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64B9-14.003 Delegation of TasksProhibited (2) Nursing activities that include the use ofthe nursing process and require the specialknowledge, nursing judgment or skills of aregistered or practical nurse, including:– (a) The initial nursing assessment or anysubsequent assessments;– (b) The determination of the nursing diagnosisor interpretations of nursing assessments;– (c) Establishment of the nursing care goals anddevelopment of the plan of care; and– (d) Evaluation of progress in relationship tothe plan of care.40

64B9-14.003 Delegation of TasksProhibited (3)Those activities for which theUAP has not demonstratedcompetence.Specific Authority 464.006 FS. Law Implemented 464.003(17),(18), (19), (20), 464.018(1)(h) FS. History–New1-1-96, Amended 4-29-96, Formerly 59S-14.003.41

464.202 Duties and powers ofthe Board of Nursing Duties and powers of the board.—The board shall maintain, or contract with or approveanother entity to maintain, a state registry of certified nursing assistants. The registry mustconsist of the name of each certified nursing assistant in this state; other identifyinginformation defined by board rule; certification status; the effective date of certification;other information required by state or federal law; information regarding any crime or anyabuse, neglect, or exploitation as provided under chapter 435; and any disciplinary actiontaken against the certified nursing assistant. The registry shall be accessible to the public,the certificate holder, employers, and other state agencies. The board shall adopt by ruletesting procedures for use in certifying nursing assistants and shall adopt rules regulatingthe practice of certified nursing assistants and specifying the scope of practice authorizedand the level of supervision required for the practice of certified nursing assistants. Theboard may contract with or approve another entity or organization to provide theexamination services, including the development and administration of examinations. Theboard shall require that the contract provider offer certified nursing assistant applicationsvia the Internet, and may require the contract provider to accept certified nursing assistantapplications for processing via the Internet. The board shall require the contract provider toprovide the preliminary results of the certified nursing examination on the date the test isadministered. The provider shall pay all reasonable costs and expenses incurred by theboard in evaluating the provider’s application and performance during the delivery ofservices, including examination services and procedures for maintaining the certifiednursing assistant registry.History.—s. 204, ch. 99-397; s. 79, ch. 2000-318; s. 5, ch. 2005-62.Note.—Former s. 468.822.42

464.004 Board of Nursing, membership;appointment, terms1) The Board of Nursing is created within the department and shall consistof 13 members to be appointed by the Governor and confirmed by the Senate. 2) Seven members of the board must be registered nurses who areresidents of this state and who have been engaged in the practice ofprofessional nursing for at least 4 years, including at least one advancedregistered nurse practitioner, one nurse educator member of an approvedprogram, and one nurse executive. These seven board members should berepresentative of the diverse areas of practice within the nursing profession. Inaddition, three members of the board must be licensed practical nurses whoare residents of this state and who have been actively engaged in the practiceof practical nursing for at least 4 years prior to their appointment. Theremaining three members must be residents of the state who have never beenlicensed as nurses and who are in no way connected with the practice ofnursing. No person may be appointed as a lay member who is in any wayconnected with or has any financial interest in, any health care facility, agency,or insurer. At least one member of the board must be 60 years of age or older 43

Licensure Requirements Licensurerequirements cover many areasof aspects of practice and preparation.Included are:– training / education requirements– fees,– language requirements,– examination stipulations and– certification processes.44

IMPORTANT NOTICE: Pursuant to Section 456.0635, Florida Statutes, effective July 1, 2009,health care boards or the department shall refuse to issue a license,certificate or registration and shall refuse to admit a candidate forexamination if the applicant has been :1. Convicted or plead guilty or nolo contendre to a felony violationregardless of adjudication of: chapters 409, 817, or 893, Florida Statutes; or21 U.S.C. ss. 801-970 or 42 U.S.C. ss 1395-1396, unless the sentence andany probation or pleas ended more than 15 years prior to the application.2. Terminated for cause from Florida Medicaid Program (unless theapplicant has been in good standing for the most recent five years).3. Terminated for cause by any other State Medicaid Program or theMedicare Program (unless the termination was at least 20 years prior to thedate of the application and the applicant has been in good standing with theprogram for the most recent five years).45

464.008 Licensure by examination 1)Any person desiring to be licensed as aregistered nurse or licensed practical nurseshall apply to the department to take thelicensure examination. The department shallexamine each applicant who:46

464.008 Licensure by examinationa) Has completed the application form andremitted a fee set by the board not to exceed 150and has remitted an examination fee set by theboard not to exceed 75 plus the actual perapplicant cost to the department for purchase ofthe examination from the National Council of StateBoards of Nursing or a similar nationalorganization. 47

464.008 Licensure by examinationb) Has provided sufficient information on or afterOctober 1, 1989, which must be submitted by thedepartment for a statewide criminal recordscorrespondence check through the Department ofLaw Enforcement. 48

