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.

the american journal for nurse practitioners releases an annual pearson report every february.

this report lists state-by-state presentation (info on what np titles are used in that state, what education is required, rx authority, etc.) as well as an overview of diagnosing and treating and prescribing by state.

you may get a pdf download from http://www.webnp.net/ajnp08.html of the pearson report. read it for yourself -- you'll see where nps are restricted and where they have "free reign."

this was from the 2008 report:

[color=#ffffff]diagnosing and treating [color=#ffffff]aspects of np practice

[color=#ffffff]

[color=#ffffff]no requirement for any physician involvement:[color=#ffffff]

alaska, arizona, colorado, district of columbia, hawaii, idaho, iowa, kentucky, michigan, montana, new hampshire, new jersey, new mexico, north dakota, oklahoma, oregon, rhode island, tennessee, utah, washington, west virginia, wyoming, maine (after the first 2 years of practice)

prescribing aspect of np practice

absolutely no requirement for any physician involvement:

alaska, arizona, district of columbia, idaho, iowa, montana, new hampshire, new mexico, oregon, washington, wyoming, maine (after the first 2 years of practice)

hope this helps.

Specializes in Critical care, gerontology, hospice.

One of the worst states: Florida. Prescriptive authority does not include ANY scheduled drugs, which is a real hassle for me since I work in hospice. We have to file our MD protocol annually. We constantly fight the Florida Medical Association in the legislature, they introduce bills to limit us even further and would get away with it if we aren't vigilant. If it weren't for the particular group I work with, I wouldn't be here.

One of the worst states: Florida. Prescriptive authority does not include ANY scheduled drugs, which is a real hassle for me since I work in hospice. We have to file our MD protocol annually. We constantly fight the Florida Medical Association in the legislature, they introduce bills to limit us even further and would get away with it if we aren't vigilant. If it weren't for the particular group I work with, I wouldn't be here.

We are right there with you here in GA....

One of the worst states: Florida. Prescriptive authority does not include ANY scheduled drugs, which is a real hassle for me since I work in hospice. We have to file our MD protocol annually. We constantly fight the Florida Medical Association in the legislature, they introduce bills to limit us even further and would get away with it if we aren't vigilant. If it weren't for the particular group I work with, I wouldn't be here.

I used to work in pain management in TX, where we can write III-V's. Unfortunately, the vast majority of people in PM are on Schedule II's and it was a major hassle tracking down the doctor to get him to sign the scripts. The DEA license was completely useless.

The majority of NP's I know don't even have a DEA license nor do they want one.

arkansas---the doctors think that we are trying to take their jobs and the rns think we are stuck up...plus the pay is bad

Anyone know about Minnesota? Is it good for NPs

Specializes in Cardiology, Psychiatry.
One of the worst states: Florida. Prescriptive authority does not include ANY scheduled drugs, which is a real hassle for me since I work in hospice. We have to file our MD protocol annually. We constantly fight the Florida Medical Association in the legislature, they introduce bills to limit us even further and would get away with it if we aren't vigilant. If it weren't for the particular group I work with, I wouldn't be here.

I am right here with you. Florida, by far, is one of the hardest states to practice in.

Specializes in SICU,CVICU,ER,PACU.
That's great-- do anything about practicing as an NP in the metro-Detroit area?

At Henry Ford, NPs are working in all areas and my manager said that they were going to increase the hiring numbers for NPs. It's a teaching hospital with a lot of diversity and very interesting cases.

I find the mentality amongst mid level provider to be quite collegial and learning opportunities are endless.

Hope it helps answer your question....

Hey all what about Arizona, New Mexico, Nevada, North or South Carolina??

Im in Michigan and am currently a nurse educator in both the critical care setting of a hospital and a community college. I am going to open my own DBA as home care NP and contract my services.

I am fed up with the AMA and Old boy network that drools all over PAs!!!!!!!!! I am making 100K a year doing this job and can't get near that as an NP very discouraging.

Just a quick correction for the link that was provided by sirI for the Pearson report on NP practice.

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

then you can click on the "download the pdf version" if you want to review it at length

thanks so much for your help I appreciate it! :reindeer:

Specializes in SICU,CVICU,ER,PACU.

My hubby and I are looking at relocating to 2 different locations: southern California or Austin ,TX. I am all for socal but my hubby argues that cost of living is out of hand there. Nonetheless it is still an option....so, my question to ACNPs is: which one of those locations offer most advantages and great working climate (and yes, the income would matter as well). Working in ICU settings, the whole "opening shop" is irrelevant to me. And yes, I have read the reports you guys kindly referenced to, but beside prescription priviledges and ability to be independant in a private practice, it didn't tell me much about the scope of practice for an ACNP, or the income, or the atmosphere and relationship with docs in critical care settings.

I would really appreciate your input. It is a big move and I'd rather not find out for myself that we made the wrong choice .

Thanks to all of you to continue to contribute to this topic !:smokin:

+ Add a Comment