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Nurse Practitioners
The nurse practitioner (NP) is a registered nurse with additional educational preparation and skills in physical diagnosis, psychosocial assessment, and management of health and illness needs in primary health care. Nurse practitioners who have been certified by the BRN may use the title R.N., N.P. after his or her name alone or include categories of specialization such as Family Nurse Practitioner, Pediatric Nurse Practitioner, or Adult Nurse Practitioner. The nurse practitioner relies on standardized procedures for authorization to perform medical functions of diagnosing and treating patients. Nurse practitioners who meet BRN requirement may obtain a furnishing number to make drugs and devices available to patients in strict accord with furnishing standardized procedures. (B&P Code Section 2834, CCR Section 1480) The Nursing Practice Act provides authority for nursing functions that are essential to providing primary health care which do not require standardized procedures. Examples include physical and mental assessment, disease prevention and restorative measures, performance of skin tests and immunizations, and withdrawal of human blood from veins and arteries. (B&P Code Section 2725)
Certified Nurse-Midwives
BRN certified nurse midwives (CNM) under the supervision of a licensed physician and surgeon, are authorized to attend cases of normal childbirth and provide prenatal, intrapartum, and postpartum care, including family planning care for the mother, and immediate care of the newborn. The practice of nurse midwifery constitutes the furthering or undertaking by a certified person, under supervision of a physician and surgeon, who has current practice or training in obstetrics, to assist a woman in childbirth so long as progress meets criteria accepted as normal. Physician supervision shall not be construed to require the physical presence of the supervising physician. All complications shall be referred to a physician immediately. The practice of nurse-midwifery does not include the assisting of childbirth by any artificial, forcible, or mechanical means, nor the performance of any version. Nurse midwives may perform or repair episiotomies, and repair first and second-degree lacerations of the perineum in a licensed alternative birth center if all conditions are met as set forth in B&P Code Section 2746.52. These conditions include the supervising physician and surgeon must be credentialed to perform obstetrical care in the facility. The CNM performs and repairs the episiotomies pursuant to protocols developed and approved by the CNM supervising physician, director of the obstetrical department and the interdisciplinary practices committee where applicable. A CNM who meets BRN requirements may obtain a furnishing number to make drugs and devices available to patients in strict accordance with approved furnishing standardized procedures. (B&P Code Sections 2746-2746.52, CCR Section 1460) The scope of nurse-midwifery practice includes providing necessary supervision, care, and advise in a variety of settings tow omen during the antepartal, intrapartal, postpartal, interconceptional periods, and family planning. It also includes conducting deliveries on his or her own responsibility and caring for the newborn and the infant. This care includes preventive measures and the detection of abnormal conditions in mother and child. The CNM obtains physician assistance and consultation when indicated, and provides emergency care until physician assistance can be obtained. Other practices and procedures may be included when the Nurse-midwife and supervising physician deem appropriate by using standardized procedures as specified in B&P Code, Section 2725. (CCR Section 1463)

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