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.

Here is a great reference with each state regarding legisative issues for NPs (includes legal authority, reimbursement, & prescriptive authority)

Philips, S.J. (2006) Eighteenth annual legislative update: A comprehensive look at legislative issues affecting advanced nursing practice. The Nurse Practitioner, 31(1), 6-38.

www.tnpj.com

I wonder why California is waiting until 2008 to require NP's to have a master's degree? Anybody know?

They have a large whiney lobby - look at san fran freeko - the legislature refusing to cooperate with the FEDERAL government regarding illegal aliens, its a disgrace.

How is Florida? I hear it isn't so good and can't prescribe controlled substances...is that going to change anytime? (I hear there are plans to change that)

Thank you

Specializes in Education, FP, LNC, Forensics, ED, OB.

Hello, flute421,

Read the Pearson Report that core0 provided regarding RX privileges in FL. I don't have firsthand information if this will change or not.

http://www.webnp.net/images/pearsonRpt_07/Alabama_Georgia.pdf

http://www.webnp.net/ajnp08.html

http://www.webnp.net/downloads/pears..._pearson08.pdf

Specializes in Nurse Practitioner-Emergency Room.

Hi, I was just admitted into a nurse practitioner program in Kentucky. I'm not sure, but it seems that NP practice in Kentucky seems pretty good. They can write prescriptions independent from MD's, including writing controlled drugs. There are regulations (only 2 wk. supplies or certains drugs, etc.) NPs must have a collaborative agreement with an MD, which states that the MD is available for consultation with the NP regarding any prescription they write, but they don't have to sign any prescriptions or charts. Many NPs work in our emergency department, and the MDs don't have to sign anything for them, but they do have to sign all of the PAs stuff in KY. Many nurse practitioners in my area have their own office, and practice independently. They are limited on procedures though. Pay isn't that bad either it doesn't seem. It depends on who you work for. NPs working for staffing agencies in EDs around here make over 80K a year, which seems resonable to me. I'm not sure what they make in other states, and nurses around here aren't paid as well as some states, but the cost of living where I'm at isn't as high as many other places either.

Being from Mississippi I can rebuke this information. A lot of patients are beginning to choose NP's over MD's or DO's for their PCP. They appreciate the fact that most NP's bring a more caring, holistic aspect of healthcare to the relationship. Some physicians do still choose to relagate the NP to the back seat and see them as someone there just to lighten their load ( a glorified office nurse), but the really good NP's gain respect from the physicians when they can show a high level of expertise in decision-making, referrals and consults.

Being from Mississippi I can rebuke this information. A lot of patients are beginning to choose NP's over MD's or DO's for their PCP. They appreciate the fact that most NP's bring a more caring, holistic aspect of healthcare to the relationship. Some physicians do still choose to relagate the NP to the back seat and see them as someone there just to lighten their load ( a glorified office nurse), but the really good NP's gain respect from the physicians when they can show a high level of expertise in decision-making, referrals and consults.

Brighteyes,

I am glad to hear this! Those specifics you mention, decision making, etc. are skills that not all doctors have, nor are they encouraged to by their training.

I am, in fact, one of those people who switched for my daughter's primary care person. We had been seeing one of the NPs in the pediatric office, and after a few visits, realized we preferred her, particularly her efforts to see the whole picture, instead of the particular complaint at the moment.

Diahni

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.

traumaRUs:

what would you say about Massachusetts?

Diahni

Specializes in EMERGENCY, FAMILY MEDICINE.

thanks for all the info. i am going to begin np here in dallas tx. i still researching regarding pay and priviledges that np have.

In NJ APN's are very independant. In So Jersey all the oncologists have them in their offices. I manage a HIV clinic and I have 2 APN's that have their own patient load

In NJ APN's are very independant. In So Jersey all the oncologists have them in their offices. I manage a HIV clinic and I have 2 APN's that have their own patient load

I can vouch for that. I was used to seeing my NPs in Philadelphia, where there has to be a doctor on-site (at least for their particular specialty), and where the prescriptions and test orders are always done in the Dr.'s name only. When I went to see an FNP in Southern NJ, I was surprised that she ran her own office. Her Rx pads list a "Consulting Physician" in another town about 45 minutes away, but her name is listed prominently as the prescriber. I asked if the Dr. was ever in the office I visited and was told no, she didn't have/need to be. We even have a couple of NP/MD partnership practices around here that I know of, where the NP's name is listed as prominently as the doctor's in all advertising.

Specializes in Psychiatric.
Yes, New York and Tennessee are 2 that I know of.

Connecticut too!

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