Steps to Becoming an APRN in Guam

1Get your Graduate Degree in Guam
2Earn your National Certification in Guam
3Apply for your License in Guam
4Renewing your License in Guam

The Guam Board of Nurse Examiners (671-735-7406), under the Department of Public Health and Social Services and within the Health Professional Licensing Office, regulates and licenses advanced practice registered nurses (APRN) in the following categories:

  • Certified Registered Nurse Practitioner (CRNP)
    • Adult Nurse Practitioner
    • Family Nurse Practitioner
    • Pediatric Nurse Practitioner
    • Family Planning Nurse Practitioner
    • Obstetric/Gynecologic Nurse Practitioner
    • Emergency Room Nurse Practitioner
    • Geriatric Nurse Practitioner
    • School Nurse Practitioner
    • Medical Nurse Practitioner
    • Maternal Child Health Practitioner
    • Neonatology Nurse Practitioner
    • Women’s Health Care Practitioner
    • Certified Registered Nurse-Midwife (CRNM)
    • Certified Registered Nurse-Anesthetist (CRNA)

To become licensed as an APRN in Guam, you must hold a current, valid RN license:

All applicants for RN licensure must complete the Guam Board of Examiners application.

  • If you are a graduate of an approved nursing program, you must complete the application and check the “Initial” and “RN” boxes on the application.
  • If you are currently, or have ever been, licensed as an RN in another state or U.S. territory, you must complete the application and Part III (Verification of Licensure Information). Complete the Verification of License form and forward to all appropriate licensing boards, including your original state of licensure. Check the “Endorsement” and “RN” boxes on the application.
  • If you are a foreign graduate, you must complete the application and provide the Board of Examiners with a notarized copy of the CGFNS credentials education verification.


Step 1. Get Your Graduate Degree

To work toward your APRN license in Guam, you must possess a master’s degree or higher. The educational program must be designed to prepare nurse anesthetists, nurse midwives or nurse practitioners, and it must be:

  • Approved by the Board; or
  • Approved or recognized by a certifying body approved by the Board.

The educational program’s curriculum must meet the following criteria:

  • The program must include theoretical and clinical instruction as to enable the student to provide primary healthcare in a nursing specialty.
  • The training in the nursing specialty must be broad enough to detect and control symptoms and minimize the potential for disease progression.
  • The program must be at least one academic year in length and must be comprised of at least 30 semester units or 45 quarter units. It must include theory and planned clinical practice under the direction of a preceptor.
  • Upon acquisition of basic theoretical knowledge within the curriculum, students must receive supervised experience and instruction within a clinical setting. The clinical experience must include intensive experience in performing diagnostic and treatment procedures.
  • The curriculum must include the following courses relevant to the specialized field:
    • Normal Growth and Development
    • Pathophysiology
    • Interviewing and Communication Skills
    • Eliciting, Recording and Maintaining a Developmental Health History
    • Comprehensive Physical Examination
    • Psychosocial Assessment
    • Interpretation of Laboratory Findings
    • Evaluation of Assessment Data to Define Health and Developmental Problems
    • Pharmacology
    • Nutrition
    • Disease Management
    • Principles of Health Maintenance
    • Assessment of Community Resources
    • Initiating and Providing Emergency Treatments
    • Practitioner Role Development
    • Instruction in Legal, Ethical and Professional Responsibilities of a Practitioner
    • Healthcare Delivery Systems


Step 2. Become Nationally Certified in your Advanced Practice Nursing Specialty

Once you have obtained your graduate degree in your APRN specialty, you are eligible to become nationally certified by a certifying body approved by the Board. The following certifying bodies are approved by the Board:

The scope of practice for all certified practitioners in Guam must be in accordance with the functions and standards set forth by the respective national certifying bodies.


Step 3. Apply for your APRN License

All applicants for APRN licensure must complete the Guam Board of Examiners application.

  • The application must be downloaded and printed, and it must be typed or printed with blue or black ink.
  • You must provide your U.S. Social Security number with your application.
  • If your name shown on your supporting documents is different from the name on your application, you must provide the Board with proof of your legal name change (e.g., a certified copy of your marriage license, divorce decree or other court order).
  • You must answer all questions. If a question is not applicable to you, you must answer with “N/A.”

In addition to a completed application, you must also provide the Board with the following:

  • A notarized application
  • A 2”x2” passport-style photograph taken within the last 3 months of the date of the application. The photo must be signed and dated on the back of the photo.
  • Official transcripts where you obtained your graduate education
  • Certificate of Education from the institution where you obtained your graduate education
  • A criminal background check that includes a police and local court clearance dated within 2 months of the date of the application
  • A copy of your current national certification (it must include an expiration date)
  • The $150 application fee (plus $150 prescriptive authority fee, if applicable) in a check or money order made payable to “Treasurer of Guam”

An application is not considered complete until the Board has received all supporting documents and fees.

Mail the completed and notarized application, the application fee and all supporting documentation to the: Guam Board of Nurse Examiners, 651 Legacy Square Commercial Complex, South Route 10, Suite 9, Mangilao, GY 96913.

