Respond to at least two of your colleagues on 2 different days

Respond to at least two of your colleagues on 2 different days in one or more of the ways listed below.
Share an insight from having viewed your colleagues’ posts.
Suggest additional actions or perspectives.
Share insights after comparing state processes, roles, and limitations.
Suggest a way to advocate for the profession.
Share resources with those who are in your state.
Discussion.
Obtaining certification in Maryland has a list of requirements that every applicant must satisfy before applying. The applicant must have an RN license in good standing, apply with the fee, school transcripts, graduate attestation, and completion of a board-approved NP program (MBON, 2022). The applicant must also turn in an intent to test to begin practicing as a graduate nurse practitioner student (MBON, 2022). Once the applicant passes boards, they will be awarded a license. The information needed to obtain certification in the state of Maryland is the Maryland Board of Nursing website.
Scope of Practice
In Maryland, the scope of a nurse practitioner includes having the ability to independently perform a thorough assessment, manage diagnoses, interpret labs, prescribe medications, and perform emergency care (MBON, 2022). In 2015, Governor Larry Hogan signed the Nurse Practitioner Full Practice Authority Act in which an NP can work independently without an agreement to work with a physician (MBON, 2022).
DEA License
The federal government requires all practitioners to obtain a DEA license to prescribe medications. In the state of Maryland, there is a four-step process with obtaining a DEA license, the applicant must complete a Controlled Dangerous Substance (CDS) 2-hour course, register with CRISP and the Prescription Drug Monitoring Program (PDMP), and then complete the application with the Federal DEA website. (Maryland Department of Health, 2022). A nurse practitioner in the state of Maryland has the authority to prepare, dispense and prescribe all medications in Schedule I-V (MBON, 2022).
Organization
Nurse practitioner organizations that Maryland is involved with are AANP, NCSBN, AACN, NONPF, and Maryland’s NPAM (NPAM, 2022). These organizations help to ensure that NPs remain active in policies that influence the day-to-day operations of healthcare. It builds a strong influence to continue to increase access to healthcare and improve health disparities where nurse practitioners can be of assistance (NPAM, 2022). Nursing organizations maintain an active relationship with the politics that have assisted states such as Maryland to authorize NPs as full practice practitioners.
Barriers
               Neighboring states of Maryland pose as a barrier for nurse practitioners. Currently, only 22 states and DC have full practice authority for nurse practitioners with the remaining at either reduced authority or no authority without the supervision of a physician (Peterson, 2017). The issue is without full practice authority each state determines the capability of the nurse practitioner to include prescriptive authority, diagnosing capabilities, and management options (Peterson, 2017). Practicing in Maryland as an independent provider still poses challenges, although given full authority because of the stigma tied to nurse practitioners. Since the beginning of the inclusion of nurse practitioners as independent providers in 1965, many states believe that nurse practitioners should always be physician extenders and often do not give nurse practitioners the same respect as a physician assistant or physician (Peterson, 2017). While performing research, I was surprised to see so many neighboring states with restrictions on nurse practitioners. Many nurses I work with live in Pennsylvania, yet work in Maryland, and similarly would not be able to practice independently in Pennsylvania but could in Maryland. As a graduate nurse practitioner student, it is imperative to be involved in organizations that will help keep me abreast of state specific guidelines and political involvement to help influence policies that further loosen restraints in neighboring states.
 
References
Maryland Board of Nursing. (2022). Advanced Practice Registered Nursing: Nurse Practitioners. https://mbon.maryland.gov/Pages/adv-prac-nurse-practitioner-index.aspx
Maryland Department of Health and Mental Hygiene (2022) CDS Application. https://health.maryland.gov/ocsa/Pages/CDS-Application.aspx
Nurse Practitioner Association of Maryland (2022). Legislative/Clinical Practice Summary. https://www.npamonline.org/page/34
Peterson M. E. (2017). Barriers to Practice and the Impact on Health Care: A Nurse Practitioner Focus. Journal of the advanced practitioner in oncology, 8(1), 74–81.