To earn of certificate of completion you have one of two options:
- Take test and pass with a score of at least 80%
- Reflect on practice impact by completing self-reflection, self-assessment and course evaluation.
(NOTE: Some approval agencies and organizations require you to take a test and self reflection is NOT an option.)
Author: Julia Tortorice (RN, MBA, MSN, NEA-BC, CPHQ)
Florida Nursing Licensure
All forms, information, and the Florida Administrative Code included in this course are located at the Florida Board of Nursing (FBN) website.
A Nursing license can be obtained by examination, endorsement, and compact act. Graduates of International nursing programs or nursing programs in jurisdictions that are not members of the National Council of State Boards of Nursing (NCSBN) have additional requirements for licensure.
APRN
- Education Requirements:
- Applicants who graduated on or after October 1, 1998, must have completed a master's degree or post-master's degree certification requirements.
- Certified Registered Nurse Anesthetist applicants who graduated on or after October 1, 2001, must have completed a master's degree program requirements.
- Applicants who graduated prior to the applicable date are exempt from this requirement.
- Graduates from either a certificate or currently closed program should submit supporting documentation demonstrating program compliance with Board guidelines.
- After July 1, 2006, applicants for licensure as an Advanced Practice Registered Nurse pursuant to section 464.012(1), FS, shall submit proof of national advanced practice certification from an approved nursing specialty board.
A Nurse currently licensed in Florida may upgrade their licenses to include multi-state practice by submitting a Multi-State License Upgrade Application, Form DH-MQA 5024, obtained here or from the Board office or on the Florida Board of Nursing website.
Dispensing Practitioners
Dispensing is defined as selling medicinal drugs. Practitioners who write prescriptions and provide samples are not dispensing.
APRNs who prescribe medication must register with the Board of Nursing by submitting a completed Dispensing Application for Advanced Practice Registered Nurse (APRN), form number DH-MQA 1185, 10/18. That form is available here or from FBN or FBN website (FAC, 2020).
The APRN dispensing practitioner must comply with all state and federal laws and regulations applicable to all dispensing practitioners under Section 465.0276. FS Compliance includes using the FAC 64B9-4.016 Controlled Substances Formulary and FAC 64B9-4.017 Standards for the Prescribing of Controlled Substances for the Treatment of Acute Pain (FAC, 2020).
License Renewal
The Florida Department of Health Division Medical Quality Assurance (MQA) is responsible for license renewal for nursing professionals. Nurses licensed in Florida must renew every two years, either with an online or by mail option. Renewal reminders are mailed out to holders of a Florida license, so keep the state Board of Nursing appraised of any address change. The postcard, which comes approximately six weeks prior to the renewal date, will be a reminder of the website for online renewals and the address and fees due for those who prefer to utilize mail.
The MQA renewal website requires a password and user ID issued at the time of original licensure. If you have misplaced your documents, simply follow the help links present on the website. Remember that important documentation should be retained as a health professional, and not much trumps license paperwork in importance.
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If the required continuing education has been met, proof of licensure will be posted promptly on the state verification website or within one to two weeks of receiving your mailed renewal.
Continuing Education Requirements
During the two-year license renewal cycle, 24 contact hours are required. The courses on ceufast.com meet all the FBN requirements.
Every two-year renewal cycle, the following courses are mandatory (FAC, 2020).
The following continuing education courses are mandatory, and they count towards the total 24 contact hours required for renewal:
- A two-hour course in the prevention of medical errors
- A one hour course in HIV/AIDS
- A two-hour course in Florida laws and rules
- A two-hour course on human trafficking
A two-hour course in recognizing impairment in the workplace is required every other renewal cycle (FAC, 2020). A two-hour course in domestic violence every third renewal cycle. The domestic violence course does not count in the 24-hour renewal requirement. The nurse will complete 26 contact hours (FAC, 2020).
Continuing education is not required for the first renewal cycle after license by examination. This exemption applies to a person licensed by endorsement during a renewal period if that person was licensed in the original state of licensure by completing an acceptable licensure examination during that biennium (FAC, 2020).
A licensee who was endorsed, reactivated, or reinstated in the middle of a renewal cycle must complete one contact hour for each calendar month remaining in the renewal period. No contact hours are required if the renewal period is equal to or less than six months (FAC, 2020).
An RN who also holds a current license as an LPN may satisfy the continuing education requirement for renewal of both licenses by completing the RN requirements.
