the authority to issue a regulatory framework for Certified Registered Nurse Anesthetist CRNA, which is currently withdrawn. The board is also responsible for issuing certificates to practice for Nurse Midwifery. All the applicants must meet the qualifications set by the board, which include the educational standards set by the board.
References
Bailey, L. R. (2011). An explanation of the scope of RN practice including standardized procedures. Board of Registered Nursing. Web.
Harrington, N., & Terry, C. L. (2008). LPN to RN transitions: Achieving success in your new role (3rd ed.). Philadelphia, PA: Wolters Kluwer Health.