A Master of Science in Nursing (MSN) provides registered nurses with the education necessary to enter advanced practice, which in Idaho means the ability to practice independently. In fact, Idaho is at the forefront of a movement led by the National Council of State Boards of Nursing (NCSBN) that, among other things, seeks to achieve uniformity in advanced practice nursing laws across all states and jurisdictions. In accordance with the NCSBN’s APRN Consensus Model, Idaho’s advanced practice registered nurses (APRNs) have the authority to practice to the full extent of their education and training, allowing them to diagnose medical conditions, develop treatment plans and prescribe drugs.
According to the National Council of State Boards of Nursing, the United States will face a shortage of physicians in the coming years, due in part to population growth and projected expansion of health insurance coverage. To meet the growing demand for health care services, the Idaho Board of Nursing has been adopting laws that allow APRNs to provide health care services with fewer restrictions. As of January 1st, 2016, all APRNs graduating with an accredited master’s or higher degree are granted prescriptive and dispensing authority upon receiving their license. This new rule allows APRNs to begin prescribing pharmacological agents to patients immediately upon establishing a treatment plan.
According to the Idaho Board of Nursing, there are 1,549 active APRN licenses in the state in the four recognized roles:
- Certified Nurse Midwife (CNM) – 49
- Certified Nurse Specialist (CNS) – 44
- Nurse Practitioner (NP) – 1,033
- Registered Nurse Anesthetist (RNA) – 423
While many graduates of MSN programs pursue careers within advanced practice nursing, others elect to pursue nonclinical roles in areas such as nursing education, patient advocacy and healthcare management.
Licensing Requirements for the Four APRN Roles Recognized by the Idaho Board of Nursing
RNs with licenses in good standing would meet the requirements for APRN licensure through the Idaho Board of Nursing by earning a master’s in nursing specific to their chosen APRN role, before going on to become nationally certified in that role. The Idaho Board of Nursing licensed APRNs in these four roles:
- Certified Nurse Midwife (CNM)
- Certified Nurse Specialist (CNS)
- Nurse Practitioner (NP)
- Registered Nurse Anesthetist (RNA)
Clinical nurse specialists and nurse practitioners further specialize through education and certification in a specific patient population focus of their choice (Adult-Gerontology; Family/Individual Across the Lifespan; Neonatal; Pediatrics; Psychiatric/Mental Health; Women’s Health). Certified nurse-midwives do not choose a patient population group since the patient population is implicit in the primary role. Registered nurse anesthetists are able to work with all patient population groups without the need to specialize beyond their primary role.
The Idaho Board of Nursing recognizes the following national certification agencies in each advanced practice role and patient population focus as granting the certification necessary for APRN licensing in the state:
- Adult Nurse Practitioner (ANP)
- Family Nurse Practitioner (FNP)
- Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP)
- Acute Care Nurse Practitioner-Board Certified (ACNP-BC)
- Adult Nurse Practitioner-Board Certified (ANP-BC)
- Family Nurse Practitioner-Board Certified (FNP-BC)
- Gerontological Nurse Practitioner-Board Certified (GNP-BC)
- Pediatric Primary Care Nurse Practitioner-Board Certified (PPCNP-BC)
- Adult-Gerontology Acute Care Nurse Practitioner-Board Certified (AGACNP-BC)
- Adult-Gerontology Primary Care Nurse Practitioner-Board Certified (AGPCNP-BC)
- Psychiatric-Mental Health Nurse Practitioner-Board Certified (PMHNP-BC)
- Adult Psychiatric-Mental Health Nurse Practitioner-Board Certified (PMHNP-BC)
- School Nurse Practitioner-Board Certified (SNP-BC)
- Acute Care Nurse Practitioner Adult-Gerontology (ACNPC-AG)
- Acute Care Nurse Practitioner Adult (ACNPC) – not aligned with APRN Consensus Model
- Pediatric Nurse Practitioner Primary Care (CPNP-PC)
- Pediatric Nurse Practitioner Acute Care (CPNPAC)
- Pediatric Primary Care Mental Health Specialist (PMHS)
- Women’s Health Care Nurse Practitioner-Board Certified (WHNP-BC)
- Neonatal Nurse Practitioner-Board Certified (NNP-BC)
