Which states have full practice authority for nurse practitioners

Nurse Types / Nurse Practitioner / Scope of Practice

Currently, there are 23 states, along with the District of Columbia, that grant nurse practitioners (NPs) full practice authority. With full practice authority, NPs can perform many of the same tasks as physicians. Some of these tasks include prescribing medications, ordering physical therapy, diagnosing and treating medical conditions, and interpreting diagnostic tests. 

Some people inaccurately perceive nurse practitioners as less experienced than physicians. However, numerous studies have shown that is not the case. In many ways, nurse practitioners provide the same level of care as physicians. 

In this post, we will explore the following: 

• What is the scope of practice for NPs in each state?
• What is ‘scope of practice’?
• Why are nurse practitioners in more demand?

What is the scope of practice for NPs in each state?

Every state has different specifications for nurse practitioner scope. Some states are more strict than others. For example, in Florida, nurse practitioners cannot diagnose or treat patients without a physician available. Meanwhile, in Washington state, nurse practitioners are able to diagnose, treat, and prescribe medications, including medical marijuana. 

What is ‘scope of practice’?

For nurse practitioners, ‘scope of practice’ refers to the responsibilities and duties they can perform based on their license. For example, a nurse practitioner has a broader scope of responsibilities than a registered nurse. However, they generally have a smaller scope of practice than physicians.

There are three different levels of practice that a nurse practitioner can have in a given state. These levels are full practice, reduced practice, and restricted practice. 

Full practice 

In a full practice state, nurse practitioners can evaluate patients, diagnose illnesses, order and interpret diagnostic tests, and prescribe medication. They are granted permission to perform these tasks through the state board of nursing. 

Reduced practice

With reduced practice, nurse practitioners can participate in at least one element of NP practice. For example, elements of practice that may be restricted include prescribing certain medications or performing certain medical procedures. They must also enter into a regulated collaborative agreement with a physician to provide patient care. The state board of nursing outlines the NPs scope of practice as they vary from state to state. 

Restricted practice

The main difference between ‘reduced practice’ and ‘restricted practice’ is the amount of oversight required. In states with restricted practice, nurse practitioners cannot engage in at least one aspect of NP practice. The state law requires that NPs work with a physician throughout their careers to provide patient care. 

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Why are nurse practitioners in more demand?

The demand for NPs has increased for two principal reasons. The first reason is that the expanded access to care created by the Affordable Care Act has insured 20 million more Americans. This expanded access has made it necessary for more physicians and nurse practitioners to enter the field. 

According to the Association of American Medical Colleges, the projected shortage of nurse practitioners will be between 61,700 and 94,700. This leaves a vacuum for nurse practitioners to fill. 

Additionally, the aging population requires more physicians to help. By 2025, the population over 65 will grow by 41%, while those younger than 18 will increase by 5%. 

Given these two factors, there’s a desperate need for nurse practitioners.