Request By:
Sharon M. Weisebeck, M.S., R.N.
Executive Director
Kentucky Board of Nursing
4010 Dupont Circle, Suite 430
Louisville, Kentucky 40207
Opinion
Opinion By: Steven L. Beshear, Attorney General; Martin Glazer, Assistant Attorney General
You seek an interpretation of the meaning of the word, "certify, " as it is used in KRS 314.011(6) and (7). You cite an example of a registered nurse who completed a twelve-week family planning nurse specialist training program and received a certificate that she had successfully completed the course and was prepared to function under appropriate supervision as a nurse practitioner relating to family planning.
The Board of Nursing has promulgated regulation 201 KAR 20:056, which is pending approval. That regulation requires the nurse who seeks to be registered as an advanced registered nurse practitioner to complete a post-basic course of study or a substitute of approved experience recognized by the Board of Nursing and recognized national organizations and also be certified by a nationally recognized organization. Such organizations usually require the candidate to successfully complete an examination before certifying said candidate as a nurse practitioner.
The 1978 General Assembly amended the Nurse Practice Act to authorize the Board to register advanced registered nurse practitioners.
KRS 314.011(6) defines "advanced registered nurse practitioner" as "one who is certified to engage in advanced registered nursing practice including but not limited to the nurse anesthetist, nurse midwife, and nurse practitioner. "
Subsection (7) defines "advanced registered nursing practice" as "the performance of additional acts by registered nurses who have gained added knowledge and skills through an organized post-basic program of study and clinical experience approved by the organization or agency which has the authority to certify the advanced registered nurse practitioner. In the performance of those procedures which are normally construed as the practice of medicine, the nurses will conform to the standards of the medical practice act and established medical protocol." (Emphasis supplied.)
Further, subsection (5) of that same section defines "registered nursing practice" as including:
"The performance of other nursing acts which are authorized or limited by the board, and which are consistent either with American Nurses' Association standards of practice or with standards of practice established by nationally accepted organizations of registered nurses. "
Nationally accepted organizations of registered nurses, and particularly the American Nurses' Association, usually require as a standard of recognition of various forms of advanced nurse practitioner that the nurse both complete an accepted course of study and be examined after such completion by a test in a particular field of study before certifying the registered nurse as an advanced registered nurse practitioner in that field.
If the General Assembly merely intended that the term, "certify, " meant only the completion of a course of study, it could have eliminated the added language found in KRS 314.011(7), "approved by the organization or agency which has the authority to certify the advanced registered nurse practitioner. "
For, there are all types of schools and programs, some very short in length. For the board to register anyone who is able to attend some course and receive a certificate from the school, regardless of its quality, or whether it is recognized by a national nurse's organization would make the advanced registered nursing program a mere sham. Such registered nurses, registered as advanced registered nurse practitioners, may be performing acts which previously could only be performed by licensed physicians.
Thus, it is incumbent on the board in registering and recognizing such advanced registered nurse practitioners to safeguard the public by seeing that they meet nationally recognized standards.
Those standards include an examination by a nationally recognized organization as well as either the completion of a course of study or a specific practice experience component.
Therefore, considering these definitions together, the term, "certify, " requires the registered nurse to complete successfully a post-basic course of study or professional experience AND be tested and certified by a nationally recognized organization or agency which has the authority to issue such certification.