Advance Practice Registered Nurse Requirements in Massachusetts
Massachusetts Advanced Practice Registered Nurses (APRNs) are under the authority of the Massachusetts Board of Registration in Nursing. They are licensed as registered Nurses (RNs) and ‘authorized’ for advanced practice. Both APRN authorization and RN licensing are state-specific; Massachusetts is not party to the Nurse Licensure Compact.
APRNs have varying scopes of practice. Massachusetts recognizes five advanced practice categories:
- Certified Nurse Practitioner (CNP)
- Clinical Nurse Specialist (CNS)
- Psychiatric Mental Health Clinical Nurse Specialist (PCNS)
- Certified Nurse Midwife (CNM)
- Nurse Anesthetist (CRNA)
Practice may be further limited by competencies the advanced practice nurse has developed: Programs for clinical nurse specialists and nurse practitioners focus on target populations; these may be broad or narrow.
APRNs in all categories are authorized on the basis of advanced education and national certification. State legislation also mandates “good moral character”.
Select a Massachusetts Advanced Practice Registered Nurse Topic:
- APRN Education Requirements
- APRN Application Materials and Process
- Additional Requirements for APRN Prescriptive Authority
- Nursing Board, Contacts, Associations and Additional Information
APRN Education Requirements
A prospective APRN must complete a program in his or her intended category. The program must be accredited by an accepted accrediting agency.
All advanced practice nurses will need to have, as part of their programs, advanced coursework in the following areas: assessment, pathophysiology and pharmacotherapeutics (Massachusetts Nurse Practitioner programs).
Certification Requirements
Advanced practitioners must hold certification through Board-recognized agencies. Recognized certifying organizations are those that meet standards described in Section 4.02 of Board rules (http://www.mass.gov/eohhs/docs/dph/regs/244cmr004.pdf).
Current approvals are as follows:
Massachusetts nurse midwives will pursue certification through the American Midwifery Certification Board (AMCB) while nurse anesthetists will pursue certification through the National Board on Certification and Recertification of Nurse Anesthetists (NBCRNA).
Psychiatric mental health clinical nurse specialists pursue certification through the American Nurses Credentialing Center (ANCC). There are two offerings: Child Adolescent Mental Health and Adult Mental Health (http://www.mass.gov/eohhs/gov/departments/dph/programs/hcq/dhpl/nursing/nursing-practice/aprn/advanced-practice-registered-nursing-faqs.html).
Clinical nurse specialists may earn certification through the American Association of Critical Care Nurses Certification Corporation (AACN) or the American Nurses Credentialing Center (ANCC).
There are a number of approved certifying agencies for nurse practitioners. Nurse practitioners in adult, adult-gerontology, and family practice may earn certification through the ANCC or the American Academy of Nurse Practitioners (AANP). Pediatric nurse practitioners may earn certification through the ANCC or the Pediatric Nursing Certification Board (PNCB); the PNCB offers two pediatric specialty examinations: one for acute care, the other for primary care. Neonatal and women’s health practitioners pursue certification through the National Certification Corporation (NCC). Psychiatric mental health nurse practitioners earn their certification through the ANCC.
Examination availability can change from year to year. The Massachusetts licensing agency notes that a number of examinations will change in late 2017 to reflect new standards under the APRN Consensus Model; the ANCC has provided additional details.
The Application Process
The Massachusetts Board contracts with Professional Credential Services Inc. (PCS) to process RN licensing and APRN authorization materials (http://www.mass.gov/eohhs/gov/departments/dph/programs/hcq/dhpl/nursing/faq/licensure.html). The application form can be downloaded from the PCS website (https://pcshq.com/?page=health,np-uapplicationprocessu).
Official transcripts are to be sent directly from the issuing institution.
An individual who has ever been licensed as a nurse in another state/ jurisdiction will need to provide license verification. An individual who has ever been credentialed as an APRN will provide verification of status.
Nurses must read the applicable statutes and regulations before making application.
A recent passport-style photograph must be attached to the application.
The fee is $150 for all APRN categories (https://pcshq.com/?page=health,np-ufeesu).
An individual may simultaneously apply for RN reciprocity and APRN authorization, but the licensing process must be complete before APRN authorization will be issued (https://pcshq.com/?page=health,np-ufrequentlyaskedquestionsfaqu).
To be authorized as an APRN by reciprocity, and individual must meet academic and certification standards described in Board rule.
Applicants who are nearing the end of an RN renewal cycle may wish to renew early. PCS notes that an APRN authorization cannot be issued in cases where the qualifying RN license will be expiring within 90 days.
An applicant who answers “yes” to Good Moral Character (GMC) questions will mail supporting documentation directly to the Massachusetts Board. Currently, this step is completed after application.
PCS can be reached by telephone at 877-887-9727 or by email at ‘aprn at pcshq.com’.
Prescriptive Authority
Massachusetts defines “controlled substance” more broadly than some other states (http://www.mass.gov/eohhs/gov/departments/dph/programs/hcq/dhpl/nursing/nursing-practice/aprn/practice-and-prescriptive-guidelinesauthority.html). The state’s advanced practitioners apply separately for their prescriptive authority. Registration applications are submitted to the Department of Public Health – Drug Control Program and the Drug Enforcement Administration.
Advanced practitioners in all categories except clinical nurse specialist are authorized to register for prescriptive authority (http://www.mass.gov/eohhs/gov/departments/dph/programs/hcq/dhpl/nursing/nursing-practice/aprn/practice-and-prescriptive-guidelinesauthority.html). Those in the categories of CNP, CRNA, or PCNS must develop prescriptive guidelines in collaboration with a doctor.
The advanced practice nurse will need training in three mandated areas before initial registration and before APRN renewal (http://www.mass.gov/eohhs/gov/departments/dph/programs/hcq/dhpl/nursing/nursing-practice/aprn/practice-and-prescriptive-guidelinesauthority.html). Mandated topics include pain management, identification of individuals with high risk for substance abuse, and patient counseling (including side effects, storage, and addiction risk).
Additional Information
Information is available from the Massachusetts Board of Registration in Nursing (http://www.mass.gov/eohhs/gov/departments/dph/programs/hcq/dhpl/nursing). The Board can be reached by telephone at 1-800-414-0168 or 617-973-0900. Additional contact information is available online (http://www.mass.gov/eohhs/gov/departments/dph/programs/hcq/dhpl/nursing/contact-us.html).
Professional associations include the following:
- Massachusetts Coalition of Nurse Practitioners http://www.mcnpweb.org/
- Massachusetts Affiliate of the American College of Nurse-Midwives http://massachusetts.midwife.org/
- Massachusetts Association of Nurse Anesthetists http://www.masscrna.com/
- New England Chapter of the American Psychiatric Nurses Association http://www.apna.org/i4a/pages/index.cfm?pageid=3368
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