states NP's practice solo?

Columnist · Dec 15, 2006

I'm pretty sure if you search this forum, you'll find this topic covered in several other threads. :)

As far as total independence, I know New Mexico allows this. I don't know if there are any other states that give NPs complete independence or not.

Trube · Dec 19, 2006

It varies by state. I live in Oregon. We can work indipendantly of a physician. As a relatively new grad, I would not think of hanging a shingle and doing my own thing.

That being said, I do work part time in a NP only practice. There are 4 of us total, and I like having someone to turn to when I have questions. I feel comfortable with their level of experience. As a practice, we have a number of informal physicians we can call on to ask questions.

My other job requires me to work closely with an orthopedic surgeon. I have a very good relationship with him and use him as a tremendous resource.

core0 · Dec 20, 2006

what states can an NP practice solo in? How solo? Like have an office w/o a doc?

Here is a list of states that allow independent practice (this is way harder to find than it should be).

NP Scope of Practice - American College of Nurse Practitioners

David Carpenter, PA-C

ANPFNPGNP · Jun 24, 2008

Here is a list of states that allow independent practice (this is way harder to find than it should be).
NP Scope of Practice - American College of Nurse Practitioners
David Carpenter, PA-C

I noticed that OK is on the list that practices independently. This is an error. OK still requires NP's to collaborate with physicians.

core0 · Jun 25, 2008

I noticed that OK is on the list that practices independently. This is an error. OK still requires NP's to collaborate with physicians.

There is another list around here that has a list of states where there is no physician involvement required to prescribe or to practice. If I remember its around 11 states. It used to be up in the sticky section but I think it got merged. I'll see if I can dig it up. Basically you take all the states in the Pearson report that allow practice without physician involvement then subtract those that require physician involvement for prescriptive authority.

David Carpenter, PA-C

dhigbee · Jun 25, 2008

I noticed that OK is on the list that practices independently. This is an error. OK still requires NP's to collaborate with physicians.

Well, not really. In Oklahoma our practice is independent, and is regulated by the state BON. In order to prescribe, however; we need a "supervising physician", who is available via telephone or email (or onsite) should we need a consult. The physician supervises our prescribing, not our practice... Clear as mud? :cool:

Dana

Editorial Team / Admin · Jun 25, 2008

david, the thread you're thinking about is found in this thread:

other "sticky" threads of interest - please read - specifically in this thead: what are the best and worst states to practice as an np?

here is the the pearson report 2008 as published in ajnp

BarbaraNP · Jun 25, 2008

In Washington state we are independent.

ANPFNPGNP · Jun 25, 2008

Well, not really. In Oklahoma our practice is independent, and is regulated by the state BON. In order to prescribe, however; we need a "supervising physician", who is available via telephone or email (or onsite) should we need a consult. The physician supervises our prescribing, not our practice... Clear as mud?
Dana

The TXBON says the same thing, but this is not independence. When we don't have any connection to a physician at all, then we can consider ourselves truly independent.

I looked up the rules on the OK BON and it doesn't look any better for your guys than it does down here in TX.

BTW, I used to live in OK City and I remember the medical community being very anti-NP and pro-PA. It's very different in TX or at least in the areas where I've lived.

cluelessRN81 · Jun 25, 2008

.....

Dr. Tammy, FNP/GNP-C · Jul 2, 2008

BTW, I used to live in OK City and I remember the medical community being very anti-NP and pro-PA. It's very different in TX or at least in the areas where I've lived.

Physicians probably like the control over PA's where as APN's operate in a totally separate discipline. Control is the key. The only control that physicians have over APN's is the control APN's allow physicians to have over APN practice. APN's allow this control to continue in many different ways, not the least of which is in our fragmented thinking of how we practice. More often than not, I have read that APN's truly consider themselves as engaged in the practice of medicine and not the practice of advance nursing. Until this changes, APN's will have no choice than to be controlled by physicians, just like PA's, since most affirm that they are practicing in another discipline (medicine) in which they are not licensed (e.g. physician and surgeon).