As of 2023, there were 9,134 Advanced Practice Registered Nurses (APRN) reported to be practicing in Indiana. These APRNs include Nurse Practitioners (NP), Clinical Nurse Specialists (CNS), Certified Nurse Midwives (CNM), and Certified Nurse Anesthetists (CRNA). APRNs are required to be licensed as Registered Nurses (RN) and meet certain educational criteria to provide APRN-level services. CNMs are the only APRNs required to hold a separate, dedicated license in Indiana. Many Indiana APRNs (NP, CNS, CNM only) hold a prescriptive authority license. This license enables APRNs to prescribe medications and requires collaborative practice agreements with a licensed physician, dentist, podiatrist, or optometrist. Approximately 71% of Indiana APRNs hold prescriptive authority licenses, meaning about 29% of RNs who self-identify as APRNs hold no APRN-level license.
In 2023, the Bowen Center conducted a fifty-state policy review of APRN licensing regulations and published the findings in a corresponding report. This policy review revealed that only Indiana and Wisconsin do not require APRN-level licensure for all practicing APRNs. Currently, Indiana has no formal process of tracking the number of APRNs, unless they are Certified Nurse Midwives, or hold prescriptive authority. Collection of data on APRNs is reliant on RNs self-reporting as APRNs. This leads to several potential challenges including the inability for individuals to easily verify credentials of APRN providers and lack of consistent and sufficiently granular data for workforce planning.
Based on the national policy review, the Bowen Center identified 4 prevailing implementation approaches to APRN licensure. SB447 and HB1151 aim to create separate licenses for each advanced nursing role, which aligns with Approach #4 outlined in the figure below.
Regardless of the approach, it’s important that APRNs do not face a complicated licensure process. Key consideration include:
- Ensuring reciprocity and portability of licenses
- Reducing administrative burdens for license holders and state agencies
- Minimizing additional licensure costs
Professional regulation ensures quality service and public safety. The question to consider: Would an Indiana APRN license be helpful to protect public health and safety and support modernization of regulation, or are the current regulatory strategies sufficient?
Check out the full report here: Advanced Practice Registered Nurse Licensing.
