Nurse Practitioner Scope of Practice by State (2024)

Nurse Types / Nurse Practitioner / Scope of Practice

There are currently 27 states, along with Washington, D.C., that grant nurse practitioners (NPs) full practice authority. This means that NPs in those states can perform many of the same tasks as physicians, including prescribing medications, ordering physical therapy, diagnosing and treating medical conditions, and interpreting diagnostic tests.

Some people think that nurse practitioners as less experienced or that their care is inferior to that provided by physicians, but that’s not true. Numerous studies have shown that, in many ways, nurse practitioners provide the same level of care as physicians.

In this post, we will explore the following: 

• Nurse practitioner scope of practice by state
• The meaning of ‘scope of practice’
• Why nurse practitioners are growing in demand

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Nurse practitioner scope of practice by state

Every state has different specifications for what nurse practitioners can and can’t do. Some states are more restrictive than others. For example, in Florida, nurse practitioners cannot diagnose or treat patients without a physician available, while in Washington state, nurse practitioners are able to diagnose, treat, and prescribe medications, including medical marijuana.

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What is ‘scope of practice’?

For nurse practitioners, “scope of practice” refers to the responsibilities and duties they can perform based on their state licensure, as well as their professional qualifications. For example, a nurse practitioner has a broader scope of responsibilities than a registered nurse but 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 medications. They are granted permission to perform these tasks through their state’s board of nursing.

Reduced practice

Reduced practice means that nurse practitioners can participate in at least one element of NP practice. Elements of practice that may be restricted include prescribing certain medications or performing certain medical procedures. Reduced practice also means that nurse practitioners must enter into a regulated collaborative agreement with a physician in order to provide patient care. Each state’s board of nursing outlines its NPs’ scope of practice, which varies from state to state.

Restricted practice

The main difference between reduced practice and restricted practice is the amount of oversight that a nurse practitioner is required to be under. In states with restricted practice, nurse practitioners cannot engage in at least one aspect of NP practice. Restricted practice state laws require that NPs work with a physician throughout their careers in order to provide patient care.

Why are nurse practitioners in such demand?

There are many reasons for the increased demand for Nurse Practitioners, but there are two that stand out above all others. One 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. 

Additionally, America’s population continues to age, and that means that people will require more medical care. By 2025, the population that is over the age of 65 will grow by 41%, while those younger than 18 will increase by only 5%. 

According to the Association of American Medical Colleges, the projected shortage of nurse practitioners will be between 61,700 and 94,700. This leaves an enormous vacuum for nurse practitioners to fill, and tremendous opportunity along with it.

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