Prescriptive Authority

Prescriptive privileges differ from state to state. Some states NPs can prescribe all classes of medications/narcotics, some states are restricted to prescribing NO narcotic medications (a higher dose of Robitussin falls in this category). As far as when you'll be able to prescribe, I think that depends on the state too...Does your state require a collaborating physician? Then there's more to think about than how many hours are involved...I think it's a little funny that you're considering FNP and your only question is about prescriptive privileges.

Every state is individual. In CA for example, the APNs are required to have additional work hours before they can prescribe and in CA they don't call it prescribing either.....hmmmm....can someone help me out with what they do call it?

I live in IL and APNs (NP, CNS, CNM, CRNA) have prescriptive authority once you are licensed.

...they actually call it "furnishing" and you need an additional Nurse Practitioner Furnishing Number on top of your NP license to write scripts. It does involve showing proof of having completed an Advanced Pharmacology course and 520 hours of physician supervised experience in furnishing drugs and devices. It sounds like LA has a similar rule as CA.

As already mentioned, prescriptive authority are spelled out differently in each state. I moved from Michigan where NP's can prescribe as a "delegated authority" from a collaborating physician and all that is required is a document that details the collaboration. Supervised hours are not required.

500 hours is roughly 2 months. That could be the length of a nurse practitioner's orientation as a new grad and new employee in a collaborative practice with a physician. That could involve having the NP see patients and discuss the assessment and plan with the physician including the need for prescriptions, and having the physician write the scripts. Once the NP is granted the prescriptive authority, it is renewed at specific intervals and there is no further requirement for physician supervision for renewals (at least in CA). I'm assuming that physicians in states with similar rules are used to this.

I am writing a paper on prescriptive authority for the NP in Michigan and am unable to find the information for general prescriptions (nonnarcotic meds). Could anyone please point me to the information? The question for my paper is: "How does an NP apply for AND maintain prescriptive authority in Michigan?" The only information I can find is from Minurses.org on narcotics (not seeking narcotics). Any assistance would be greatly appreciated. Also, if anyone has a great article on ethical /legal considerations, would be appreciated. No. 1 is my most pressing question. Thank you. (Sorry, I could not find the link for a "new post" other than reply.).

Michigan is one of those states that is more of an "exception rather than the rule" in terms of NP practice. There is actually no detailed scope of practice for NP's written in the laws of the state. The practice of NP's rely on separately written documents outlined in the Michigan Public Health Code which defines nursing as a profession, defines delegation of the act of prescribing to a nurse with advanced education, and allows the board of nursing to grant specialty certification to nurses who are NP's, CNM's, and CRNA's. The link provided by Minurses.org is basically a summation of how the practice of NP's are covered by the law.

The state recognizes (though not expressly written as such) that Nursing and Medicine are separate professions and that advanced nursing practice falls under Nursing and not Medicine. In this regard, there is no expressed requirement of physician supervision in terms of practicing as a nurse practitioner because our practice falls under nursing. This is the reason why Michigan is listed as one of the states where a nurse practitioner can practice solo.

However, the practice of nursing as the state defines it does not include the authority to issue prescriptions. In order to allow non-physicians to prescribe, the law states that physicians can delegate the act of issuing prescriptions to nurses with advanced education as well as Physician Assistants. This is also found in the Michigan Public Health Code under the Section on the Practice of Medicine.

I encourage you to read items in the Michigan Public Health Code in the link below in addition to the link provided by the Michigan Nurses' Association on Advanced Practice.

http://www.legislature.mi.gov/(S(tdt...ct-368-of-1978

NP Gilly,
Thank you *so much*for your clarification. I will read the link you provided and see if this does not clear up my confusion specifically on NP prescriptive authority. (Understand must work w/ collaborative agreement with physician). Thank you for taking the time to explain.
aquakat