Alabama’s advanced practice nurses (APNs) hold multiple credentials. They are licensed as registered nurses and approved to work as advanced practice nurses. They must hold both their RN license and advanced practice approval through the Alabama Board of Nursing; Alabama is not a member of the nurse license compact.
Alabama recognizes four advanced practice categories:
Approval is granted on the basis of graduate education and specialty certification.
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Advanced practice nurses must complete accredited master's programs or post-master's certificates in their respective roles. There are exceptions. CRNAs who do not hold master’s degrees are eligible for credentialing if they completed their programs before December 31, 2003. A CRNP or CNM who completed a BSN and certificate program prior to 1996 is exempt from the master’s degree requirement; to be exempt from the ‘BSN and certificate’ requirement and be certified on the strength of a certificate program, he or she must have completed the program by 1984. Administrative rules state that the Board may, at its discretion, waive the master’s degree requirement.
In most cases, an advanced practice nurse is required to pursue national certification through a Board-recognized certification agency and to maintain the credential at all times. However, a clinical nurse who completes a program in a field of nursing for which there is no certification program is allowed to petition the Board.
Nurse anesthetists are to pursue their certification through the National Board for Certification and Recertification of Nurse Anesthetists. Nurse midwives are to pursue their certification through the American Midwifery Certification Board.
There are multiple certification agencies for clinical nurse specialists and nurse practitioners. The Alabama Board recognizes the following:
The Board also recognizes some sub-specialty certifications in oncology and hospice/ palliative care.
Some organizations offer multiple approved certification examinations. The Alabama Board has provided a document listing available examinations; the frequently asked questions page includes a link to the current document. Examination availability changes periodically. Some certifications are no longer available to new ANPs. Those who hold certification, however, can continue to recertify.
Nurse practitioners and nurse midwives have a scope of practice that includes prescribing authority. Alabama requires them to have collaborative agreements with physicians. A collaborating physician must have an unrestricted Alabama license. He or she must meet Board experience requirements unless a waiver has been granted. Clinical nurse specialists and nurse anesthetists are not required to have collaborative agreements.
Collaboration is discussed in the Board’s list of frequently asked questions for APNs (https://www.abn.alabama.gov/Content.aspx?id=626). Nurse practitioner and nurse midwife requirements are detailed in Chapter 610-X-5 of Alabama Administrative Code: Advanced Practice Nursing Collaborative Practice (https://www.abn.alabama.gov/Content.aspx?id=123). Nurse anesthetist and clinical nurse specialist requirements are detailed in Chapter 610-X-9: Advanced Practice Nursing.
Alabama does not extend reciprocity to out-of-state APNs. However, in some cases, an individual who met requirements in the distant past may be licensed on the basis of lesser requirements.
Applications are submitted online (https://www.abn.alabama.gov/Content.aspx?id=26).
The Board requires official transcripts and official documentation of certification status.
Initial APN approval currently costs $150.
The Board has provided a list of application deadlines for individuals who need to have collaborative agreements approved (https://www.abn.alabama.gov/Content.aspx?id=628).
A nurse anesthetist, nurse midwife, or nurse practitioner can be granted provisional approval prior to meeting certification requirements. He or she will need to have authorization to test from the applicable certifying agency.
The graduate is to apply before making an examination attempt; an applicant who has already made an attempt cannot secure the needed documentation.
A provisionally approved advanced practice nurse who fails an examination attempt loses the privilege of working under provisional approval. The nurse may, however, retake the certification examination, pass it, and then re-apply to the Alabama Board.
A professional working under provisional approval may use the title Graduate Nurse Midwife, Graduate Registered Nurse Practitioner, or Graduate Registered Nurse Anesthetist, as applicable.
RN and APN licenses are renewed together every two years; the APN may have an earlier expiration date if the certification expires before the RN license does.
The advanced practice nurse will need to demonstrate current certification. The Board will require official verification from the certifying agency.
Nurse anesthetists, nurse practitioners, and clinical nurse specialists must complete six hours of pharmacology as part of their continuing education requirement.
Information about advanced practice is available from the Alabama Board of Nursing (https://www.abn.alabama.gov). The Alabama Board can be reached by telephone at 1-800-656-5318. The Board has provided a list of contacts for advanced practice nurses and applicants (https://www.abn.alabama.gov/Content.aspx?id=624). Interested individuals can subscribe to an advanced practice ListServ.
The Nurse Practitioner Alliance of Alabama (https://npalliancealabama.enpnetwork.com/) and the Alabama Association of Nurse Anesthetists (http://www.alabamacrna.org/) are additional professional resources.
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