You have learned a lot during your training to become a Registered Nurse. At this point in your education, where do you see yourself as a nurse? What unit would you like to work in and why?

To be able to care for patients, you must be able to care for yourself. What are some practices you plan to implement to help you care for yourself and why?

 Instructions:
During the first two weeks, we have explored Principles of Disease and Pathology and the Primary Mechanisms of Disease. Review the material covered and provide a minimum of five key points about one of the key content areas covered that are listed below.  You may include sign/symptoms, diagnostic tools, and/or treatments.

Genetics & Congenital Alterations
Cancer
Immune Responses
Infection
Malnutrition & Obesity
Aging
Trauma
Please be sure to validate your opinions and ideas with citations and references. 

due 10-15-23 @10am

Give 2 examples (1 negative, 1 positive) of how you feel the impact the disappearing borders is impacting world health. 

Respond to what he wrote, be argumentative with the answers, and polite. References, and at least 2 paragraphs.

This discussion investigates the steps, requirements, and instructions related to the certification and licensure process of a Psychiatric-Mental Health Nurse Practitioner in Florida. It will also cover aspects of obtaining a DEA license, prescriptive authority, restrictions on controlled substance prescriptive authority, and the Prescription Drug Monitoring Program – E-FORCSE, a collaborative agreement between doctors and nurses specific to Florida.

The Nurse Practice Act of the Florida State Board of Nursing outlines specific requirements to obtain certification and licensure. One requirement is obtaining a Master's Degree or post-master's degree certification recognized by the Florida Board of Nursing with a graduation date before the application submission. Maintaining an active Florida Registered Nurse license for practice within the state is mandatory. Certification application with the Florida Board of Registered Nursing involves applying via the https://floridasnursing.gov website with supporting documents, such as transcripts, evidence of clinical practice hours, completing a background check, which costs $110, and proof of malpractice insurance (Florida Board of Nursing, n.d.). APRNs can only sit for an examination if a third-party certifying organization has comprehensively checked their academic background and established educational standards. After passing the certification exam, the next step is to submit a license application on the licensing board's website. The Florida Board of Nursing evaluates and verifies the form and certification and sends a confirmation letter after approval (Florida Board of Nursing, n.d.).

The Florida Board of Nursing outlines the scope and limitations of psychiatric nursing practice, prescriptive authority, supervision requirements, and inpatient psychiatric services (Benson, 2021). In Florida, psychiatric mental health nurse practitioners can prescribe psychiatric medications to patients independently as long as they fall within their scope of practice. PMHNPs can prescribe controlled substances II-IV, but only under the supervision of a licensed psychiatrist (Kellams & Maye, 2017, p. 136). Florida law mandates PMHNPs to collaborate with a supervising physician for patient diagnosis and treatment. They cannot serve as treating physicians for patients admitted to inpatient psychiatric facilities but can provide consultations and follow-up care post-discharge. A typical collaboration between physicians and PMHNPs in Florida involves comprehensive treatment plans discussing diagnostic assessments, symptom management strategies, and medication management for complex cases (Stone-Gale, 2023). Florida PMHNPs must stay up-to-date with legislative changes to provide safe and appropriate patient care within their scope of practice.

Since October 2020, the Board of Nursing has initiated registration for autonomous APRN practice applications. To be eligible, individuals had to have acquired at least 3000 hours of practice under physician protocol within the last five years, completed three graduate semester hours, possess an unencumbered license, and have a clean record within the past five years (Benson, 2021). Advanced nursing practice is conducted under Florida Statute §464.0123 (3), allowing the nurse to operate independently without physician supervision or supervisory protocol. Unfortunately, it was approved for APRNs practicing in Family Medicine, General Pediatrics, General Internal Medicine, and Certified Nurse Midwives (Stone-Gale, 2023).

A PMHNP in Florida is authorized to prescribe controlled substances under particular schedules. They can prescribe Schedule II controlled substances, drugs with a high potential for abuse and severe dependency, such as stimulants for ADHD, and some opioids for chronic pain management. Schedule III controlled substances with a moderate to low potential for abuse and dependency, such as testosterone, ketamine, and limited combinations of opioids and non-opioid analgesics. Schedule IV controlled substances have a lower potential for abuse and dependency than II, and III and include some medications for anxiety, sleep disorders, and muscle relaxants. To apply for a DEA license, a nurse must have an active Florida license and pay the registration fee of 731$ for three years (Reynolds et al., 2021).

The E-FORCSE system is a prescription monitoring program that allows Florida healthcare professionals and pharmacists to submit and access information related to controlled substance prescriptions. It provides a database for healthcare professionals to review a patient's controlled substance prescription history, countering abuse and diversion. The system enables healthcare professionals to safeguard patients, manage their care more efficiently, and target those who might need assistance for substance misuse (Perez et al., 2017). State and federal regulations govern access to E-FORCSE to protect patient privacy and confidentiality and only authorized healthcare professionals and pharmacists are granted access to the system. It is crucial to have the appropriate credentials and gain practical experience while working under the supervision of a physician. Current Florida regulations require practitioners to comply with predetermined criteria in their field of competence. Because of this, APRNs often have a limited scope of practice, which gets in the way of their efforts to improve patient care.

In the context of the current Florida regulations, attaining the required credentials and gaining practical experience while working under physician supervision is imperative. These regulations often lead to APRNs encountering limitations within their scope of practice, hindering their efforts to enhance patient care. In this dynamic healthcare landscape, it remains utmost for Florida's Advanced Practice Registered Nurses (APRNs) to enthusiastically embrace the concept of prescriptive autonomy. Recognizing their pivotal role in patient care, APRNs can proactively lead the movement toward legislative changes aimed at achieving full practice authority. By skillfully navigating healthcare policies, they can ensure that their contributions are optimized to improve the well-being of the communities they serve (Unruh et al., 2018).