NP Independent Practice States

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Hi all.

I am in the NP program and getting ready to move as a new NP. I currently live in an independent practice state and would like to move to another state that allows NPs independent practice. I have looked for a definitive list of which states are independent, heavily regulated, moderately regulated, and minimally regulated. I found one list but it was published in 2007 and I'm wondering if there have been any changes. Does anybody have a complete list of states?

Thanks,

Sarah

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Hi all.

I am in the NP program and getting ready to move as a new NP. I currently live in an independent practice state and would like to move to another state that allows NPs independent practice. I have looked for a definitive list of which states are independent, heavily regulated, moderately regulated, and minimally regulated. I found one list but it was published in 2007 and I'm wondering if there have been any changes. Does anybody have a complete list of states?

Thanks,

Sarah

Hawaii just went independent. Others are New Mexico, Arizona, Alaska, District of Columbia, Idaho, Montana, New Hampshire, Oregon, Rhode Island, Washington, Wyoming. That's all I know of.

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Specializes in ICU, ER, OR, FNP.

Texas is one of the "heavily regulated". The Texas Association of Family Physicians prides itself on defeating every measure taken to the legislature regarding APRNs. Texas is probably going to be in the dark ages for some time to come.

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Texas is one of the "heavily regulated". The Texas Association of Family Physicians prides itself on defeating every measure taken to the legislature regarding APRNs. Texas is probably going to be in the dark ages for some time to come.

Which is why, as a Texan, I'm right next door in New Mexico.:D

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Specializes in acute care.

Maine is independent after 24 months of supervised practice.

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Vermont also has independent practice if you have been an NP for 2 years or more. Just passed the new legislation about a month ago!!!

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Allright! That's great! :yeah:

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Vermont also has independent practice if you have been an NP for 2 years or more. Just passed the new legislation about a month ago!!!

This is great to hear. Does this supervised practice (which should absolutely happen anyway, legislation or not) have to happen in vermont? or could you have done 2 years in another state and move to Vermont and open your own clinic?

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I am curious if there has been discussion as to moving legislation forward nationally on this by means of the commerce clause in the U.S. constitution? I am a new APRN, and also an attorney, and this seems to be an avenue worth exploring as the Commerce Clause protects the rights of people in the U.S. to move freely from one state to another without encumbrances. I imagine it has been discussed but just curious how it might impact the discussion.

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I am curious if there has been discussion as to moving legislation forward nationally on this by means of the commerce clause in the U.S. constitution? I am a new APRN, and also an attorney, and this seems to be an avenue worth exploring as the Commerce Clause protects the rights of people in the U.S. to move freely from one state to another without encumbrances. I imagine it has been discussed but just curious how it might impact the discussion.

If the commerce clause doesn't restrict the ability of states to continue to license and regulate the practice of RNs, physicians, attorneys, plumbers, electricians, etc., within their own borders, I don't see how an argument could be made that NPs are some special case.

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In theory states are supposed to recognize the licenses of other states, like drivers licenses. However, states can regulate how you operate your vehicle within their boarders. Of course this isn't the case with all licenses as we see with concealed carry permits. So in theory there is no basis for one state to recognize the practice rights of another state, but they should recognize your right to practice within that states standard of practice.

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In theory states are supposed to recognize the licenses of other states, like drivers licenses. However, states can regulate how you operate your vehicle within their boarders. Of course this isn't the case with all licenses as we see with concealed carry permits. So in theory there is no basis for one state to recognize the practice rights of another state, but they should recognize your right to practice within that states standard of practice.

Driver's licenses are recognized (only) because all the states got together back in the dawn of the Automobile Age and signed a compact agreeing to do so (a compact is like a treaty, but within regions of a country rather than between two or more separate countries), the same as the NLC (Nurse Licensure Compact) except that not all states have chosen to sign the NLC. And new legislation has been introduced to try to force states to recognize other's states concealed carry permits (which suggests that there is no existing requirement or encouragement that they do so). I've never heard a "theory" that states are "supposed" to recognize licenses across state lines; I've always heard exactly the opposite -- that states maintain the right to license and regulate practice within their own borders (and I am one of the many who does not want to see that get changed).

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