Nurse Reporter Spring 2009 - Wyoming State Board of Nursing

Have you ever been lost in time while cleaning an out an attic, closet or basement as you look through old pictures? That is what is happening
to us at the WSBN as we sift through old applications. We wonder about the stories that these nurses could tell! Above are some pictures found
in license application folders of staff and members of the WSBN. Have some fun as you try to identify these nurses!!! Please send a picture
of yourself at the “dawn” of your nursing career. Tell us how things have changed (or not changed) since the beginning of your nursing career.
Send images (PDF preferred) to mstepa@state.wy.us or to the Wyoming State Board of Nursing, 1810 Pioneer Ave., Cheyenne, WY 82002.
Question: We reviewed the Nurse Practice
Act and are writing for clarification of
whether administration of medications is something
that RN or APRN can delegate to CNA
under direct supervision. For example, can we
train CNAs to administer injections?
Answer: It is not appropriate to delegate the
injection of medications to a CNA. Administration
of medications, at this point, is not
within the CNA’s range of functions according
to the Wyoming Practice Act and Administrative
Rules and Regulations. For specific details
about the basic nursing functions, tasks and
skills that may be delegated, refer to the Rules
and Regulations, Chapter VII, Section 8.
However, according to Advisory Opinion 05-
150, “after delegation by a Registered Nurse
(RN) to a Certified Nursing Assistant (CNA),
the CNA may assist the client with self-administered
medications following the criteria listed
below:
The assistance that may be provided:
•Reminding the client to take medications;
•Removing medication container from
storage;
•Assisting with removal of a cap;
•Assisting with the removal of a medication
from a container for clients with a disability
(i.e., arthritis) which prevents independence
in this act; and
•Observing the client take the medication
Prescription medications shall be dispensed
from a licensed pharmacist, labeled with the
following:
PRACTICE QUESTIONS
Mary Beth Stepans, PhD, RN is the Practice and Education Consultant for the Wyoming State Board of Nursing.
•Names, address and phone number of the
pharmacy
•Name of client
•Name and strength of drug
•Directions for use
•Date filled
•Expiration date
•Prescription number
•Name of physician
•Controlled substances shall have a warning
label on the bottle
• The RN maintains accountability and responsibility
for supervision and management of all
medication administration” (Advisory Opinion
05-150: Assistance with the Self-Administration
Of Medications—CNA).
Question: I’m confused about Master’s prepared
RNs calling themselves Advanced
Practice Registered Nurses (APRN) despite not
holding APRN recognition in the State of Wyoming
nor having passed an advanced practice
certification. I am concerned that this is a false
representation to patients and the staff. Is this
correct?
Answer: According to the Nurse Practice
Act (NPA), “Advanced Practice Registered
Nurse” is defined as follows:
(i) “Advanced practice registered nurse
(APRN)” means a nurse who:
(A) May prescribe, administer, dispense or
provide nonprescriptive and prescriptive medications
including prepackaged medications,
except schedule I drugs as defined in W.S. 35-7-
1013 and 35-7-1014;
(B) Has responsibility for the direct care and
management of patients and clients in relation
to their human needs, disease states and therapeutic
and technological interventions;
(C) Has a master’s degree in nursing, or an advanced
practice registered nurse specialty or has
completed an accredited advanced practice registered
nurse educational program prior to January
1, 1999; and
(D) Has completed an advanced program of
study in a specialty area in an accredited nursing
program, has taken and passed a national certification
examination in the same area and has
been granted recognition by the board to practice
as an APRN (NPA 33-21-120).
In addition, “title protection” is outlined in the
law:
“(b) Any person who holds a license to practice
as an advanced practice registered nurse
in this state shall have the right to use the title
“Advanced Practice Registered Nurse” and the
abbreviation “A.P.R.N.” No other person shall
assume this title or use this abbreviation or any
words, letters, signs or devices to indicate that
the person using same is an advance practice
registered nurse” [NPA 33-21-134, (b)].
It is not required by Wyoming law that Clinical
Nurse Specialists (CNSs) be licensed as APRNs
but a CNS or other master’s prepared RN cannot
legally use the title “APRN” unless granted
APRN recognition by the WSBN. The behavior
you describe constitutes misrepresentation
and violation of title protection.
24 Wy o m i n g Nu r s e Re p o r t e r