- Certified in Nurse-Midwifery (CNM)
Clinical Nurse Specialists
- Clinical Nurse Specialist; Wellness through Acute Care (Adult-Gerontology) (ACCNS-AG)
- Clinical Nurse Specialist; Wellness through Acute Care (Pediatric) (ACCNS-P)
- Clinical Nurse Specialist; Wellness through Acute Care (Neonatal) (ACCNS-N)
- Acute/Critical Care Clinical Nurse Specialist (Adult, Pediatric & Neonatal) (CCNS) – not aligned with APRN Consensus Model
- Adult Health Clinical Nurse Specialist-Board Certified (ACNS-BC)
- Adult-Gerontology Clinical Nurse Specialist-Board Certified (AGCNS-BC)
- Adult Psychiatric-Mental Health Clinical Nurse Specialist-Board Certified (PMHCNS-BC)
- Child/Adolescent Psychiatric-Mental Health Clinical Nurse Specialist-Board Certified (PMHCNS-BC)
- Gerontological Clinical Nurse Specialist-Board Certified (GCNS-BC)
- Home Health Clinical Nurse Specialist-Board Certified (HHCNS-BC)
- Pediatric Clinical Nurse Specialist-Board Certified (PCNS-BC)
- Public/Community Health Clinical Nurse Specialist-Board Certified (PHCNS-BC)
Certified Registered Nurse Anesthetist (CRNA)
- Certified Registered Nurse Anesthetist (CRNA)
Earning a Master of Science in Nursing (MSN) in Idaho
Though there is only one MSN program in Idaho, located in Pocatello, aspiring APRNs can select accredited online MSN programs recognized by advanced nursing education accrediting bodies. Online programs allow RNs to prepare for advanced practice without sacrificing current work obligations. Program advisors help students find clinical placement in an approved Idaho medical facility.
Separate MSN program accrediting bodies accredit programs in the four respective APRN roles:
Nurse practitioner and clinical nurse specialist programs are accredited by:
Registered nurse anesthetist programs are accredited by:
Certified nurse-midwife programs are accredited by:
Idaho Requirements for MSN Programs that Prepare Advanced Practice Registered Nurses
All master’s and higher degree programs that prepare Idaho APRNs for national certification and state licensure in all roles and patient population groups must meet the nursing program education requirements set forth by the Idaho Board of Nursing. These requirements include, but are not limited to:
- Programs must be part of an educational institution accredited by an organization recognized by the United States Department of Education
- Programs must provide resources including facilities, equipment, supplies, and qualified administrative, instructional, and support personnel and services.
- Programs must provide one faculty person in the clinical agencies for no more than 10 students, unless approved otherwise by the Board
- Programs must have at least one qualified nursing administrator for each nursing education department or division.
- Programs must provide both theoretical instruction and practice experiences
- Program faculty must maintain nursing competence through activities and research consistent with institutional and professional requirements
- Programs must have provisions for student input on the planning, implementation, and evaluation of academic curriculum
In addition to offering interdisciplinary education through both clinical experience and didactic content, programs must offer courses on topics including:
- Advanced theory and research in nursing
- Biological and behavioral sciences
- Cultural diversity
- Economics and informatics
- Legal, ethical, and professional responsibilities of a graduate prepared registered nurse
Selecting the Right Type of MSN Program Based on Current Education
RNs will find that master’s programs that prepare them for national certification and state licensure in one of the four APRN roles are structured in one of a few different ways so as to build off of a nurse’s current level of education and training:
RNs with a Bachelor of Science in Nursing – RNs who have received their Bachelor of Science in Nursing are eligible to apply to conventional MSN programs, often referred to as terminal master’s programs. These BSN-MSN programs typically consist of between 40-60 course credits and take between 18-30 months to complete. RNs who enroll in BSN-DNP programs may earn their master’s degree en route to their doctorate degree over the course of 4-5 years. These programs often offer an opt-out MSN option, providing flexibility for students.
