Ala. Admin. Code r. 540-X-8-.21 - Temporary Approval To Practice As A Certified Nurse Midwife

(1) The applicant for approval to practice as a certified nurse midwife may be granted temporary approval for practice under the following stipulations until such time as the application is approved or denied by the Board of Nursing and the Board of Medical Examiners.
(a) The applicant shall meet the requirements of Rules 540-X-8-.15 and 540-X-8-.17.
(b) The collaborating physician shall meet the qualifications established in Rule 540-X-8-.16.
(c) Temporary approval is limited to the standard protocol and formulary, including oxytocics, approved by the Joint Committee of the Alabama Board of Nursing and the Alabama State Board of Medical Examiners and does not include the authority to:
1. Perform additional skills as provided in Rule 540-X-8-.22.
2. Prescribe drugs other than oxytocics that are defined in the standard formulary with "Restrictions."
(2) Provisional Approval: A registered nurse who meets the requirements of Rules 610-X-5-.15 and 610-X-5-.17 with the exception of national certification, and who has applied for initial certification may be granted temporary approval under paragraph (1)(c) of this rule with these additional stipulations.
(a) Practice under the on-site supervision of an approved certified nurse midwife or a licensed physician.
(b) During a minimum of the first thirty days of practice or until satisfactory clinical skills are demonstrated, the collaborating physician or covering physician shall be in attendance at all deliveries by the nurse midwife. The nurse midwife shall contact the collaborating physician or the physician providing medical coverage.
(c) The nurse midwife with provisional approval may use the designation "Graduate Nurse Midwife."
(d) Provisional approval to practice is limited to a maximum of six months and shall expire immediately upon:
1. Notification of approval by the Board of Nursing.
2. Notification of failing the certification exam.
(3) Interim Approval: If the relationship with the collaborating physician is terminated, a certified nurse midwife approved to practice under the provisions of these rules may continue in a collaborative practice with an interim physician after application for approval until such time as the new application is approved or denied, provided all requirements and stipulations for temporary approval cited in paragraph (1) are met.
(4) An applicant for approval to practice as a certified nurse midwife may be granted temporary approval when either the collaborating physician or certified nurse midwife applicant is under investigation by a state or federal authority. The temporary approval shall remain in force until the application has been approved, denied, or withdrawn. However, the Board of Nursing or Board of Medical Examiners may decline to approve the application until the investigation has been concluded. The Board of Medical Examiners may withdraw temporary approval in accordance with Rule 540-X-8-.13.


Ala. Admin. Code r. 540-X-8-.21
New Rule: Filed June 20, 1996; effective July 26, 1996. Repealed New Rule: Filed August 25, 2003; effective September 29, 2003. Amended by Alabama Administrative Monthly Volume XXXIII, Issue No. 10, July 31, 2015, eff. 8/6/2015. Amended by Alabama Administrative Monthly Volume XXXIX, Issue No. 07, April 30, 2021, eff. 6/14/2021.

Was previously Rule 540-X-8-.19, renumbered as per certification filed April 23, 2004; effective May 28, 2004.

Author: Alabama Board of Medical Examiners

Statutory Authority: Code of Ala. 1975, ยงยง 34-24-53, 34-21-84, 34-21-85.

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