The demand for primary care is on the rise, mostly due to the growing healthcare needs of the aging population, longer life expectancy, and greater access to healthcare by persons who had little or no coverage. In spite of the heightening demands, trends reveal a decline in the number of primary care physicians. The challenges that North Dakota’s rural population places on the health care system was the subject of a 2017 biennial report released by the UND School of Medicine and Health Sciences. Among the challenges, the current and future scarcity of physicians stands out prominently. The impact of the shortage of primary care professionals will impact the state’s well-being.
Though North Dakota’s physician population grew progressively in recent decades, the state still lags per capita behind the U.S. as a whole. The majority of those who go into primary care choose to set up practices in populated regions, further exacerbating the problem. The UND estimates a physician shortage of 260 to 360 by 2025. The shortage may be higher if the population grows at the projected rates.
The state of North Dakota, like other states, meets the needs of patients by tapping into the skills of nurse practitioners. According to the Bureau of Labor Statistics, there were approximately 440 nurse practitioners in North Dakota in 2016. They are a category of advanced practice registered nurses (APRNs) that are authorized to evaluate patients, diagnose illnesses, prescribe medication, and order lab reports without the oversight of a physician. Using their advanced education, gained in the Master of Science in Nursing (MSN) degree program, APRNs can fill the gap in primary care and meet the growing demand for care in rural areas.
Most nurse practitioners already have experience as a registered nurse that when added to their expertise in a specialty will make them a vital force in primary care. Several studies confirm that nurses practitioners offer a quality of care that meet or exceed that of primary care physicians. Their caseloads might be smaller than physicians, which will give them the freedom to spend more time with each patient, increasing the perceived value from a patient’s perspective.
Physicians and their respective organizations have strongly rejected the idea of using nurse practitioners as a solution to the primary care shortage. However, numerous health care organizations believe nurse practitioners’ efficiency and expertise provide a suitable means of easing the burden on the health care system. The American Academy of Nurse Practitioners supports full practice privileges for nurse practitioners, including the ability to prescribe medications. North Dakota grants licenses to Nurse Practitioners permitting them full practice authority with optional prescriptive authority.
Though physicians question NPs ability to diagnose and treat complex illnesses on their own, several studies reveal that the care shown is comparable to and more cost-effective than the care delivered by primary care physicians. Despite the ability of both groups to practice independently in North Dakota, patients will always benefit when health care professionals take a collaborative approach to care.
The demand for APRNs is expected to increase. Nurse practitioners are especially needed to care for patients living in rural communities across North Dakota. The aging population requires more health care services to treat multiple chronic conditions and demand is expected to skyrocket as more baby boomers retire. The MSN program emphasizes the treatment of the whole patient, so graduates will provide holistic care rather than focusing specific symptoms. This approach to care is especially beneficial to senior and disabled residents in underserved areas.
To prepare nurses for advanced practice roles, the MSN curriculum seeks to empower nurses to function with efficiency and confidence in the increasingly complex healthcare environment. Students learn how to pull and analyze data to develop care plans that will benefit patients on an individual and collective level. They learn how to be effective advocates for their chosen population and focus and adjust treatment plans to meet specific needs.
The MSN curriculum covers advanced theory and practical experiences in a specialized clinical area of nursing. Graduates will have the expertise to assume advanced practice roles as nurse practitioners, clinical nurse specialists, nurse midwives, or nurse anesthetists. Further specialization is also possible, leading to roles such as family nurse practitioners, pediatric nurse practitioners, adult-gerontology nurse practitioners, and much more. There is also the option to prepare for roles in education, leadership, administration, and informatics. The program’s emphasis on theory, professional development, and use of research also prepares graduates for doctoral study.
Graduates are eligible to apply for authorization to work as an advanced practice registered nurse. They must hold advanced practice certification their specialties to be eligible for licensure. According to the specialty, the graduate may apply to sit a national certification exam through a specialty board.
The MSN program offers multiple-entry options for both nurses and non-nurses. Multiple advanced practice specialties appeal to those with varied interests and goals and flexible formats for delivery suit working professionals.
Here are three options to pursue an MSN degree:
RN to MSN: Nurses who want to expand their career potential by earning an MSN can take the fast-track through the RN to MSN program. The flexible, accelerated program helps registered nurses achieve their goal of becoming an advanced practice nurse in just two years. The program may be offered in a distance learning format to give students to opportunity to prepare for specialty practice without relocating. The student may be required to complete prerequisite courses in English, humanities, social science, lifespan development, nutrition, statistics, and natural science. Applicants must have an associate degree or diploma in nursing, a license to practice as a registered nurse, and some experience in clinical nursing practice.
Direct Entry MSN: If you have a Bachelor of Science in Nursing degree (BSN) and want to work as an advanced practice nurse, direct entry to the MSN program will help you achieve your goal. Most specialties can be completed in one year. The curriculum will cover core courses that all master’s degree students must complete as it provides the basis for integrating theory into advanced practice. The specialty coursework will cover 25 to 32 semester credit hours and will include theory and practical coursework in the chosen specialty. The clinical experience place students in a healthcare setting where they’ll function in an advanced practice role.
Post-Master’s Certificate: The post-master’s certificate is designed for nurses who want to change or add to their advanced practice role. It gives them the opportunity to build upon their clinical skills and knowledge to prepare for an area different from the one chosen in the MSN degree to explore a new direction in practice. The curriculum broadens the clinical and management functions of nurses prepared at the master’s level.
