Report gauges the state of NPs’ scope of practice

Nurse practitioners (NP) seeking to practice with no restrictions should look for work in the Pacific Northwest, upper New England, or the Rocky Mountain states, but not the South, according to an issue brief by the Kaiser Family Foundation. The brief, titled “Tapping the Potential of Nurse Practitioners to Meet Rising Demand for Primary Care,” was released this week.

Today, NPs in 19 states and the District of Columbia have full practice authority, the brief states. Nineteen states require NPs to have a formal, written collaborative agreement with a physician to provide care, and these states restrict NP practice in at least one domain (e.g., treatment, prescribing). The remaining 12 states require physician supervision or delegation for NPs to provide care.

States in the Pacific Northwest, the Mountain States, and Northern New England, which generally have few primary care physicians and large rural areas, are more likely to permit broader scope of practice for NPs. However, states in the South, even those with large rural areas, are among the most restrictive states.