What are the BEST and WORST States to practice as an NP? - page 6

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... Read More

  1. by   sirI
    Quote from traumaprincess
    I agree. I just recently moved to Tx. and I rarely see NPs. I was from Az where they worked very independantly in many different areas. My goal was NP but I am not sure now that I am in Tx I should pursue it?

    RNcrissy and Siri, thank you for the links. That was VERY helpful.
    Hi, traumaprincess,

    I grad from the U of T years ago and was amazed that the state had education for NP, but didn't utilize NPs. That's not changed much I see. A shame.
  2. by   platon20
    Quote from Traveler
    In Tennessee a NP can set up shop on their own. Perhaps someone else can speak to this better than I, but I believe in Tennessee the only regulation is a physician with whom the NP can collaberate PRN and a periodic review of a percentage of charts.
    Thats not what I call "independent practice"

    What are the states that allow total unmitigated, independent practice? By this I mean myself as an NP can open up a full blown clinic, no MD signature EVER, and I NEVER have to consult with an MD for ANY REASON. No collaboration agreement, no supervision, nothing. Where are these states because thats where i want to move
  3. by   platon20
    Quote from sailornurse
    OK but for NP's it's not as good as it could be. NP's in Texas have to have a "collaborating physician" & they can not write for schedule 2 narcotics, that requires a "triplicate carbon copy" so even some cough meds, NP's can not give. I went to FNP program at UT-El Paso. As for one of the best states to practice in- New Mexico. Np's have complete independent practice with full prescriptive priveledges. Many NP's have their own practices & have admitting priveledges at hospitals. The Board of Medicine does not regulate NP practice as in some states, The Board of Nursing regulates NP practice. Controlled substance regulation for prescriptive authority is issued by Board of Pharmacy.
    OK, are you saying that I can move to New Mexico as an NP, open and run my own clinic, and that I DONT have to have a collaboration agreement with a doctor? I dont have to consult with him, I dont have to have him review charts even once?

    These are the places i'm looking for. 100% independence. NO collaboration agreement, all sched 2 drugs, zero consultation with MD, zero chart review zero cosignatures.
  4. by   platon20
    Quote from Psychaprn
    Only NP's and PA's can write scripts-other than MD's.
    Thats not true.

    Chiropractors
    Psychologists
    Pharmacists
    Physical Therapists

    Can all write scripts in one or more states.
  5. by   suzanne4
    Quote from platon20
    Thats not true.

    Chiropractors
    Psychologists
    Pharmacists
    Physical Therapists

    Can all write scripts in one or more states.
    Sorry, but you are wrong.
    Psychologists do not have prescribing priv., the med order has to come from the psychiatrist, or they can make a recommendation to the PMD, but they cannot write the Rx.
    Pharmacists do not write prescriptions, they can take a verbal order. But they cannot prescribe medication that needs a prescription.
    Physical Therapists can not write a medication prescription, they can order devices for patient, or order treatments, but they cannot order medications.
    Chiropractors in most states do not have prescriptive authority, and if they do, it is severely restricted.
  6. by   mango-lo-maniac
    Psychologists with extra training can write scripts from a limited formulary in New Mexico & Louisiana. Don't know anything about chiros, PTs or pharmacists, though.
  7. by   Nightingale Apolonia
    Quote from traumaRUs
    I don't know guys - Illinois ranks up there on the "worst" list. That's why I'm in a generic MSN program - it doesn't pay to be a NP.
    Why? what do you think IL makes it in one of those in the worst list? ...lol....I'm in IL but still a student- i have some choices where to practice in a few years...choices are NY, CA and IL??? Can you help ?...lol...
  8. by   chazmike
    I DON'T KNOW ABOUT ANY OTHER STATE BUT NP IN KENTUCKY SEEM TO DO ALRIGHT. I HAVE SEVERAL FRIENDS THAT ARE NP AND THEY SEEM TO ENJOY IT. THEY CAN WRITE PRESCRIPTIONS AND EVEN HAVE THEIR OWN CLINICS. THEY HAVE TO HAVE AN AGREEMENT WITH MD IN ORDER TO ADMIT PT. RECENTLY THE LEGISLATURE PASSED LAW THAT NP COULD NOW WRITE PRESCRIPTIONS FOR NARCS. THEY HAVE TO APPLY FOR DEA NUMBER, MEDICARE NUMBER ETC. THIS LAW GOES INTO EFFECT JUNE I THINK. BUT MY FRIEND MAKE A LOT MORE MONEY THAN I DO AS A NURSE EDUCATOR AND HAVE MORE AUTONOMY THAN I DO
  9. by   chazmike
    I Don't Know About Any Other State But My Np Friends Here In Kentucky Seem To Do Alright. They Can Open Their Own Clinics, Write Prescriptions And Beginning In June They Will Be Able To Write Prescriptions For Narc, Get Their Own Dea Numbers Etc. I Only Like 33 Hours And I Am Thinking About Returning To School. My Friends Make A Lot More Money Than I Do As A Nurse Educator. One Of My Friends Makes Over 100,000/year, Pretty Good Money For Me.
  10. by   rnsrgr8t
    I am a PNP in Delaware (who used to live in GA). I moved up here for the job. We are treated very well here. I can perscriptions, have a DEA # so I can write for narcotics and have a UPIN # so I can write/bill for labs and medical supplies for medicaid patients. It is definitely a step up from what it was in GA. It is actually quite ironic because our fellow and residents cannot write scripts for narcotics b/c they do not have their DEA numbers yet.
  11. by   SueBee RN-BSN
    What a shame that any state would make it hard for NP's to provide care. Many people can't afford healthcare/$$$doctors. Many MD's are quitting many of the states listed in this fourm, because malpractice insurance is to costly. Is the NP being MD's controled, thus the MD withholding care from people who need it?

    Here in Missouri I hear NP's have it good, but the CNM can not do diliveries. What a shame.
  12. by   yellow finch
    Quote from SueBee RN-BSN
    What a shame that any state would make it hard for NP's to provide care. Many people can't afford healthcare/$$$doctors. Many MD's are quitting many of the states listed in this fourm, because malpractice insurance is to costly. Is the NP being MD's controled, thus the MD withholding care from people who need it?

    Here in Missouri I hear NP's have it good, but the CNM can not do diliveries. What a shame.
    Here in GA the Georgia Medical Association fought tooth and nail to prevent NPs from earning prescriptive rights. We still won, but it's embarrassing. There are plenty of NP clinics that are managed and run by NPs, NPs assess and diagnose, NPs decide on which prescriptions to write. But the scripts can only be called in with the physician's name even if the MD never sets foot into the clinic or sees patients. Earning a paycheck for doing nothing! Isn't that something?!
  13. by   Papadoc
    Quote from yellow finch
    Here in GA the Georgia Medical Association fought tooth and nail to prevent NPs from earning prescriptive rights. We still won, but it's embarrassing. There are plenty of NP clinics that are managed and run by NPs, NPs assess and diagnose, NPs decide on which prescriptions to write. But the scripts can only be called in with the physician's name even if the MD never sets foot into the clinic or sees patients. Earning a paycheck for doing nothing! Isn't that something?!
    It looks like GA takes the cake of the worst State for NPs for now. I'm sorry to hear that

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