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The Georgia Board of Nursing issued 12,592 registered nurse (RN) licenses in FY 2015, which marks a 19% increase from the 10,887 RN licenses issued in FY 2014. This upward trend is likely to continue, as the number of applicants for RN licensure in Georgia has increased every year since 2011, according to the Board.
As Georgia’s nursing field grows at unprecedented rates, an increasing number of RNs are enrolling in Master of Science in Nursing (MSN) programs to further their careers by specializing in an advanced area of nursing. MSN degrees serve as a launching point for RNs who wish to become advanced practice registered nurses (APRN) or pursue nonclinical careers in areas like administration, academia, or informatics.
According to the Georgia Board of Nursing, there were 9,948 active APRN licenses in the state as of 2015. The Board’s four recognized APRN roles are:
- Certified Nurse Midwife (CNM)
- Nurse Practitioner (NP)
- Certified Registered Nurse Anesthetist (CRNA)
- Clinical Nurse Specialist (CNS)
To be eligible for APRN licensure, RNs in Georgia are required to complete a master’s degree program dedicated to their role as well as earn national certification from a Board-recognized certifying body.
Master’s programs and national certification for nurse practitioners and clinical nurse specialists are further specialized according to one of six population foci (Family/Individual Across the Lifespan, Adult-Gerontology, Women’s Health, Neonatal, Pediatrics, and Psychiatric/Mental Health). Depending on the certifying body, primary certifications in some population foci involve selecting a specialty such as acute or primary care, while further optional specialty certification is available in areas like oncology and palliative care.
The value of graduate education for nurses in Georgia is reflected in the salaries associated with both APRNs and nonclinical nursing careers that require an MSN. According to a May, 2014 report from the U.S. Bureau of Labor Statistics (BLS), APRNs in Georgia earned a significantly higher mean annual salary than the state’s RNs, most of whom only held an associate’s or bachelor’s degree in nursing:
- Registered Nurses ($62,520)
- Nurse Practitioners ($89,920)
- Certified Nurse Midwives ($91,650)
- Certified Registered Nurse Anesthetists ($136,840)
The BLS report additionally stated that the top 10% of the state’s nursing educators earned a mean annual salary of $91,910, demonstrating the earning potential for MSN-prepared nurses in nonclinical roles.
Requirements for MSN Programs that Prepare RNs for APRN Licensure in Georgia
In addition to campus-based programs, RNs in Georgia may elect to pursue accredited online programs. Online programs give RNs the flexibility to further their education without compromising current work obligations. Through these programs, RNs collaborate with an advisor to establish placement for their required clinical work.
As of January 2016, there were 15 master’s programs in nursing approved by the Georgia Board of Nursing. A complete list of schools offering master’s degree programs in nursing can be found on the Board website.
Georgia’s MSN programs that prepare APRNs must offer both theoretical and practical components. Additionally, the programs must meet the national guidelines set forth by the Board-recognized certifying body that governs the program’s area of specialty.
Certified Nurse Midwife (CNM) Program Requirements
The American College of Nurse-Midwives (ACNM) is the accrediting agency for nurse-midwife programs. The American College of Nurse Midwives (ACNM) requires all CNM programs to prepare students for the core competencies for basic midwifery practice. These competencies include:
- Hallmarks of Midwifery
- Components of Midwifery Care: Professional Responsibilities of CNMs
- Components of Midwifery Care: Midwifery Management Process
- Components of Midwifery Care: Fundamentals
- Components of Midwifery Care of Women
- Components of Midwifery Care of the Newborn
To prepare CNMs for the fundamental components of nurse-midwifery care, programs must offer courses in the following areas:
- Anatomy and physiology, including pathophysiology
- Normal growth and development
- Psychosocial, sexual, and behavioral development
- Basic epidemiology
- Nutrition
- Pharmacokinetics and pharmacotherapeutics
- Principles of individual and group health education
- Bioethics related to the care of women, newborns, and families
- Clinical genetics and genomics
In addition to coursework, the ACNM sets forth clinical experience requirements for all CNM programs. The clinical work must adhere to the following standards:
- Attainment of clinical skills must meet Core Competencies for Basic Midwifery Education
- An AMCB-certified CNM or APRN who has clinical expertise and didactic knowledge commensurate with the content taught must supervise the clinical practice
- The clinical practice must teach the following skills:
- Management of primary care for women throughout the lifespan, including reproductive health care, pregnancy and birth
- Care of the normal newborn
- Management of sexually transmitted infections in male partners
Clinical Nurse Specialists (CNS) Program Requirements
The Commission on Collegiate Nursing Education (CCNE) and the Accreditation Commission for Education in Nursing (ACEN) are the accrediting agencies for nurse practitioner and clinical nurse specialist programs at the graduate and residency levels.
