1. Section Editor(s): Newland, Jamesetta PhD, RN, FNP-BC, FAANP, DPNAP

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The 28th Annual APRN Legislative Update offers the latest information on NP legislative and regulatory activity as reported by State Boards of Nursing and nursing organizations representing advanced practice registered nurses (APRNs). I congratulate Susanne Phillips, DNP, FNP-BC for her creativity in keeping the update interesting, informative, and practical every year. This year (for the first time), Dr. Phillips introduces a U.S. territory, the Commonwealth of the Northern Mariana Islands, which is in the North Pacific Ocean, east of the Philippines, and extends north of Guam toward Japan.

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In the future, you can look forward to the inclusion of additional U.S. territories where APRNs are actively licensed and practicing, expanding the report beyond the 50 U.S. States and the District of Columbia. Despite the challenges we continue to face in seeking full practice authority for APRNs everywhere, understanding our collective success provides an opportunity for mutual encouragement and empowerment-especially for our colleagues in other countries.


Setting the standard

Although different health systems and legislative rules may impact the capacity to practice as NPs do here in the United States, other countries look to the U.S. nursing model of NP education for guidance. Those deterrents, however, do not diminish their efforts to achieve advanced nursing practice (ANP) roles. The International Council of Nurses (ICN) defines an NP/APN as "a registered nurse who has acquired the expert knowledge base, complex decision-making skills, and clinical competencies for expanded practice, the characteristics of which are shaped by the context and/or country in which s/he is credentialed to practice. A master's degree is recommended for an entry-level position." ( Therefore, titling and scope of practice will vary as will degree educational preparation and training (to some degree).


International resource

The ICN International Nurse Practitioner/Advanced Practice Nurse Network is an excellent resource for anyone interested in learning more or becoming involved in international ANP. Membership in this voluntary network is free. The key goal of the network is to become an international resource for nurses practicing in NP or ANP roles and interested stakeholders, such as policymakers, educators, regulators, and health planners by "making relevant and timely information about practice, education, role development, research, policy and regulatory developments, and appropriate events widely available; providing a forum for sharing and exchange of knowledge expertise and experience; supporting nurses and countries who are in the process of introducing or developing NP or ANP roles and practice; and accessing international resources that are pertinent to this field." If you are not familiar with the Network, check out their website at The next conference will be in Hong Kong in September 2016.


A shared goal

My personal experiences in Botswana, Japan, and now Lithuania have helped me realize that nurses all over the globe share a common goal: to provide the highest quality of care to improve health outcomes for patients. I am currently collaborating with faculty at the Lithuanian University of Health Sciences, where they established an NP program in the Department of Nursing in September 2015. Unlike efforts in many other countries, their tireless petitions to policymakers resulted in concurrent legislative approval to prepare nurses for ANP in the NP role. This is an amazing accomplishment, and I look forward to their dissemination of the journey and continued development of NPs in Lithuania. We can all learn from each other.


An uphill battle: All 50 states

I do not have to remind NPs and other APRNs how important it is in 2016 to stay informed about issues related to our profession. There will be numerous opportunities to cast votes for legislators at all levels of government. It is up to us to be fully informed about candidates before voting. Make your presence and work known in your local communities. Having (only) 21 states and D.C. in the United States with full practice authority for NPs is not sufficient. We need all 50 plus.


Jamesetta Newland, PhD, RN, FNP-BC, FAANP, DPNAP

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