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 <strong>of</strong> staff and members <strong>of</strong> the WSBN. Have some fun as you try to identify these nurses!!! Please send a picture <strong>of</strong> yourself at the “dawn” <strong>of</strong> your nursing career. Tell us how things have changed (or not changed) since the beginning <strong>of</strong> your nursing career. Send images (PDF preferred) to mstepa@state.wy.us or to the <strong>Wyoming</strong> <strong>State</strong> <strong>Board</strong> <strong>of</strong> <strong>Nursing</strong>, 1810 Pioneer Ave., Cheyenne, WY 82002. Question: We reviewed the <strong>Nurse</strong> Practice Act and are writing for clarification <strong>of</strong> whether administration <strong>of</strong> 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 <strong>of</strong> medications to a CNA. Administration <strong>of</strong> medications, at this point, is not within the CNA’s range <strong>of</strong> functions according to the <strong>Wyoming</strong> 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 <strong>Nurse</strong> (RN) to a Certified <strong>Nursing</strong> 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 <strong>of</strong> a cap; •Assisting with the removal <strong>of</strong> 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 <strong>Wyoming</strong> <strong>State</strong> <strong>Board</strong> <strong>of</strong> <strong>Nursing</strong>. •Names, address and phone number <strong>of</strong> the pharmacy •Name <strong>of</strong> client •Name and strength <strong>of</strong> drug •Directions for use •Date filled •Expiration date •Prescription number •Name <strong>of</strong> physician •Controlled substances shall have a warning label on the bottle • The RN maintains accountability and responsibility for supervision and management <strong>of</strong> 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 <strong>Nurse</strong>s (APRN) despite not holding APRN recognition in the <strong>State</strong> <strong>of</strong> <strong>Wyoming</strong> 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 <strong>Nurse</strong> Practice Act (NPA), “Advanced Practice Registered <strong>Nurse</strong>” 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 <strong>of</strong> 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 <strong>of</strong> 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 <strong>Nurse</strong>” 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 <strong>Wyoming</strong> law that Clinical <strong>Nurse</strong> 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 <strong>of</strong> title protection. 24 Wy o m i n g Nu r s e Re p o r t e r
Wy o m i n g Nu r s e Re p o r t e r 25
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