Nurse Practitioner Scope of Practice by State
Currently, 27 states and Washington, D.C., offer nurse practitioners (NPs) the autonomy to practice independently. In these areas, NPs can perform tasks like prescribing medication, ordering physical therapies, diagnosing illnesses, and interpreting lab tests, similar to what physicians do. Despite some misconceptions about NPs having less expertise or providing lower quality care, research indicates that NPs often deliver care on par with doctors. This article will delve into:
- NP practice scope by state - Definition of 'scope of practice' - Rising demand for nurse practitioners
NP Practice Scope by State
Each state has unique rules regarding NP responsibilities. Some states impose more constraints than others. For example, in Florida, NPs require a physician's oversight to diagnose or treat, whereas in Washington, NPs can independently handle diagnosis, treatment, and even prescribe drugs, including cannabis for medical use.
**States with Full Practice Authority:** - Alaska - Arizona - Colorado - Connecticut - Delaware - Hawaii - Idaho - Iowa - Kansas - Maine - Maryland - Massachusetts - Minnesota - Montana - Nebraska - Nevada - New Hampshire - New Mexico - New York - North Dakota - Oregon - Rhode Island - South Dakota - Utah - Vermont - Washington - Washington, D.C. - Wyoming
**States with Reduced Practice Authority:** - Alabama - Arkansas - Illinois - Indiana - Kentucky - Louisiana - Mississippi - New Jersey - Ohio - Pennsylvania - West Virginia - Wisconsin
**States with Restricted Practice Authority:** - California - Florida - Georgia - Michigan - Missouri - North Carolina - Oklahoma - South Carolina - Tennessee - Texas - Virginia
**Understanding 'Scope of Practice'**
For NPs, 'scope of practice' dictates the tasks they can perform, based on state regulations and their training. Generally, NPs have more duties than registered nurses but fewer than doctors. NPs can operate under three practice levels: full, reduced, or restricted.
**Full Practice**
In these states, NPs can assess, diagnose, order and analyze tests, and prescribe medications independently, as approved by the nursing board.
**Reduced Practice**
Here, NPs can perform some NP functions but may face restrictions like limited drug prescriptions or specific procedures. They must collaborate with a physician for patient care, following state nursing board guidelines.
**Restricted Practice**
Unlike reduced practice, restricted practice involves more oversight. NPs must collaborate with a physician for the entirety of their career in these states, as mandated by law.
**Why Demand for NPs is Rising**
The demand for NPs is climbing due to expanded healthcare coverage from recent reforms, ensuring millions more Americans. This coverage boost necessitates more healthcare providers, including NPs and doctors. Additionally, the aging U.S. population leads to higher medical service needs. Those over 65 are expected to increase significantly, while the under-18 demographic will grow slightly. This anticipated shortage of NPs presents a huge opportunity for them to fill the gap.
