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There are plenty of benefits that come with pursuing a Master of Science in Nursing (MSN) and becoming an advanced practice registered nurse (APRN) in the District of Columbia. Washington D.C.’s APRNs practice independently, which means that they may evaluate patients, order and interpret diagnostic tests, diagnose, initiate and manage treatments, and prescribe medications without the need for a collaborative physician agreement or other oversight.
The District of Columbia Board of Nursing has aligned its licensing laws and practice standards with the APRN Consensus Model, allowing APRNs to practice to the full extent of their education and training. This has helped provide the citizens of D.C. with more healthcare options than ever before.
The Board recognizes APRNs as licensed registered nurse with advanced education, knowledge, skills, and scope of practice and with national certification through a recognized certifying body. The general scope of practice for APRNs in DC involves:
- Treating those with health conditions/problems
- Medical diagnosis
- Prescribing
- Advanced assessment
- Selecting, administering, and dispensing therapeutic measures
Other nurses in D.C. that must regularly possess MSNs or other graduate degrees in nursing include:
- Nursing Administrators
- Clinical Leaders
- Public Health Nurses
- Nursing Educators
- Nursing Informaticists
Licensing Requirements for the APRN Roles Recognized in Washington D.C.
The District of Columbia Board of Nursing (part of the Department of Health) licensed qualified registered nurses in the following advanced practice registered nursing (APRN) roles:
- Certified Nurse-Midwives (CNMs)
- Certified Registered Nurse Anesthetists (CRNA)
- Clinical Nurse Specialists (CNS)
- Certified Nurse Practitioners (CNP)
Nurse practitioners can further specialize by becoming educated and certified in a specific patient population focus (family-individual across the lifespan; adult-gerontology primary or acute care; neonatal; women’s health; psychiatric-mental health).
The Master of Science in Nursing (MSN) remains the minimum educational pursuit for RNs in Washington D.C. seeking APRN certification. RNs in Washington D.C. must complete an MSN or other graduate degree and attain national certification in a chosen APRN role and population focus.
Upon completing an MSN or other graduate APRN program, candidates in Alabama would seek national certification in the role and population focus that coincide with their MSN education. Certifying bodies recognized by the District of Columbia Board of Nursing for the purpose of APRN licensure are:
Registered Nurse Practitioner (RNP)
- American Academy of Nurse Practitioners
- Adult nurse practitioner (ANP)
- Family nurse practitioner (FNP)
- American Nurses Credentialing Center
- 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)
- Psychiatric-mental health nurse practitioner – Board certified (PMHNP-BC)
- Adult psychiatric- mental health nurse practitioner – Board certified (PMHNP-BC)
- Adult-gerontological acute care nurse practitioner (AGACNP-BC)
- Pediatric Nursing Certification Board
- Pediatric nurse practitioner primary care (CPNP-PC)
- Pediatric nurse practitioner acute care (CPNPAC)
- National Certification Corporation
- Women’s health nurse practitioner – Board certified (WHNP-BC)
- Neonatal nurse practitioner – Board certified (NNP-BC)
Clinical Nurse Specialist (CNS)
- AACN Certification Corporation
- 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)
- American Nurses Credentialing Center
- Adult Psychiatric-Mental Health Clinical Nurse Specialist-Board Certified (PMHCNS-BC)
- Child/Adolescent Psychiatric-Mental Health Clinical Nurse Specialist-Board Certified (PMHCNS-BC)
Certified Nurse-Midwife
- American Midwifery Certification Board
- Certified in Nurse-Midwifery (CNM)
Certified Registered Nurse Anesthetist (CRNA)
- National Board of Certification and Recertification for Nurse Anesthetists
- Certified Registered Nurse Anesthetist (CRNA)
Earning a Master of Science in Nursing (MSN) in Washington D.C.
The Board of Nursing recognizes MSN and other graduate APRN programs recognized by the U.S. Secretary of Education and/or the Council for Higher Education Accreditation (CHEA).
Even RNs that don’t reside near a school with an accredited MSN program have a number of options through the many institutions that now offer partially or fully online programs. These programs allow students to complete all of their didactic requirements through online study. Most institutions partner with clinical sites throughout the country, which then allow students to complete the clinical requirements of their program at sites close to home.
The national accrediting bodies for graduate programs in the four APRN roles are:
Clinical Nurse Specialist and Nurse Practitioner Programs
- The Commission on Collegiate Nursing Education (CCNE) accredits nursing programs at the baccalaureate, graduate, and residency levels. There are six CCNE-accredited programs in D.C.
- The Accreditation Commission for Education in Nursing (ACEN) accredits nursing education programs—post-secondary and the higher degree—that offer, among others, master’s/post-master’s certificates. There are no ACEN-accredited programs in Washington D.C.
Certified Registered Nurse Anesthetist Programs
- The Council on Accreditation of Nurse Anesthesia Educational Programs (COA) is the accrediting agency for nurse anesthetist programs. There is one COA-accredited program in Washington D.C.
Certified Nurse-Midwife Programs
- The Accreditation Commission for Midwifery Education (ACME) is the accrediting agency for nurse-midwives programs. There is one ACME-accredited program in Washington D.C.
District of Columbia Board of Nursing Requirements for MSN Programs that Prepare Advanced Practice Registered Nurses
Accredited MSN programs for the respective APRN roles and population foci must align with the requirements for national certification in terms of clinical hours and coursework:
Nurse Practitioner: The National Task Force on Quality Nurse Practitioner Education requires graduates of accredited nurse practitioner programs to possess the following competencies:
- Health Delivery System Competencies
- Scientific Foundation Competencies
- Quality Competencies
- Leadership Competencies
- Ethics Competencies
- Technology and Information Literacy Competencies
- Independent Practice Competencies
- Practice Inquiry Competencies
- Policy Competencies
All programs must include at least 500 hours of supervised clinical experience.
