Advanced Practice Nurse Requirements in California
California’s advanced practice nurses are under the jurisdiction of the California Board of Registered Nursing (BRN). In order to be certified as an advanced practice nurse, a practitioner must also be licensed as a registered nurse.
The Board recognizes the following graduate-level advanced specialty areas:
- Nurse Anesthetist (NA)
- Nurse Practitioner (NP)
- Nurse-Midwife (NMW)
- Clinical Nurse Specialist (CNS)
- Psychiatric/ Mental Health Nurse (PMH)
There is just one pathway to certification as a nurse anesthetist; the Board is very specific about education (Nurse Practitioner programs in California) and certification requirements. For other specialties, there are multiple pathways a nurse may use to demonstrate that requirements have been met.
Nurse practitioners and nurse-midwives may be authorized to order medication for patients; for this, they will need a “furnishing number”.
Select a California Advanced Practice Nurse Topic:
- Nurse Anesthetist Requirements
- Nurse Practitioner Requirements
- Nurse-Midwife Requirements
- Clinical Nurse Specialist Requirements
- Psychiatric/ Mental Health Nurse Requirements
- APN Application Materials and Process
- Prescriptive Privilege
- Out-of-State Nurses
- APN License Renewal Requirements
- Nursing Board, Contacts, Associations and Additional Information
Nurse Anesthetist Requirements
A nurse anesthetist must attend a program accredited by the Council on Accreditation of Nurse Anesthesia Educational Programs and seek certification through the Council on Certification/Recertification of Nurse Anesthetists.
The Board has provided a listed of accredited programs located within California (http://www.rn.ca.gov/education/apprograms.shtml#crna).
Nurse Practitioner Requirements
A nurse can become an NP by 1) completing an in-state program recognized by the Board as meeting standards 2) earning certification through an accepted organization or 3) completing an equivalent program.
The Board has provided a list of approved California programs (http://www.rn.ca.gov/education/apprograms.shtml#np).
The following certification agencies have been approved for nurse practitioner certification:
- American Academy of Nurse Practitioners (AANP)
- American Association of Critical-Care Nurses (AACN)
- American Nurses Credentialing Center (ANCC)
- National Certification Corporation for the Obstetric, Gynecologic and Neonatal Nursing Specialties (NCC)
- Pediatric Nursing Certification Board
In order to be certified by equivalency, a nurse will need to verify clinical experience and clinical competency in provision of primary care services. Clinical competency will be verified by both a licensed physician and a licensed nurse practitioner.
The licensing agency will also need documentation of course content.
A nurse can demonstrate qualification for California nurse-midwife certification by completing an approved California program, completing another program that meets standards described in Section 1462 of state regulation, or achieving certification through the American Midwifery Certification Board (AMCB).
The Board has provided a list of approved nurse-midwife programs (http://www.rn.ca.gov/education/apprograms.shtml#nmw); there are currently three approved in-state programs.
Unless the prospective nurse-midwife is a recent graduate, he or she will need to submit a recency form, verifying clinical experience from the previous five years.
Clinical Nurse Specialist Requirements
A nurse can become a clinical nurse specialist on the strength of a master’s degree in a clinical nursing specialty or a master’s degree in a related clinical field.
If the master’s program meets Board standards, the graduate can qualify by verifying education and clinical experience. The professional who verifies clinical experience must be a familiar with the clinical nurse specialist role and must have observed the applicant carry out the five advanced nursing component areas: expert clinical nursing practice, clinical leadership, research, education, and consultation.
A clinical nurse specialist who qualifies by equivalency will need to document having had coursework in the five component areas; this is in addition to clinical experience.
A clinical nurse specialist who qualifies by certification will hold credentialing through one of the following organizations:
- American Association of Critical-Care Nurses
- American Nurses Credentialing Center
- Oncology Nursing Certification Corporation
Psychiatric/ Mental Health Nurse Requirements
A master’s level nurse may be placed on the list of California psychiatric/ mental health nurses (and be eligible for direct insurance reimbursement in some instances) if he or she completes a master’s level mental health nursing program and then accrues two years of clinical experience; at least one year of experience must be accrued post-master.
The mental health nurse may also achieve PMH status by earning national certification through the American Nurses Credentialing Center.
The Board notes that placement on the PMH list does not expand scope of practice.
The Application Process
Applications forms are available for download from the BRN website (http://www.rn.ca.gov/applicants/ad-pract.shtml). There are separate application packets for each field of advanced practice nursing.
A nurse anesthetist application may instead be submitted online.
The advanced practice applicant will need to include a passport-style photograph.
The Board will require third party documentation of eligibility. A representative of the educational institution will fill out the educational verification form; the institution will also provide transcripts.
Some applicants will need to provide additional documentation.
The application fee is $75.
In order to be issued a furnishing number, a nurse-midwife must complete a master’s or post-master advanced pharmacology course. The course must meet standards outlined in the application packet. The course does not have to be taken through a California institution. The Board can accept courses taken through nationally accredited nurse-midwife programs.
In order to be eligible, a nurse practitioner will complete an advanced pharmacology course through an approved program. A course can be accepted if taken through any national accredited nurse practitioner program. Course standards are outlined in the application packet.
The furnishing number application is to be submitted with a $50 fee and educational verification. Advanced practice nurses who completed their courses more than five years in the past will need to provide additional documentation of their qualifications. The Board will seek employment verification, a copy of the out-of-state certificate, a copy of the other state’s regulations for prescriptive authority, and a copy of the DEA identification card. If a collaborative agreement was required, a copy of this should be included as well.
Out-of-state nurses who do not yet hold California RN licensing must submit endorsement RN applications. They may apply for temporary nurse practitioner certification; this will allow them to begin work sooner.
Advanced practice certificates are renewed at the same time as RN licenses (http://www.rn.ca.gov/licensees/lic-renewal.shtml). The BRN does not impose continuing education requirements beyond that which is required for renewal of the RN license. In some cases, renewal is automatic. However, renewal of nurse anesthetist, clinical nurse specialist, or nurse-midwife certificates requires payment of additional fees. Additional fees are required for renewal of furnishing numbers.
Certification information is available from the California Board of Registered Nursing (http://www.rn.ca.gov/applicants/ad-pract.shtml).The Board can be reached at (916) 322-3350.
The following are additional professional resources:
California Association for Nurse Practitioners https://canpweb.org/
California Association of Clinical Nurse Specialists http://cacns.org/
California Association of Nurse Anesthetists http://canainc.org/
California Chapter of the American Psychiatric Nurses Association http://www.apna.org/i4a/pages/index.cfm?pageid=3444
California Nurse-Midwives Association http://california.midwife.org/
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