An RN who holds an APRN license may satisfy the continuing education requirement for both licenses by completing appropriate continuing education for an RN or may satisfy up to 50% of the continuing education requirement by completing continuing medical education coursework equivalent to the contact hours required (FAC, 2020).
A nurse who is the spouse of a member of the Armed Forces absent from Florida due to the spouse's duties with the Armed Forces shall be exempt from continuing education requirements. The licensee must prove the absence and the spouse's military status (FAC, 2020).
If you serve as an expert witness and probable cause panel member, additional requirements are outlined in 64B9-5.007 (FAC, 2020).
The Florida Department of Health employs an online verification system to confirm the completion of continuing education at the time of renewal. This tracking system checks its records when you renew, and if the required course work is present, the renewal process is allowed to continue. If the requisite hours or specified training are not present, you will be prompted to report completions through the state-contracted CE Broker online service before being allowed to continue your license renewal. A nurse can check their progress toward the completion of contact hours here.
CEUfast.com automatically reports your contact hours to CE Broker the day you complete the course. Some CE providers do not report completed contact hours to CE Broker. It will be up to you to be on top of items that you need to enter by hand into the electronic verification system. Each license holder can report completed hours by logging here.
Nursing Documentation Standards
Documentation that is poor, filled with errors, or appears falsified comprises some of the most frequent complaints filed against a nurse's license. In Florida, the Board of Nursing and the Department of Health take such matters very seriously.
The Florida Department of Education details in its curriculum structure the need for nursing programs to emphasize demonstrating procedures for accurate documentation and record-keeping in nurses' training.
Accurate documentation of care is necessary to meet quality patient care's legal and ethical aspects. Clear, accurate, and succinct charting journals the course of care and provides the foundation for shared information about client and disease management.
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If an RN or ARNP in private practice dies or leaves the practice, additional document maintenance requirements are noted in 64B9-11.001.
Delegation
Delegation can be a difficult concept with multiple nuances. RNs can delegate. LPNs can supervise or assign, but they cannot delegate. APRNs must delegate tasks just as other RNs would. APRNs may not delegate as physicians do. Training is not the same as delegating. Your responsibility to a trainee ends when his or her training is complete.
In the delegation process, the delegator must use nursing judgment to consider the suitability of the task or activity to be delegated.
- Factors to weigh in selecting the task or activity include (FAC, 2020).:
- Potential for patient harm
- The complexity of the task
- Predictability or unpredictability of outcome including the reasonable potential for a rapid change in the medical status of the patient
- Level of interaction required or communication available with the patient
- Resources both in equipment and personnel available in the patient setting
- Factors to weigh in selecting and delegating to a specific delegate include (FAC, 2020).:
- Routine assignments of a CNA or UP
- Validation or verification of the education and training of the delegate
Delegation Principles3
Right task - Appropriate activities for the specific level of practice
Right circumstances - Match the complexity of the activity with the competency, training, of delegee and level of supervision needed or available
Right person - Instruct, assess, verify and identify the competency of an individual for the task
- Right direction and communication
- Situation specific communications include:
- Specific data to be collected, method, and timeliness for reporting
- Specific activities to be performed and client-specific instruction and limitations
- Expected results or potential complications and the timeline for communicating such information
- Situation specific communications include:
Right supervision and evaluation - Supervise performance of the activity or assign supervision to other licensed nurses
Tasks Prohibited from Delegation
The RN or licensed practical nurse shall not delegate (FAC, 2020).:
- Those activities are not within the delegating or supervising nurse's scope of practice.
- Nursing activities that include the use of the nursing process and require the special knowledge, nursing judgment, or skills of a registered or practical nurse, including:
- The initial nursing assessment or any subsequent assessments;
- The determination of the nursing diagnosis or interpretations of nursing assessments;
- Establishment of the nursing care goals and development of the plan of care; and,
- Evaluation of progress with the plan of care.
- Those activities for which the certified nursing assistant (CNA) or unlicensed personnel (UP) has not demonstrated competence.
Supervision by Licensed Practical Nurses (LPN) in Nursing Home Facilities
- The LPNs working in a nursing home qualify to supervise by meeting the following requirements (FAC, 2020).:
- Completing a minimum of thirty (30) hour post-basic education course prior to accepting any supervisory assignments.
- A work history of no less than six months of full-time clinical nursing experience in a hospital or nursing home.
- An RN provides supervision of the LPN.
- The LPN shall delegate tasks and activities to the CNA or UP based on the following (FAC, 2020).:
- The task/activity is within the area of responsibility of the nurse delegating the task. The task/activity is within the nurse's knowledge, skills, and ability to delegate tasks.