Certified Nurse-Midwife: The ACNM Core Competencies for Basic Midwifery Practice are:
- Components of Midwifery Care of the Newborn
- Components of Midwifery Care of Women
- Components of Midwifery Care: Fundamentals
- Components of Midwifery Care: Midwifery Management Process
- Components of Midwifery Care: Professional Responsibilities of CNMs
- Hallmarks of Midwifery
Clinical experiences should include:
- Management of sexually transmitted infections in male partners
- Management of primary care for women throughout the lifespan (reproductive health care, pregnancy and birth)
- Care of the normal newborn
Certified Registered Nurse Anesthetist: The Council on Accreditation of Nurse Anesthesia Educational Programs (COA) requires the academic curriculum and prerequisite courses of nurse anesthesia programs to include:
- Anatomy, physiology, and pathophysiology
- Research
- Clinical conferences
- Basic and advanced anesthesia practices
- Professional aspects of nurse anesthesia practice
- Pharmacology of anesthetic agents and adjuvant drugs within the concepts of biochemistry and chemistry
- Radiology and ultrasound
Clinical experiences should allow students the opportunity to:
- Apply knowledge to clinical problems
- Test theory
- Learn anesthesia techniques
Clinical Nurse Specialist: The National CNS Competency Task Force requires all accredited CNS programs to prepare students in the following competencies:
- Direct Care Competency
- Consultation Competency
- Systems Leadership Competency
- Collaboration Competency
- Coaching Competency
- Research Competency
- Ethical Decision-Making, Moral Agency and Advocacy Competency
Selecting the Right Program Based on Education
A number of different types of graduate programs exist to accommodate students with different educational backgrounds:
- RNS with a BSN: RNs that possess a Bachelor of Science in Nursing pursue a conventional Master of Science in Nursing in their chosen APRN role and population focus.
- RNs with an ADN: RNs that possess an associate’s degree in nursing must complete both their BSN and MSN to qualify for APRN licensure in Washington D.C. A number of RN-to-MSN programs accommodate these students, allowing them to complete their BSN and MSN in an accelerated format.
- RNs with an MSN: RNs that already possess a generalist MSN and are seeking initial APRN licensure may complete a post-graduate APRN certificate program in their chosen APRN role and population focus.
Scope of Practice and D.C. State Laws Governing Advanced Practice Registered Nursing
Certified Nurse-Midwife Scope of Practice
CNMs in Washington D.C. may perform the following acts:
- Manage the care of the normal obstetrical patient
- Perform post-partum examinations
- Perform minor surgical procedures
- Manger care of the newborn
- Provide primary healthcare
- Provide gynecological care for women
- Prescribe appropriate medications
- Provide gynecological care for women
- Prescribe appropriate medications
- Provide family planning and STD services
- Manager the normal obstetrical patient during labor and delivery
- Initiate and perform local anesthetic procedures
Certified Nurse Practitioner Scope of Practice
Nurse practitioners in Washington D.C. may perform actions of medical diagnosis, treatment, prescription, and other functions. Authorized acts may include:
- Initiating, monitoring, and altering drug therapies
- Initiating appropriate therapies or treatments
- Make referrals for appropriate therapies or treatments
Certified Registered Nurse Anesthetist Scope of Practice
CRNAs in Washington D.C. may perform the following functions:
- Determine the health status of the patient as it is related to anesthesia management
- Determine the appropriate type of anesthesia based on the patient’s history, physical assessment, and lab results
- Order pre-anesthetic medication
- Order and administer:
- General and regional anesthesia
- Inhalation agents and techniques
- IV agents and techniques
- Techniques of hypnosis
- Order and perform monitoring procedures related to the anesthetic healthcare management of the patient
- Support life function during anesthesia care
- Recognize and take appropriate actions for abnormal patient responses to anesthesia
- Recognize and treat cardiac arrhythmia while patient is under anesthesia
- Manage patient while in the post-anesthesia recovery phase
Clinical Nurse Specialist Scope of Practice
CNSs in Washington D.C. may perform the following functions:
- Manage health-related or psychiatric problems
- Initiate/monitor/alter therapies
- Design and evaluate innovations
- Provide primary care, including health promotion and disease prevention
- Perform additional procedures and treatments specific to their specialty scope of practice
Prescriptive Authority for APRNs in Washington D.C.
APRNs in Washington D.C. have authority to prescribe legend drugs and controlled substances (Schedules II through V) in accordance with all applicable D.C. and federal laws.
APRNs that want to prescribe controlled substances must possess a District of Columbia controlled substance registration and certificate of registration from the DEA.
The APRN Consensus Model and Independent Practice in Washington D.C.
The APRN Consensus Model is a national effort to make education, certification, licensure and practice privileges for APRNs consistent across all jurisdictions in an effort to improve healthcare delivery. One of the key recommendations in the Model is to remove barriers that prevent APRNs from practicing to the full extent of their education and training. Proponents of the Model argue that APRNs granted independent practice improve patient access to high-quality care, particularly in remote and underserved areas.
Washington D.C. is now part of a growing number of states that now allow APRNs independent practice authority without the need to enter into a collaborative physician agreement. Full practice authority for D.C. APRNs includes full prescriptive authority, including controlled substances.
Continuing Education Requirements for APRNs in Washington D.C.
RN/APRN renewal in Washington D.C. occurs on June 30 of even-numbered years.
APRNs in Washington D.C. must complete at least 24 contact hours in their current area of practice. At least 15 of the 24 required contact hours must include pharmacological content. All continuing education must be relevant to the APRN’s current field of practice.
More information on continuing education options can be found here.
APRNs may renew their Controlled Substances Registration after they renew their APRN certification.