The National Association of Clinical Nurse Specialists, the preeminent advocacy association for clinical nurse specialists with the stated goal of furthering the positive influence of CNSs in practice, requires all master’s-level CNS programs to meet criteria in the following five areas:
- Program Organization and Administration
- CNS Program Resources: Faculty, Clinical, and Institutional
- Student Admission, Progression and Graduation
- CNS Curriculum
- CNS Program Evaluation
The association additionally requires all CNS programs to prepare students for the following core competencies:
- Direct Care Competency
- Consultation Competency
- Systems Leadership Competency
- Collaboration Competency
- Coaching Competency
- Research Competency
- Ethical Decision-Making, Moral Agency and Advocacy Competency
Each competency has its own set of behavioral statements, found in detail on the Association website.
Certified Registered Nurse Anesthetist (CRNA) Program Requirements
The Council on Accreditation of Nurse Anesthesia Educational Program (COA) governs the standards of graduate nurse anesthesia programs. The Council requires MSN programs for nurse-anesthetists to include coursework in the following areas:
- Anesthesia practice
- Pharmacology of anesthetic agents and adjuvant drugs including concepts in chemistry and biochemistry
- Anatomy, physiology, and pathophysiology
- Professional aspects of nurse anesthesia practice
- Basic and advanced principles of anesthesia practice including physics, equipment, technology and pain management
- Research
- Clinical correlation conferences
- Preanesthetic preparation and evaluation
- Anesthesia induction, maintenance and emergence
- Perianesthetic and clinical support functions
- Postanesthesia care
Programs must additionally provide students with clinical experience opportunities that promote the learning of anesthesia techniques, the testing of theory, and the application of knowledge to clinical problems.
Nurse Practitioner Program Requirements
The Commission on Collegiate Nursing Education (CCNE) and the Accreditation Commission for Education in Nursing (ACEN) are the accrediting agencies for nurse practitioner and clinical nurse specialist programs at the graduate and residency levels.
The standards for NP programs are defined by the National Task Force on Quality Nurse Practitioner Education. According to these standards, nurse practitioner programs must prepare students for the nine core competencies of professional practice:
- Scientific Foundation Competencies
- Leadership Competencies
- Quality Competencies
- Practice Inquiry Competencies
- Technology and Information Literacy Competencies
- Policy Competencies
- Health Delivery System Competencies
- Ethics Competencies
- Independent Practice Competencies
Programs must also prepare students for the NP Core Competencies based on population focus.
NP programs must also offer clinical experience opportunities that include a minimum of 500 supervised direct patient care clinical hours directly related to the student’s patient population focus and specialty.
Selecting the Right Program Based on Current Education
Nursing students enrolling in master’s programs would pursue programs structured to build off their current level education.
Prospective Graduate Students with a Bachelor of Science in Nursing – Nurses who have already received their Bachelor of Science in Nursing (BSN) are eligible to apply to conventional MSN programs. These BSN-MSN programs typically consist of between 40-60 credits and take between 18-30 months to complete.
Prospective Graduate Students with an Associate’s Degree in Nursing – RN-to-MSN programs allow RNs that currently hold an associate’s degree in nursing to complete a full BSN and MSN curriculum in one accelerated program that grants both degrees. These programs typically consist of seven-to-nine semesters of study and are usually completed in two to three years (part-time study may extend the completion process). There are five RN-to-MSN programs in Georgia, located in the following cities:
- Atlanta
- Morrow
- Thomasville
- Valdosta
RNs may additionally apply to online RN-to-MSN programs, conducting their clinical work at an approved Georgia medical facility.
Prospective Graduate Students with a Bachelor’s in an Area Other than Nursing – Professionals who have earned a bachelor’s degree in an area other than nursing may enroll in direct-entry MSN programs. These programs are designed to help bachelor’s-educated professionals in other fields earn their master’s degree through an accelerated learning process that can typically be completed in 15-24 months. The only direct-entry MSN program in Georgia is located in Augusta. However, RNs may pursue their MSN through direct-entry online programs.
Scope of Practice and Laws Governing Advanced Practice Registered Nursing in Georgia
The scope of practice for Georgia’s APRNs varies based on their particular APRN role (CRNP, CNM, CRNA, or CNS). Still, APRNs in all roles share the same rules with regard to prescriptive authority and what functions fall within the auspice of a collaborative practice agreement with a physician.
