What are the BEST and WORST States to practice as an NP?

Specialties NP Nursing Q/A

I am speaking primarily from two perspectives here:

1. The degree to which NP's are accepted, recognized, and utilized in that area/state.

2. The degree to which state law recognizes NP's, and grants them autonomy, and privledges such as the ability to write prescriptions.

Specializes in ICU.

I wish my husband would be more of an adventurer. As of now, he doesn't want to leave his comfort zone in order for a better life. What are the chances that once I graduate I'll enjoy a more rewarding career as a FNP compared to my current job in GA?

Granted, I probably won't have to work the awful nights, weekends, and holidays as often. :)

I think it's time I join some groups to fight for independency for APRNs.

What is NY like for NP's?

Hi. Can someone please tell me how Texas is like for NP's based on earnings and level of independence? Thank You.

Specializes in ICU, CV-Thoracic Sx, Internal Medicine.

I believe TX is one of 7 (maybe 12) states that requires MD endorsement (supervision) for prescriptive priviliges and limits drug class that NP's are allowed to write for. From some e-mails that I've received from my school and CNAP it appears that TX is pretty restrictive (albeit it's relative to what state you reside in now). Hope that helps.

Hi. Can someone please tell me how Texas is like for NP's based on earnings and level of independence? Thank You.

I live in Texas and we are presently fighting for complete independence from physician oversight. We're going after it in urban and rural areas, but the MD lobbyists are fighting us like crazy, but I really feel we'll get it in rural areas. I wonder if there are any states that allow NP's to practice

independently in rural areas only?

As far as earnings, it just depends on where you live. I've heard that NP's in Austin are a dime a dozen and make around 65K-70K annually. However, I'm seeing 6 figure salaries in rural areas and in the Houston area. It's all about supply and demand. Hospitalist NP's are in high demand in South Texas and they are all earning >100K. TX is VERY restrictive as far as scope of practice, so you'll need to be an Acute Care NP in order to practice as a hospitalist around here.

I believe TX is one of 7 (maybe 12) states that requires MD endorsement (supervision) for prescriptive priviliges and limits drug class that NP's are allowed to write for. From some e-mails that I've received from my school and CNAP it appears that TX is pretty restrictive (albeit it's relative to what state you reside in now). Hope that helps.

NP's in Texas can write controlled substances (Schedules III-V), but we must have a DEA # tied to a physician in order to do so. However, there are very few NP's who even bother to get a DEA number, because it isn't necessary to have one in order to write prescriptions. I practice in both primary and urgent care and it's very rare that I need to write a controlled substance. I know NP's and PA's who don't have a DEA number, so they just have a protocol set up with their SP and they just call the script into the pharmacy under the doc's name or have the doctor sign it if he's available. In the chart, they indicate that the medication was ordered by the doctor.

Also, we aren't allowed to write for more than a 30 day supply of a controlled substance nor are we allowed to refill a controlled substance. I actually LIKE it that way, b/c it gives me a way out when a drug seeker is asking for Lortab, etc.

Another thing, it cost $25.00 to get a TX DPS license and then $550.00 to get a DEA license, so make sure you get your SP to pay for it.

What is the market like for NP practice in Ohio? Cincinnati, Dayton, or Columbus areas?

Hi. I am a psych np in north florida. While we have prescriptive ability we cannot write for controlled substances. Reimbursement for nps by 3rd parties is terrible. We are under protocol with an MD. Some physicians are welcoming, some are threatened by us. Florida is very southern when you are north of orlando.

So whats the theory of better practice? We were told in school the further north the better the practice....

So I am guessing us folks in the south especially in the so called bible belt have the good-boy league against us.

Does practice rights/regulations seen to improve north-east or north-west..

Iowa does not--NPs in Iowa have full prescription rights.

What is NY like for NP's?

I worked as a RN in NYC and I remember it being tough for NP's b/c there are so many doctors there. It seems that everyone wants to live in the Big Apple, so there really isn't a shortage of physicians.

Can you give me more info on NP's in Florida?

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