464.008 Licensure by examinationc) Is in good mental and physical health, is a recipient ofa high school diploma or the equivalent, and has completedthe requirements for graduation from an approved program,or its equivalent as determined by the board, for thepreparation of registered nurses or licensed practicalnurses, whichever is applicable. Courses successfullycompleted in a professional nursing program which are atleast equivalent to a practical nursing program may beused to satisfy the education requirements for licensure asa licensed practical nurse. 49

464.008 Licensure by examinationd) Has the ability to communicate in the Englishlanguage, which may be determined by anexamination given by the department. Eachapplicant who passes the examination andprovides proof of meeting the educationalrequirements specified in subsection (1) shall,unless denied pursuant to s. 464.018, be entitledto licensure as a Registered Professional Nurse ora Licensed Practical Nurse, whichever isapplicable 50

464.008 Licensure by examination2) Any applicant who fails the examination threeconsecutive times, regardless of the jurisdiction inwhich the examination is taken, shall be required tocomplete a board-approved remedial course beforethe applicant will be approved for reexamination.After taking the remedial course, the applicant maybe approved to retake the examination up to threeadditional times before the applicant is required toretake remediation. The applicant shall apply forreexamination within 6 months after completion ofremediation. The board shall by rule establishguidelines for remedial courses. 51

464.009 Licensure by endorsement 1)The department shall issue theappropriate license by endorsement topractice professional or practical nursing toan applicant who, upon applying to thedepartment and remitting a fee set by theboard not to exceed 100, demonstrates tothe board that he or she/he:52

464.009 Licensure by endorsementa) Holds a valid license to practice professional orpractical nursing in another state of the UnitedStates, provided that, when the applicant secured hisor her/he original license, the requirements forlicensure were substantially equivalent to or morestringent than those existing in Florida at that time;or b) Meets the qualifications for licensure in s.464.008 and has successfully completed a state,regional, or national examination which is substantialequivalent to or more stringent than the examinationgiven by the department 53

464.009 Licensure by endorsementc) Has actively practiced nursing in another state,jurisdiction, or territory of the United States for 2 ofthe preceding 3 years wit without having his or herlicense acted against by the licensing authority ofany jurisdiction. Applicants who become licensedpursuant to this paragraph must complete within 6months after licensure a Florida laws and rulescourse that is approved by the. Once the departmenthas received the results of the national criminalhistory check and has determined that the applicanthas no criminal history, the appropriate license byendorsement shall be issued to the applicant. 54

464.009 Licensure by endorsement 2)Such examinations and requirementsfrom other states shall be presumed to besubstantially equivalent to or more stringentthan those in this state. Such presumptionshall not arise until January 1, 1980.However, the board may, by rule, specifystates the examinations and requirements ofwhich shall not be presumed to besubstantially equivalent to those of thisstate.55

464.009 Licensure by endorsement 3)An applicant for licensure by endorsementwho is relocating to this state pursuant to his orher military-connected spouse's official militaryorders and who is licensed in another state thatis a member of the Nurse Licensure Compactshall be deemed to have satisfied therequirements of subsection (1) and shall beissued a license by endorsement uponsubmission of the appropriate application andfees and completion of the criminal backgroundcheck required under subsection.56

464.009 Licensure by endorsement4) The applicant must submit to the department a set offingerprints on a form and under procedures specified by thedepartment, along with a payment in an amount equal to thecosts incurred by the Department of Health for the criminalbackground check of the applicant. The Department of Healthshall submit the fingerprints provided by the applicant to theFlorida Department of Law Enforcement for a statewide criminalhistory check, and the Florida Department of Law Enforcementshall forward the fingerprints to the Federal Bureau ofInvestigation for a national criminal history check of theapplicant. The Department of Health shall review the results ofthe criminal history check, issue a license to an applicant whohas met all of the other requirements for licensure and has nocriminal history, and shall refer all applicants with criminalhistories back to the board for determination as to whether/he alicense should be issued and under what conditions. 57

464.009 Licensure by endorsement 5)The department shall not issue alicense by endorsement to any applicantwho is under investigation in another statefor an act which would constitute a violationof this part or chapter 456 until such time asthe investigation is complete, at which timethe provisions of s. 464.018 shall apply.58

464.009 Licensure by endorsement6) The department shall develop an electronicapplicant notification process and provide electronicnotification when the application has been receivedand when background screenings have beencompleted, and shall issue a license within 30 daysafter completion of all required data collection andverification. This 30-day period to issue a licenseshall be tolled if the applicant must appear before theboard due to information provided on the applicationor obtained through screening and data collectionand verification procedures. 59

464.115 Certification of clinicalnurse specialists 1)Any nurse seeking certification as aclinical nurse specialist must apply to thedepartment and submit proof that he or sheholds a current license to practiceprofessional nursing, a master's degree in aclinical nursing specialty, and either:60

464.115 Certification of clinicalnurse specialists a)Proof of current certification in aspecialty area as a clinical nurse specialistfrom a nationally recognized certifying bodyas determined by the board; or61

