The Limits on Nurse Practitioner Practice: Current and Future Trends. In contrast, full-practice authority states, such as Delaware, allow NPs to practice primary care without supervision of a physician. Reduced and restricted practice states have any number of regulations that prohibit NPs from engaging in some aspect of their practice, even though they are educated, trained and licensed to provide care for patients. Surprisingly, there were only small and largely insignificant differences in day-to-day practice autonomy between NPs in fully restricted states and those in states with independent practice but restricted prescription authority. Some states require a NP to have a relationship with a physician that outlines procedures the nurse practitioner may perform and procedures for consulting with the physician. Nurse Practitioner (NP) Practice Authority By State & Scope of Practice Nurse practitioners (NPs) are graduate-trained professionals who provide high-quality and cost-effective healthcare. Another 16 states have reduced practice and the rest are totally restricted. Restricted Practice: State practice and licensure laws restricts the ability of a nurse practitioner to engage in at least one element of NP practice. In some states, policy specifies whether a nurse practitioner must complete a transition to practice … § 32-1601 (15)). State requires supervision, delegation, or team-management by an outside health discipline in order for the NP … Creating productive practice environments that can retain NPs is a potential strategy for increasing the March 27, 2014 - A growing number of states are removing restrictions that limit a nurse practitioner’s ability to practice.. The third model is the restricted practice model, which is similar to the reduced practice model, but with increased supervision and operation under the management of an external health export. These are the 10 worst states to be a nurse practitioner, according to data from staffing firm Barton Associates. Let’s take a look at which states are the most NP- and PA-friendly. While some states grant NPs partial autonomy, others offer full practice authority (FPA), which enables them to practice without the oversight of a physician. Earning a nurse practitioner degree and becoming an NP is a rewarding career path for nurses in many locations around the nation. This is awesome for the nurse practitioner entrepreneur. However, some states allow NPs to oversee more than others, effectively granting them much more autonomy. Legislation Evolves to Enable Change Some states allow full practice, but others are severely restricted and require full physician oversight. Restricted Practice: State practice and licensure laws restrict the ability of NPs to engage in at least one element of NP practice. A collaborative agreement is a written statement between a physician and a nurse practitioner that defines the joint practice in the working relationship. That is half the country! The location in which you practice can have a huge effect on how you operate. However, NP scope of practice regulations vary from state-to-state ranging from autonomous practice to direct physician oversight. In restricted practice states, laws prohibit NPs from providing care they were educated to provide and require costly supervisory agreements between NPs and physicians. Some legislators are even running marketing campaigns attempting to lure NPs from other states within their boarders on the basis of more favorable scope of practice legislation. Currently, 22 states allow full practice for nurse practitioners, 16 states allow reduced practice, and 12 states restrict practice and require full physician oversight. The theory breaks down a little bit when comparing states identified as having “reduced practice” and “restricted practice”. restricted practice of NPs are allegedly to protect the public, yet the research has shown NP care to be equal to that of physicians. In the 1980s, states with more rural and remote areas were among the first to allow nurse practitioners more independent practice, as physicians were few and far between. - - - Massachusetts Yes - No No No Michigan Yes - No No No Minnesota No Yes. It provides legal protection of the nurse practitioner and puts forth the rights and responsibilities of each party. Results: After matching, no statistically significant difference was found in patient outcomes for RHCs in reduced practice states compared to those in restricted practice states. Background: For decades, U.S. rural areas have experienced shortages of primary care providers. “Opening your own practice takes guts, time, and dedication. Limited Practice Authority Twenty-nine (57%) states limit NP practice authority. States with restricted scope of practice — marked red on the map. Yes. Restricted Practice: State practice and licensure laws restrict the ability of NPs to engage in at least one element of NP practice. NPs working in restricted practice states would find it challenging to purchase or own a practice independent of physician direct supervision. In fact, a total of 17 states and the District of Columbia have removed restrictions and granted independence to nurse practitioners. States who are considered having restricted practice, such as California, are overseen by the board of nursing along with physician supervision, delegation or team management. Restricted Practice: “State practice and licensure law restricts the ability of a nurse practitioner to engage in at least one element of nurse practitioner practice. If you’re missing any of those, it’s not worth it,” says Graig Straus, DNP(c), APRN, CEN, FF-NREMT, founder and owner of Rockland Urgent Care Family Health NP … To the contrary, researchers found: “NP visits in states with practice independence had a higher odds of receiving physician referrals than those in restricted states.” SB25 has been endorsed by AARP Pennsylvania, the Hospital and Healthsystems Association of PA, the PA Rural Health Association, and numerous other stakeholders.

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