RNs with an Associate’s Degree in Nursing – Associate’s prepared RNs in Idaho who enroll in online RN-to-MSN bridge programs would complete a BSN and MSN curriculum in one accelerated program. Typically consisting of seven-to-nine semesters of study, these programs take between two to three years to complete, although part-time study may extend the completion process.
Non-Nursing Professionals with a Bachelor’s Degree in an Area Other than Nursing – Online direct-entry MSN programs are designed for professionals who have received a bachelor’s degree in an area other than nursing. These direct entry programs typically consists of between 15-24 months of study.
Scope of Practice and Idaho State Laws Governing Advanced Practice Registered Nursing
The Idaho Board of Nursing defines the scope of practice for APRNs based on role, patient population focus and specialty. As a point of reference, the Board offers a Decision Making Model. According to the Board, all nurse practitioners, clinical nurse specialists, nurse-midwives and nurse-anesthetists may perform acts including, but not limited to:
- Providing client services in area of specialty
- Evaluating and, when appropriate, implementing current evidence-based research findings related to APRN role
- Assessing, diagnosing, and managing client conditions through appropriate pharmacologic and nonpharmacologic interventions and agents
- Teaching other health care team members in areas related to APRN role
The Idaho Board of Nursing defines the specific scope of practice for the respective APRNs roles as follows:
CNMs may perform acts including, but not limited to, providing primary health care services to women throughout the lifespan in the following areas:
- Preconception care
- Prenatal care
- Postpartum care
- Reproductive health care treatment of male partners of female clients
- Newborn care
Clinical Nurse Specialist
A CNS may provide services including, but not limited to:
- Ensuring communication between patients, their families, the healthcare team and components of the health care delivery system
- Direct care
- Expert consultation
- Monitoring for quality indicators
- Care coordination
Certified Nurse Practitioner
CNPs are authorized to provide services including, but not limited to:
- Serve as a health counselor educator
- Identify and manage effects of illness on clients and clients’ families
- Provide approved primary care services
Certified Registered Nurse Anesthetist
A CRNA may provide the full spectrum of anesthesia care and related services to patients across the lifespan. Patients’ health status may range across the wellness-illness continuum.
Implementation of the APRN Consensus Model in Idaho
Idaho is one of 11 U.S. states to adopt all major components of the national APRN consensus model, a national framework for APRN education standards, certification and scope of practice created in 2008 with input from more than 40 nursing organizations. APRNs in Idaho may practice independently and do not require a collaborative agreement with a physician to provide medical services.
The Idaho Board of Nursing is continuing to work towards complete alignment with the model. To do so, the Board’s Strategic Plan for 2014-2017 involved making revisions to the state’s Nursing Practice Act in 2014 so as to implement the APRN Consensus Model.
Upon receiving their license to practice from the Idaho Board of Nursing, APRNs may prescribe pharmacologic agents within the course of their professional practice. Additionally, an APRN may only prescribe pharmacologic agents after establishing a bona fide APRN/patient relationship, except in the circumstances set forth in Section 54-1733(4), Idaho Code.
Continuing Education Requirements for APRNs in Idaho
The Idaho Board of Nursing requires all nurse practitioners, clinical nurse specialists, nurse-midwives and nurse-anesthetists to complete 30 contact hours of CE during each two-year renewal period, to include 10 contact hours in pharmacology. The renewal cycle in Idaho runs through August 31 of odd-numbered years. The Board sets requirements for APRN Continuing Education to inlcude:
- Hours must be obtained from a nationally recognized nursing organization, a nationally accredited academic institution, or a provider of CE that is recognized by another nursing board or regulatory body of discipline
- Hours must be related to APRN role
- Hours must consist of coursework from the above approved CE providers or activities including, but not limited to research, publishing material, and teaching. Activities may not constitute more than three hours each of CE
In addition to CE hours, APRNs must submit the following to the Board:
- Forms that confirm a minimum of 200 hours of advanced registered nursing practice within the preceding two years.
- Evidence of participation in a peer review process approved by the Board