- A completed application for admission to graduate studies
- A BSN degree from an NLNAC or CCNE accredited program
- A minimum GPA of 3.0 for BSN nursing study
- Graduate or undergraduate statistics
- An active unencumbered registered nursing license
- A year’s experience as a registered nurse
- An interview completed in person or via the web
- Meet the health and immunization requirements
- A current CV or resume
- A state of professional goals
- Three letters of recommendation
- Satisfactorily complete a background check
Admission is competitive so selection may be based on your demonstrated competency to successfully complete the program. It is critical that you complete the statistics course before applying to the program.
Requirements For Advanced Practice Registered Nurses North Dakota
The North Dakota Board of Nursing licenses advanced practice registered nurses in the four recognized categories: nurse practitioner, clinical nurse specialist, certified nurse midwife, certified registered nurse anesthetist.
Practice in the state requires an unencumbered RN license issued by the North Dakota Board of Nursing or a compact state. A compact state refers to a state that belongs to the Nurse Licensure Compact. As part of the NLC, North Dakota grants RNs holding a multistate license the privilege of practicing without acquiring another license. The APRN license is not covered under the NLC.
Guidelines for Initial APRN Licensure
Apply for licensure as an APRN after you’re completed an approved graduate program and have an active license to practice as a registered nurse.
Submit the following to the North Dakota Board of Nursing:
- A completed application for Initial Advanced Practice License with or without Prescriptive Authority Application
- Include your RN license number on the application
- Enclose the initial non-refundable fee of $100. If requesting prescriptive authority, include an additional $50. An additional processing fee of $20 is required if you answer “no” to the Criminal History Record Check question
- Evidence of completing an accredited graduate level APRN program in one of the four roles with a population focus. Official transcripts must be sent from the nursing program directly to the Board of Nursing. Transcripts must indicate the degree posted. Use the Request for Release of Transcript form if requesting a paper copy from the college. You may also request that the transcript be sent electronically from the college to firstname.lastname@example.org.
- Proof of current certification from a national nursing certifying body in an APRN role and population focus related to your educational program. Certification must be submitted directly from the certifying organization to the Board of Nursing.
- Complete a Criminal History Record Check
If you want to include prescriptive authority within your scope of practice, you may apply for prescriptive authority. You must have an APRN license in North Dakota or applying for licensure as an APRN.
- Complete the designated portion of the application
- Enclose the additional fee of $50
- The transcript must indicate completion of advanced pharmacotherapy, pathophysiology, and physical assessment.
- Provide proof of completing at least 30 contact hours of education in pharmacotherapy related to your scope of practice. The education must have completed within a 3-year period of your application for prescriptive authority.
The Board will issue a license with prescriptive authority after you’ve met all the requirements established by the Board. The Board will communicate your authorization to prescribe directly to the North Dakota Board of Pharmacy.
You must complete the application process within one year, or you’ll forfeit the fee, and a new application will need to be submitted if you want to continue with the licensure process.
You may be eligible for a temporary permit if you hold an active registered nurse license, submitted a complete application to the Board of Nursing and application fee, and provide proof of completing the educational requirements. The temporary permit is valid for ninety days and grants nurses the authorization to practice as an APRN in a category if:
- Submitting an application for licensure under section 54-05-03.1-04
- Applying as a first-time candidate for the national certification exam for an APRN category
- Awaiting results of a certification exam
The Board will not issue a paper temporary permit. You can confirm your status using the “Verify” section of the Board’s website. The permit will not include prescriptive authority.
ND Advanced Practice licenses have the same license number and expiration date as your ND RN license. Your license expiration date on the “Verify” section of the Board’s website.
APRN Renewal Requirements North Dakota
Check the “Verify” section of the website to monitor the license’s expiration date.
Renewing a nursing license in North Dakota requires:
- Completion of 400 hours of nursing practice – completed in the preceding four years
- If you completed a refresher course or graduate program in the last four years, you would be eligible to renew your license without the 400-hour requirement
- Completion of 12 contact hours of CE in the preceding 2 years
- Completion of 15 contact hours of education in pharmacotherapy in the preceding 2 years
- Application renewal fee of $160 or $210 if renewing prescriptive authority
For the online renewal, you’ll need to provide your first and last name according to the Board’s records, social security number, license number, total number of hours worked in the current and previous year, and a means of submitting the payment.
During the online renewal, you will be prompted to submit the payment using a Visa, MasterCard, or Discover credit or debit card, checking account, or PayPal account.
Continuing Education Requirements
All continuing education requirements must be completed within the two years prior to the license expiration date.
Renewing your RN license requires completion of 12 contact hours of CE units.
Prescriptive authority requires completion of 15 contact hours of education in pharmacology related to your scope of practice. The 15 contact hours of CE required for renewing prescriptive authority may meet the requirements for APRN/RN renewal contact hours.
Contact the Board of Nursing
ND Board of Nursing
Address: 919 S 7th St, Suite 504
Bismarck, ND 58504-5881
MSN Programs North Dakota
Bismarck, ND MSN programs
University of Mary
7500 University Drive, Bismarck, ND 58504
Fargo, ND MSN programs
North Dakota State University
1401 Albrecht Boulevard, Fargo, ND 58102
Grand Forks, ND MSN programs
University of North Dakota
430 Oxford Street, Grand Forks, ND 58202-9025