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What You Need to Know About Nurse Practitioner Practice Authority – Get the Facts

What You Need to Know About Nurse Practitioner Practice Authority – Get the Facts

It’s no secret that the health care industry has been growing by leaps and bounds over the past few years. Plenty can be attributed to this growth including the baby boomer generation who are now retiring and relying on health care services more than they were in their younger years. It’s put a lot of new strain on the health care system and created an influx in jobs.

And it’s not just the baby boomers who are dictating this growth, there is also the fact that people, in general, are just more in touch with their health and well-being. No longer is medicine and care thought of as a response only, it is also being seen as a preventative measure. 

What makes the growth even more exciting is the fact it’s not just in the traditional careers, there are new and exciting paths that health care workers can take to secure their future in the industry. Nurse practitioners are nothing new, but there has been a real shift in how these professionals are viewed and now many states are providing them with practice authority. So what is practice authority and what can it mean for your future in the health care industry? 

Let’s work through all the facts.

The History of Nurse Practitioners

Before diving into practice authority and what the prospects are for nurse practitioners, it can be helpful to look back at their history. It was back in 1971 that nurse practitioners were first recognized. The first state to do so was Idaho, giving these professionals the ability to diagnose and treat patients. It didn’t take long for this career to take off, and just two years later there were over 65 different programs across the country meant to train nurse practitioners. From there, the country hasn’t looked back, continuing to grow this field each year.

The exciting change happened in 1994 when five states made the move to recognize nurse practitioners by providing full practice authority. Today, there are now 22 states that offer full NP practice authority.

What Does Full Practice Authority Mean?

For those not in the field of an NP, you may not be familiar with the term full practice authority. What this means is that nurse practitioners can give their patients primary care to the “full extent” of the post-graduate education they pursued, their clinical training, as well as their national certification. Some of the duties they can perform include:

  • Diagnosing patients
  • Evaluating patients
  • Prescribing medications for patients, which can include controlled substances
  • Managing treatments for patients
  • Ordering and then interpreting various diagnostic tests

In a nutshell, practice authority means a nurse practitioner can go ahead and practice and prescribe the same way a doctor would. This can be done without any supervision – full practice authority.

What States Offer NP Full Practice Authority?

If you wish to pursue a career as a nurse practitioner, you may be curious to know which states offer full practice authority. This can help you to decide where you go to school and ultimately settle down for your career.

The states that offer full practice authority for NPs are:

  • Alaska
  • Arizona
  • Colorado
  • Connecticut
  • Hawaii
  • Idaho
  • Iowa
  • Maine
  • Maryland
  • Minnesota
  • Montana
  • Nebraska
  • Nevada
  • New Hampshire
  • New Mexico
  • North Dakota
  • Oregon
  • Rhode Island
  • South Dakota
  • Vermont
  • Washington
  • Wyoming

Also included in the list is the District of Columbia.

What Are the Relevant Statistics for Nurse Practitioners?

Because you need higher education to become a nurse practitioner, the salary will reflect that level of education. According to the U.S. Bureau of Labor Statistics, nurse practitioners had a median pay of $117,670 in 2020. The field is growing at an astronomical rate right now, with jobs expected to grow by 45% by the year 2029. That is much faster than the national job growth average.

It should also be noted there are a handful of states where you can make well above the median pay, these include California ($145,970) and New York ($126,440). Of course, you also need to take into account these states can have a higher cost of living, so that has to be worked into your equation.

The Conversation Is Still Happening

The fact nurse practitioners have practice authority in so many states is a positive step forward, but it’s also an ongoing conversation. Regulatory laws and legislation are notoriously changing, and it varies from state to state. This can positively or negatively affect NPs. Outside of the full authority practice, there is also reduced and restricted practice. If you want to be able to control your career path, a full authority practice is the best option.

The most limited is restricted practice and as of right now, only 12 states have designated NPs in this category. Keep in mind even the restrictions themselves will vary depending on the state, it’s not a blanket set of rules. A restricted practice means that a nurse practitioner can still treat patients but must be under supervision while doing so. That supervision needs to come from a physician.

The Trends Shaping the Future of NP Full Practice Authority

Any time you are looking to change careers, pursue higher education, and forge a new path it makes sense to take a look at the current trends. This can help to paint a picture of what a job as a nurse practitioner would be like, giving you realistic expectations for the immediate and long-term future.

Right now, there are a whole lot of pros in terms of trends, which paints a very bright picture for aspiring nurse practitioners. People are now starting to see NPs as a way to fill the gap in the health care industry, providing more access to more patients across the country. Not every person out there has a physician, and they can be difficult to find in more rural or remote areas. That is the gap that NPs can fill, giving patients the care they need. This is more the case in states where full practice authority has been given.

It’s becoming quite clear that by providing more access to health care the patient outcome is much higher, and suddenly you can move into preventative care – which is best for the health and the economy. There have even been some studies that show increasing access to NPs can reduce the amount of ambulatory care and emergency room visits. This frees up those emergency services to deal with more pressing issues. It’s a domino effect but in a good way.

Is It Easy to Set Up Your Practice?

You may be wondering if it’s easy to set up your full authority practice. You should still view it as a business and in that sense, you are a start-up. Sure, it may be an easier business to begin in terms of attracting “customers”, but it is still a start-up. This means you’ll have challenges, growing pains, obstacles, and issues to overcome. That should deter you from following your career dream though, as owning a practice can prove to be incredibly fulfilling.

Some of the benefits in becoming an NP with full practice authority is that you are in control of your career, it is a challenging job, it is extremely rewarding, you can work with all ages, you will feel as though you’re giving back to the community, each day will be fresh and new, you can set your hours, it will appeal to your specific passions and talents, the salary is quite good, there is still room for advancement (there’s no need to feel “stuck”), and it can help you to achieve the perfect work-life healthy balance you’re striving for.

Those who have successfully set up a nurse practitioner practice do have some helpful advice and tips to share. Some of the main messages they convey include:

  • Make sure you’re mindful of cash flow. You will need to deal with Medicaid and Medicare as well as HMOs. Knowing the in’s and out’s will help your business to get off the ground. Experts also point out that you should assume that for at least the first six months your expenses will far exceed your income, so be prepared.
  • You should also take the time to learn the law so you know exactly what kind of practice is allowed in that state.
  • You’ll need to hire excellent, qualified, and skilled staff to ensure the office runs smoothly – just like a professional business should.
  • It wouldn’t hurt to pick a niche, as this can help you to stand out from other health care practitioners and even position you as an expert in the field.
  • Make sure the office space you choose is convenient, comfortable, and functional for you and your patients.

An Exciting Path to Follow

The fact is that it is a very exciting time for those eyeing a career as a nurse practitioner. The job is very much in demand and with so many states offering full practice authority, it makes the career path all the more attractive.

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