- The task/activity is of a routine, repetitive nature and shall not require the CNA or UP to exercise nursing knowledge, judgment, or skill.
- The CNA or UP can perform the task/activity with the degree of care and skill expected of the nurse.
CNA Authorized Duties
A CNA can provide care and assist clients with the following tasks.
- Tasks associated with personal care (FAC, 2020).:
- Bathing
- Dressing
- Grooming
- Shaving
- Shampooing and caring for hair
- Providing and assisting with oral hygiene and denture care
- Caring for the skin
- Caring for the feet
- Caring for the nails
- Providing pericare
- Bed making and handling linen
- Maintaining a clean environment
- Tasks associated with maintaining mobility (FAC, 2020).:
- Ambulating
- Transferring
- Transporting
- Positioning
- Turning
- Lifting
- Performing range of motion exercises
- Maintaining body alignment
- Tasks are associated with nutrition and hydration (FAC, 2020).:
- Feeding and assisting the resident with eating
- Assisting the resident with drinking
- Tasks associated with elimination (FAC, 2020).:
- Toileting
- Assisting with the use of the bedpan and urinal
- Providing catheter care
- Collecting specimens
- Emptying ostomy bags or changing bags that do not adhere to the skin
- Bowel and bladder training
- Tasks associated with the use of assistive devices:
- Caring for dentures, eyeglasses, contact lenses, and hearing aids
- Applying or donning established or previously fitted and adjusted prosthetic and orthotic devices
- Applying or donning previously fitted and adjusted orthotic braces
- Applying fitted antiembolus stockings
- Assisting with wheelchairs, walkers, or crutches
- Using comfort devices such as pillows, cradles, footboards, wedges, and boots
- Assisting with and encouraging the use of self-help devices for eating, grooming, and other personal care tasks
- Utilizing and assisting residents with devices for transferring, ambulation, alignment, and positioning
- Using restraints
- Tasks associated with maintaining environment and resident safety, including:
- Handling of blood and body fluid
- Cleaning resident care areas
- Tasks associated with data gathering:
- Measuring temperature, pulse, respiration, and blood pressure
- Measuring height and weight
- Measuring and recording oral intake
- Measuring and recording urinary output, both voided and from urinary drainage systems
- Measuring and recording emesis
- Measuring and recording liquid stool
- Recognition of and reporting of abnormal resident findings, signs, and symptoms
- Post mortem care
- Tasks associated with resident socialization, leisure activities, reality orientation, and validation techniques
- Tasks associated with the end of life care
- Tasks associated with basic first aid, CPR skills, and emergency care
- Tasks associated with compliance with resident's/patient's rights
- Tasks associated with daily documentation of CNA services provided to the resident
CNAs will work with knowledge and awareness of a client's rights and developmental level. A CNA shall not perform any task which requires specialized nursing knowledge, judgment, or skills.
A CNA may receive additional training beyond that required for initial certification, and upon validation of competence in the skill, an RN may perform such skills as authorized by the facility.
A CNA shall not work independently without the supervision of an RN or a licensed practical nurse.
LPN Administration of Intravenous Therapy
- Insert a peripheral IV
- Remove IV catheters
- Set up and use IV pumps
- Maintain an IV site
- Administer IV fluids and medications
- Accurately assess an IV site
- Respond to complications of IV therapy
Aspects of intravenous therapy that are outside the scope of practice of the LPN unless under the direct supervision of the RN or physician include the following (FAC, 2020).:
- Initiation of blood and blood products
- Initiation or administration of cancer chemotherapy
- Initiation of plasma expanders
- Initiation or administration of investigational drugs
- Mixing IV solution
- IV pushes, except heparin flushes and saline flushes
Discipline Process
FBN has the authority by law to investigate nurses having the appearance of violating practice standards or those against whom allegations have been made. FBN is also authorized to implement disciplinary action.
There are several options that the Board of Nursing might take depending on the results of an individual appraisal process and discipline hearing.
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Another option available in Florida for nurses struggling with impairment is the Intervention Project for Nurses (IPN).
IPN is a free resource for nurses licensed in Florida and provides referrals to Board approved addiction, mental health, or other treatment providers. The staff at IPN assists nurses, working alongside them with ongoing support, and should a disciplinary action already be present, goes with the nurse to hearings confirming that they are engaged in the recovery process.