464.115 Certification of clinicalnurse specialists(b) Proof that he or she holds a master's degree ina specialty area for which there is no certificationwithin the clinical nurse specialist role and specialtyand proof of having completed 1,000 hours of clinicalexperience in the clinical specialty for which he orshe is academically prepared, with a minimum of500 hours of clinical practice after graduation. Theapplicant for certification as a clinical nurse specialistmust submit an affidavit to the Board of Nursingaffirming the required hours of clinical experience.Falsification of the affidavit constitutes grounds fordiscipline in accordance with s. 464.018(1)(f). 62

464.115 Certification of clinicalnurse specialists 2)The board shall certify, and thedepartment shall issue a certificate to, anynurse who fulfills the qualifications of thissection. The board shall establish anapplication fee not to exceed 75 and abiennial renewal fee not to exceed 75. 3) he board may adopt rules necessary toadminister this section pursuant to ss.120.536(1) and 120.54.63

464.012 Certification of AdvancedRegistered Nurse Practitioners; fees 1)Any nurse desiring to be certified as anadvanced registered nurse practitioner shallapply to the department and submit proofthat he or she/he holds a current license topractice professional nursing and that he orshe/he meets one or more of the followingrequirements as determined by the board-64

464.012 Certification of AdvancedRegistered Nurse Practitioners a)Satisfactory completion of a formal postbasic educational program of at least oneacademic year, the primary purpose ofwhich is to prepare nurses for advanced orspecialized practice.65

464.012 Certification of AdvancedRegistered Nurse Practitioners b)Certification by an appropriate specialtyboard. Such certification shall be required forinitial state certification and any recertificationas a registered nurse anesthetist or nursemidwife. The board may by rule provide forprovisional state certification of graduate nurseanesthetists and nurse midwives for a period oftime determined to be appropriate for preparingfor and passing the national certificationexamination.66

464.012 Certification of AdvancedRegistered Nurse Practitioners c)Graduation from a program leading to amaster's degree in a nursing clinical specialtyarea with preparation in specialized practitionerskills. For applicants graduating on or afterOctober 1, 1998, graduation from a master'sdegree program shall be required for initialcertification as a nurse practitioner underparagraph (4) (c). For applicants graduating onor after October 1, 2001, graduation from amaster's degree program shall be required forinitial certification as a registered nurseanesthetist under paragraph (4) (a).67

464.012 Certification of AdvancedRegistered Nurse Practitioners 2)The board shall provide by rule theappropriate requirements for advancedregistered nurse practitioners in thecategories of certified registered nurseanesthetist, certified nurse midwife andnurse practitioner.68

464.012 Certification of AdvancedRegistered Nurse Practitioners 3)An Advanced Registered NursePractitioner shall perform those functionsauthorized in this section within theframework of an established protocol. Apractitioner currently licensed under chapter458, chapter 459, or chapter 466 shallmaintain supervision for directing thespecific course of medical treatment. Withinthe established framework, an advancedregistered nurse practitioner may.69

464.012 Certification of AdvancedRegistered Nurse Practitioners– a) Monitor and alter drug therapies.– b) Initiate appropriate therapies for certainconditions.– c) Perform additional functions as may bedetermined by rule in accordance with S464.003(3) (c).– d) Order diagnostic tests and physical andoccupational therapy70

464.012 Certification of AdvancedRegistered Nurse Practitioners 4)In addition to the general functionsspecified in subsection (3), an AdvancedRegistered Nurse Practitioner may performthe following acts within his or her/hespecialty.71

464.012 Certification of AdvancedRegistered Nurse Practitioners a)The Certified Registered NurseAnesthetist may, to the extent authorized byestablished protocol approved by themedical staff of the facility in which theanesthetic service is performed, perform anyor all of the following:72

464.012 Certification of AdvancedRegistered Nurse Practitioners– i) Determine the health status of the patient as itrelates to the risk factors and to the anestheticmanagement of the patient through theperformance of the general functions.– ii) Based on history, physical assessment, andsupplemental laboratory results, determines,with the consent of the responsible physician,the appropriate type of anesthesia within theframework of the protocol.– iii) Order under the protocol pre-anestheticmedication.73

464.012 Certification of AdvancedRegistered Nurse Practitioners– iv) perform under the protocol procedurescommonly used to render the patient insensibleto pain during the performance of surgical,obstetrical, therapeutic, or diagnostic clinicalprocedures. These procedures include orderingand administering regional, spinal, and generalanesthesia; inhalation agents and techniques;intravenous agents and techniques; andtechniques of hypnosis.74

464.012 Certification of AdvancedRegistered Nurse Practitioners– v) Order or perform monitoring proceduresindicated as pertinent to the anesthetic healthcare management of the patient.– vi) Support life functions during anesthesiahealt

laws and rules that govern the practice of nursing in Florida. To receive Board approval, each course must include content on Chapters 456 & 464 of the Florida Statutes and the rules in Title 64B9 of the Florida Administrative Code. Rulemaking Authority 464.013 FS. Law Implemented 464.013 FS. History-New 4-21-13. 3