Certification and Licensure in Arizona In Arizona, the following are requirement

Certification and Licensure in Arizona
In Arizona, the following are requirements to obtain initial APRN Certification: a current AZ RN license in good-standing, submission of a verified application to the Board, a fingerprint card on a form provided by the Board, submission of official transcripts, a letter of completion from Walden University sent directly from the school, and the required application fee (Arizona State Board of Nursing, 2018).
The Arizona State Board of Nursing website: www.azbn.gov/licenses-and-certification/apply-for-a-license has a drop-down menu for ‘advanced practice’ that provides a sample school letter and the information about where to email or mail said letter and transcripts to (Arizona State Board of Nursing, 2019b).
The aforementioned website gives information about Prescribing and Dispensing authority, how to obtain a DEA Registration Number (www.dea.gov) and how to register for the state’s Controlled Substance Prescription Monitoring Program (CSPMP). If a provider plans on prescribing they must pay an additional fee and be approved by the state to have this authority. If a provider plans to prescribe any controlled substances a DEA application and number is required. Once a provider does obtain a DEA number it must be reported to the AzBON. In Arizona, APRN’s (referred to as Registered Nurse Practitioners in AZ) can prescribe Schedule II, III, IV, and V controlled substances. Within each of these ‘Schedules’ are specific rules as well (Arizona State Board of Nursing, 2019).
Article 5, R4-19-508 refers to the AZ Standards Related to the Registered Nurse Practitioner’s (RNP) scope or practice. The most notable details are: the RNP will refer or collaborate with other physicians or providers as appropriate to ensure safe and quality care to the patient. The RNP *in their population focus* can examine a patient, establish a diagnosis, admit patients to a facility, manage care, and discharge patients from a facility. They can order and interpret lab and diagnostic tests. They can prescribe, order, administer, and dispense therapeutic measures such as pharmacologic agents and devices. This can include DME, home health, etc. RNPs can also establish care plans, perform procedures they are qualified to perform, delegate as appropriate, and perform additional acts that they are qualified to perform within their population of focus. Importantly, an RNP can only provide services and prescribing/dispensing within their population focus (Arizona State Board of Nursing, 2019).
AZ is one of many states that gives nurses full independent practice authority. NP’s practice under the licensure authority of the AZ Board of Nursing instead of a physician. As discussed above, the BON allows an NP to prescribe/dispense drugs and devices within their population focus. NPs are also recognized as primary care providers (National Conference of State Legislatures, 2022).
My last quarter preceptor and I have discussed the role of the APRN in Arizona at great length so truthfully the majority of this did not surprise me because I had researched it already. I do think, however, that there are times when the “rules” expressed by the state board leave some room for grey areas and that can be stressful as a new grad. For example: If I were treating an elderly patient for acute psychosis and blood work reveals a UTI, would it be under my “jurisdiction” to prescribe an antibiotic to treat the infection which treats that psychosis, or would I need to refer out to a different provider, potentially delaying care? What about the use of metformin to mitigate the side effects of antipsychotics or colace for Clozaril? From my research these answers are not explicitly answered anywhere in the guidelines set forth for Arizona practitioners and this could be considered a barrier for independent practice.
References
Arizona State Board of Nursing. (2018). Apply for a license. https://www.azbn.gov/licenses-and-certifications/apply-for-a-license
Arizona State Board of Nursing. (2019). Rules of the state board of nursing [PDF file]. https://www.azbn.gov/sites/default/files/2020-03/RULES.Effective.June3_.2019.pdf
National Conference of State Legislatures. (2022). Scope of practice policy. Arizona. https://scopeofpracticepolicy.org/practitioners/nurse-practitioners/sop/practice-authority