Collaborative Agreement

All APRNs in Guam must make a written plan for a collaborative agreement that must be approved by the Board. The agreement must be signed by the APRN and the collaborating physician who provides consultation and periodic review of the services being provided by the APRN.

Periodic review of the collaborative agreement must be done during the first year of the agreement and then every 6 months thereafter. The agreement must include:

  • A written protocol to be used by the APRN for the management of patients and for the referral of cases
  • The procedure for an alternative collaborating physician

If the collaborative agreement is terminated, either by the physician or the APRN, the APRN must inform the Board within writing within 3 working days, and the license issued to the APRN will immediately terminate. A new license is issued only after the Board receives and approves a new collaborative agreement that is signed by both the APRN and the physician.

Prescriptive Authority/Controlled Substances

APRNs in Guam have prescriptive authority to prescribe and dispense Schedule II, Schedule III, Schedule IV and Schedule IV controlled substances in the course of professional practice. To apply for authority to prescribe, administer or dispense controlled substances in Guam through the Department of Public Health and Social Services Division of Environmental Health, Controlled Substances Program, you must complete the

Application to Prescribe, Administer, and/or Dispense Controlled Substances form to receive a Guam controlled substances registration number.

You must also register with the U.S. Drug Enforcement Administration. You can obtain application for a DEA certification by visiting the DEA Office of Diversion Control’s website.

Temporary License

If you are currently awaiting the opportunity to write a national certification examination, you may apply for a temporary license. A temporary license is valid for 6 months, or until the applicant has either passed or failed the examination, whichever comes first. To practice in Guam on a temporary license, the APRN must submit a written preceptorship agreement to the Board that is signed by both the APRN and one physician currently licensed to practice in Guam.

All documentation of patient contacts must be certified by the collaborating or delegated physician and submitted and approved by the Board. The applicant must pay $75 for an APRN temporary work permit in addition to the $150 APRN application fee.


Step 4. Renewing Your License

All RN and APRN licenses must be renewed on a biennial basis on September 30th of ODD-numbered years.

The Board mails all applications for renewal to your last known address. If you do not receive a renewal application, notify the Board and download and print the Guam Board of Examiners application.

To qualify for license renewal, you must complete the renewal application and return it, along with:

  • The renewal fee of $180 ($100 APN renewal fee plus $80 RN renewal fee) in a check or money order made payable to “Treasurer of Guam” (plus an additional renewal fee of $130 for prescriptive authority, if applicable)
  • A copy of your current national certification (it must include an expiration date)
  • A notarized document showing your clinical practice, which must include at least 180 patients within the last 24 months
  • Evidence of at least 30 hours of continuing education in the last 24 months in a field related to your APN specialty

Mail the completed renewal application, the renewal application fee and all supporting documentation to the: Guam Board of Nurse Examiners, 651 Legacy Square Commercial Complex, South Route 10, Suite 9, Mangilao, GY 96913.

Continuing Education

All continuing education courses must meet the criteria and guidelines developed by the National Continuing Education Approving Organization.

Reinstatement

Any application for renewal that is postmarked after September 30th is considered delinquent and the license is considered lapsed and invalid. You must apply for reinstatement using the Guam Board of Examiners application and provide the following:

  • The reinstatement fee of $175 ($150 APN reinstatement fee plus $125 RN reinstatement fee) in a check or money order made payable to “Treasurer of Guam”
  • A copy of your current national certification (it must include an expiration date)
  • A notarized document showing your clinical practice, which must include at least 180 patients within the last 24 months
  • Evidence of at least 30 hours of continuing education in the last 24 months in a field related to your APN specialty

Mail the completed reinstatement application, the reinstatement application fee and all supporting documentation to the: Guam Board of Nurse Examiners, 651 Legacy Square Commercial Complex, South Route 10, Suite 9, Mangilao, GY 96913.

Advanced Practice Nurse Associations in Guam

There are a number of professional organizations that support advanced practice nurses in Guam:


Guam Nurse Practitioner Salary

Salary information specific to Guam’s advanced practice registered nurses is not readily available, however, the US Depart of Labor’s Bureau of Labor Statistics published findings from a 2011 salary survey revealing figures for Guam’s RNs, inclusive of APRNs. As of 2011 some 450 registered nurses were employed in Guam, earning an average of $52,210. The top 25 percent earned an average of $62,440, while top earners in the 90th percentile made $73,200 on average in 2011.

Registered Nurse Salary

Area name
Employment
Annual mean wage
Guam
450
52210

These tables provide salary and employment information compiled by the US Department of Labor’s Bureau of Labor Statistics in May 2011. The data contained herein does not include self-employed nurses in independent practice.

When responding to the salary survey, some advanced practice registered nurses identified themselves as RNs while others identified themselves as health diagnosing and treating practitioners. When available, both sets of data were included for comparative purposes.

* These figures represent earnings that are at or above $90.00 per hour or $187,199 per year. The Bureau of Labor Statistics does not publish earnings beyond $90.00 hourly or $187,199 yearly.

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