In 2008, over 40 major nursing organizations collaborated to establish the national APRN consensus model, a set of rules designed to provide uniformity in the regulation of APRN roles in each state. Georgia has adopted four major components of the model, including:
- APRN title
- Roles
- Education
- Certification
Collaborative Practice Agreement and Prescriptive Authority
In order to practice as an APRN, nurses must enter into a written collaborative agreement with a licensed delegating physician. The agreement must include the following, as detailed in the Rules and Regulations of the State of Georgia:
- Specific details regarding the medical acts delegated by the physician to the nurse
- Provisions for periodic review of patient records by the delegating physician
- Provisions for immediate consultation with the delegating physician or a physician designated in the absence of the delegating physician
- Provisions regarding the procedure for dispensing and ordering of any controlled substance (if APRNs choose to enter into a nurse protocol agreement that details prescription authority)
APRNs who have included prescriptive authority under their collaborative agreement with a delegating physician must submit a nurse protocol agreement, which details their prescriptive authority. APRNs who have been granted prescriptive authority must adhere to the following regulations:
- APRNs may not prescribe Schedule 1 controlled substances or Schedule 2 controlled substances.
- APRNs may not prescribe drugs intended to cause an abortion.
- APRNs may not order prescription refills for more than the time period defined by the physician in the agreement. The time period must be less than or equal to 12 months, except for the following prescription drugs, which may be ordered for up to 24 months:
- Oral contraceptives
- Hormone replacement therapy
- Prenatal vitamins
- APRNs must follow the prescription documentation and form regulations defined in the agreement.
- APRNs must receive annual pharmacology training, which is documented by the delegating physician.
- APRNs may order and distribute drug samples if granted the authority to do so by the delegating physician.
Georgia Board of Nursing provides a Scope of Practice Decision Tree as a basic resource for APRNs.
Practice Standards in for the Four APRN Roles
In addition to state regulations, APRNs in Georgia must adhere to the practice standards defined by their respective national certifying body:
- CNMs must practice in accordance with the standards set forth by the American College of Nurse Midwives.
- CRNAs must practice in accordance with the American Association of Nurse Anesthetists’ current guidelines and standards for nurse anesthesia practice.
- CNSs must practice in accordance with their population focus and area of further specialization, defined by the national certifying body from which they received their certification
- NPs must practice in accordance with their population focus and area of further specialization, defined by the national certifying body from which they received their certification
Additional details regarding the Board’s definition of specific APRNs may be found below:
Certified Nurse Midwives (CNMs)
Georgia’s CNMs manage women’s health care. The Georgia Board of Nursing lists the following areas of focus for CNMs in the state:
- Pregnancy
- Childbirth
- The postpartum period
- Newborn care
- Gynecology
- Family planning
Certified Registered Nurse Anesthetists
The Georgia Board of Nursing defines CRNAs as APRNs who specialize in the following areas of care:
- Preanesthetic work
- Anesthesia induction, maintenance, and emergence
- Perianesthetic and clinical support functions
- Postanesthesia
Clinical Nurse Specialists
CNSs in Georgia may provide consultation, liaison services, and clinical supervision to patients, healthcare systems, and other nurses.
The Georgia Board of Nursing provides additional details regarding the scope of practice for clinical nurse specialists in psychiatric/mental health (CNS/PMH), who are recognized as primary mental health care providers. The Georgia Board of Nursing authorizes state-licensed CNS/PHMs to provide the following forms of care:
- Liaison services
- Psychotherapy
- Clinical supervision
- Consultation
CNS/PMHs must additionally follow the practice rules and standards set forth by the American Psychiatric Nurses Association.
Nurse Practitioners
In providing medical care and services, Georgia’s nurse practitioners must emphasize the following:
- Health promotion
- Disease prevention
- Diagnosis and management of acute and chronic diseases
Continuing Education Requirements for APRNs in Georgia
Effective January 31st, 2016, all APRNs in Georgia must complete the Georgia Board of Nursing’s CE requirements for RNs during each two-year renewal period. The Board offers the following five CE options for satisfying these requirements:
- Completing thirty CE hours by a Board-approved provider
- Completing an accredited academic program of study in nursing or a related field as recognized by the Board
- Receiving competency verification from a health care facility or a physician’s office that is part of a health system; verification must include employer certification of at least 500 hours practiced
- Graduating from a nursing education program or completing a Board-approved re-entry program
- Maintaining certification or recertification through a national certifying body recognized by the Board. Recognized bodies include:
- American Academy of Nurse Practitioners
- American Association of Critical-Care Nurses Certification Corporation
- American Midwifery Certification Board
- American Nurses Credentialing Center
- National Certification Corporation
- National Board of Certification and Recertification for Nurse Anesthetists
- Pediatric Nursing Certification Board