Advanced Practice Registered Nurses
- Certified Nurse Midwife Practice and Prescriptive Authority
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Full independent practice authority for low-risk pregnancies but physician relationship required for prescriptive authority.
NMs may practice independently for "low-risk" pregnancies. The certificate to practice nurse midwifery authorizes the holder to attend cases of low-risk pregnancy and childbirth and to provide prenatal, intrapartum, and postpartum care, including interconception care, family planning care, and immediate care for the newborn.
If the pregnancy does not meet the definition of "low-risk," a physician relationship is required. The NM must practice with a physician and surgeon under mutually agreed-upon policies and protocols that delineate the parameters for consultation, collaboration, referral, and the transfer of the patient's care signed by both the NM and physician and surgeon. Cal. Business and Professions Code §2746.5
NMs are authorized to provide and order drugs, and medical devices including controlled substances (Schedule II-V) only under the supervision of a physician and when directed by the standardized procedures or protocols developed by the supervising physician and the midwife. Cal. Business and Professions Code §2746.51
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- Nurse Practitioner Practice and Prescriptive Authority
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Transition to independent practice and prescribing period required.
NPs may apply to practice independently after completing the transition to practice requirement of three years or 4,600 hours. Prior to three years or 4,600 hours, NPs must practice pursuant to standard operating procedures which specifies scope and extent of supervision. Cal. Business and Professions Code §2836.1
If approved, the NP may independently prescribe, order, dispense, procure or furnish pharmacological agents including controlled substances. Schedules II-V are allowed but Schedule II authority requires the completion of extra continuing education requirements. Cal. Business and Professions Code §2837
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- Nurse Practitioner Authority to Sign POLST Forms
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NPs are authorized to sign POLST forms under the supervision of a physician if its within the scope of practice authorized by law. Cal. Probate Code §4780(c)
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- Nurse Practitioner as a Primary Care Provider
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NPs are recognized in state policy as primary care providers. Primary care provider means a person responsible for coordinating and providing primary care to members, within the scope of their license to practice, for initiating referrals and for maintaining continuity of care. A primary care provider may be a primary care physician or nonphysician medical practitioner including a nurse practitioner, certified nurse midwife or physician assistant. 22 Cal. Code of Reg. §53810(gg)
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