Maryland NPs seek more autonomy

As the debate over expanding advance practice professionals’ scope of practice continues nationwide, nurse practitioners (NP) in Maryland are asking for changes in state laws and regulations that limit their ability to practice independently as primary care providers. They are also seeking more standardization of regulations regarding NPs.

Seventeen states and the District of Columbia have loosened restrictions on NPs; 12 states have very tight limits. Maryland is among those states that have some significant restrictions on nurse practitioners. Among these limits are prescription requirements. Although verbal orders are allowed for certain prescriptions and other patient needs, many written orders require a physician sign-off on the request. Another hurdle is that each NP in the state must have a letter of attestation signed by a physician, even though the physician writing the letter may have little or no experience with general practice.