Unprofessional Conduct
Unprofessional conduct includes (FAC, 2020).:
- Inaccurate recording
- Misappropriating drugs, supplies, or equipment
- Leaving a nursing assignment without advising licensed nursing personnel
- Stealing from a patient
- Violating the integrity of a medication administration system or an information technology system
- Falsifying or altering patient records or nursing progress records, employment applications, or time records
- Violating the confidentiality of information or knowledge concerning a patient
- Discriminating based on race, creed, religion, sex, age, or national origin in the rendering of nursing services as it relates to the human rights and dignity of the individuals
- Engaging in fraud, misrepresentation, or deceit in taking the licensing examination
- Impersonating another licensed practitioner or permitting another person to use his certificate to practice nursing
- Providing false or incorrect information to the employer regarding the status of the license
Practicing beyond the scope of the licensee's license, educational preparation, or nursing experience - Using force against a patient, striking a patient or throwing objects at a patient
- Using abusive, threatening, or foul language in front of a patient or directing such language toward a patient
Accepting a gift from a patient, the value of which exceeds the employer's policy regarding gifts - Knowingly obtaining or using or attempting to obtain or use a patient's property with the intent to temporarily or permanently deprive the patient of the use, benefit, or possession of the funds, assets, or property, or to benefit someone other than the patient
Conclusion
The state of Florida needs nurses and is an excellent place to work. Clear, consistent standards describe nursing duties, education, and expectations. Whether seeking a license to practice nursing by exemption or examination, those considering making Florida their home can find a worthwhile career choice as a nurse in the sunshine state.
Select one of the following methods to complete this course.
Take TestPass an exam testing your knowledge of the course material.
OR
Reflect on Practice ImpactDescribe how this course will impact your practice. (No Test)
Implicit Bias Statement
CEUFast, Inc. is committed to furthering diversity, equity, and inclusion (DEI). While reflecting on this course content, CEUFast, Inc. would like you to consider your individual perspective and question your own biases. Remember, implicit bias is a form of bias that impacts our practice as healthcare professionals. Implicit bias occurs when we have automatic prejudices, judgments, and/or a general attitude towards a person or a group of people based on associated stereotypes we have formed over time. These automatic thoughts occur without our conscious knowledge and without our intentional desire to discriminate. The concern with implicit bias is that this can impact our actions and decisions with our workplace leadership, colleagues, and even our patients. While it is our universal goal to treat everyone equally, our implicit biases can influence our interactions, assessments, communication, prioritization, and decision-making concerning patients, which can ultimately adversely impact health outcomes. It is important to keep this in mind in order to intentionally work to self-identify our own risk areas where our implicit biases might influence our behaviors. Together, we can cease perpetuating stereotypes and remind each other to remain mindful to help avoid reacting according to biases that are contrary to our conscious beliefs and values.
References
- Florida Administrative Code, 64B9. (January 2, 2020). Retrieved 3/7/20. Visit Source.
- Florida Health Medical Quality Assurance. (2020). Retrieved 3/7/20. Visit Source.
- Texas Board of Nursing. (2018). Practice-Delegation Resource Packet. Retrieved 3/7/20. Visit Source.
FAQs
What laws and rules govern the practice of nursing in Florida? ›
In Florida the law that regulates the practice of nursing is Title XXXII Chapter 456 Regulation of Professions and Occupations Chapter 464 Nursing, referred to as the Florida Nurse Practice Act (NPA). Administrative Law takes the form of rules and regulations enacted by agencies created by legislatures.
What is the legal document that ensures every nurse practicing in Florida meets minimum requirements for safe practice? ›The Nurse Practice Act, enacted by the Florida Legislature, provides a framework for providing safe, professional nursing care and offers a layer of protection to the individuals seeking such care. Board rules must follow the laws enacted by the legislature and adopted in the Nurse Practice Act.
How often must Florida nurses complete a 2 hour class on the key aspects of the nurse Practice Act? ›All Florida nurses are required to renew their licenses and complete mandated continuing education every two years. The Act stipulates that up to 30 hours of continuing education may be required each biennium [3].
Can a nurse refuse an assignment in Florida? ›A nurse may refuse a work assignment. However, the refusal may be considered insubordination or abandonment.
What are 3 common laws involving the nursing practice? ›Examples of common law include informed consent, the patient's right to refuse treatment, negligence, and malpractice.
What are the laws that regulate the practice of nursing? ›The NPA is the law for governing nursing practice in each state and is used for guidance to action. Therefore, the NPA has terms and phrases clearly defined for the state boards of nursing to use for enforcement.