What are the prescriptive authority allowed new NP in your state?

  1. 0
    Hi all.

    I am a FNP student in Colorado. They are changing the law in CO for ANP for prescriptive authority for new NP or if you transfer to CO for practice.

    On or about July 2010, all applicants for ANP who wish to prescribe must:

    1) Before you are even given a "provisional" prescribing license you have to complete 1800 hours with a physician or physician and NP team with their signatures. You do not have a license to prescribe medicine so how do you do this? Work free for a year and trying to find a doctor that will let you follow him around for a year? !

    2) AFTER that you are granted a provisional license and must complete ANOTHER 1800 hours with a signed plan with a proctor physician.

    Then you have full prescriptive authorithy within the scope of practice.

    Initially, I thought that is not so bad. However, please help me understand this because may be your state is all ready like the above requirements......my later concern.....It appears that after I graduate and pass my boards that I will have to work for a year before I can get prescriptive, even provisional. Not a good job prospect. How can you complete 1800 hours of a mentorship without even a provisional license to prescribe medications?! I can see a provisional license for the first year, but it sounds like when I graduate I will have to find a physician willing to hire me or allow me to "follow" him around for a year when I can't prescribe medications until that.

    Help me understand. I am now thinking about not finishing my NP degree if that is that way. It sounds like my job prospects will be very dismal for the first year, because I can't prescribe medicines at all until I "work" for 1800 but can't prescribe meds?

    I hope I am reading this wrong.

    Thanks.
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  3. 11 Comments so far...

  4. 0
    That does sound very restrictive, and no, we don't have a similar rule in my state (MI). I'm sure the new NP's have found a way to work around administrative rules like that. For instance, an ACNP working in a hospital setting would probably write medications as a verbal order and have the physician sign later during team rounds. FNP's in a clinic setting would probably write the prescription and physically approach one of the physicians on the team to have the prescription signed. Note that this would require that you discuss the case with the collaborating physician including stating your patient assessment and plan and why you are starting the medication/s you want prescribed. I am assuming such a rule came about to allow for a very close collaborative relationship with a physician during the first year of NP role transition. If it's any consolation, you can always move to a more permissive state once you're ready to practice.
  5. 0
    I live and practice in IL and APNs can prescribe up to class II. Our class II prescriptive authority has been approved but the rules are being hammered out. APNs in IL are NP, CNS, CNM and CRNA.

    Sounds very restrictive to me also.
  6. 0
    Thank you for your reply. As an attorney, I should have researched the law better. :-). Here is what I found out:

    They are changing the law in CO. Right now NP have to have 1800 hours of working with a physician before they can be given authority to write prescriptions. Now they are adding an extra 1800 hours. THEN after that the NP has independent prescriptive authority up to class IV medications. So they are in essence making you do 1 year working with a physician where he has to sign your prescriptions, your second year you have to work with a physician in a working agreement but can write your own prescriptions. After the 2 years so you are independent.

    CO's board for making the rules consists of MDs and NPs to it is compromise to expand the NP prescriptive authority. They gave us independence after 2 years, but increased our needed MD involvement by an extra year. It is going to add some difficulty to getting a job as a new graduate, but if you can get employment under MD for 1 year, you can get to the independence soon.

    If you transfer in from another state. You have to prove you have had 2 years of prescriptive authority before you can be granted prescriptive authority.
  7. 0
    Hi ya. That does sound very restrictive, however, the laws vary all over the map. Here in CT, APRNs as prescribers need all the academic qualifications and licenses AND a collaborative agreement w. a physician for supervision. This is interpreted in various ways and is not very effective. I expect CT will go the way of many other states in the next few years and allow autonomous practice. Good luck to you!
  8. 0
    Here in NH, we have autonomous practice, no physician involvement required. I also work in MA and a collaborative practice is in effect. I do not have a physician on site, but available by phone or Email.
  9. 0
    In California NP's are simply medical technicians and can only "furnish" medications--not prescribe. This is largely due to many factors. First, NP's have very little sense of the importance of, or the capability to distiguish between the practice of medicine and that of advanced practice nursing. Many APN's truly believe they are practicing medicine and not advanced nursing. Acording to our state board of nursing (all but one who were recently fired) nursing functions which "encroach the practice of medicine" must be covered under a standardized procedure. Second, the physician groups have a pretty tight strangle hold on the process, such as their anti-NP campaign that caused NP's not to go independent last year.

    Hopefully, one day, APN's in California will understand that nursing-directed care is the basis for practice at the APN level. Dentists and optometrists prescribe in their practice which does not constitute the practice of medicine, and hopefully one day, prescribing will be considered an APN function without the need for supervision by another separate profession.
  10. 0
    In New Mexico, as I understand it, once I received my CNP license I am allowed to prescribe any drug or DME except CS. I applied to the board of Pharmacy for a cs license, once they issue I have to apply for and be approved if not have the dea number to the tune of $550 for 3 yrs. After that it is soup to nuts.

    My quandary is how do I get a prescription pad for the small business I am going to start?
  11. 0
    Quote from nursetim
    In New Mexico, as I understand it, once I received my CNP license I am allowed to prescribe any drug or DME except CS. I applied to the board of Pharmacy for a cs license, once they issue I have to apply for and be approved if not have the dea number to the tune of $550 for 3 yrs. After that it is soup to nuts.

    My quandary is how do I get a prescription pad for the small business I am going to start?
    Covered here:
    http://allnurses.com/nurse-practitio...er-298749.html

    That being said tamper proof laser paper and an EMR is the way to go.

    David Carpenter, PA-C
  12. 0
    Hi, I just have a quick question. I just posted my question on this website, but what would you have to do in michigan after applying for DEA license? I just applied for my DEA license as a NP and people say I need to fax a copy of my license/certification and a copy of prescriptive authority or letter with my supervising physician's signature. My classmates' companies did all this work for them and I'm going though this all by myself. Will you please tell me what I need to do to be able to prescribe the schedule II meds and the letter thing?


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