The 10 Worst States To Be A Nurse Practitioner


 
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By Allana Akhtar

Nurse practitioners are among the fastest growing jobs in the US — making about $113,930 per year — and are in high demand in rural areas with few doctors.

Yet some state regulations, called scope of practice laws, bar nurse practitioners from practicing without doctor supervision.

These are the 10 worst states to be a nurse practitioner, according to data from staffing firms

Nurse practitioners are among the fastest-growing — and most in-demand — jobs in the US, according to the Bureau of Labor Statistics. Plus the job's lucrative: these medical professionals can expect to make $113,930 per year, BLS reported..

Yet some states bar nurse practitioners from practicing without the supervision of a doctor. Scope of practice laws dictate the type of care a nurse practitioner can provide.

In most states, nurse practitioners can evaluate, diagnose, and treat patients by prescribing medicine — following the recommendations of the National Academy of Medicine and the National Council of State Boards of Nursing. Nurse practitioners are taught these skills in higher level nursing programs.

Still, some states reject these recommendations and restrict a nurse practitioner's ability to treat patients without a doctor present. This is most common in southern states, where rural areas already face a shortage of doctors, and nurse practitioners' ability to treat patients is restricted.

Nurse practitioners can help fill healthcare gaps in areas where there are few doctors, according to a 2018 study by the University of Michigan. While doctors tend to practice in affluent neighborhoods, nurse practitioners serve low-income communities, which could make up for the lack of doctors, the study found.

Here are 10 of the worst states to be a nurse practitioner due to scope of practice laws.

1. Florida

Florida consistently ranks as among the worst state to be a nurse practitioner due to strict supervision laws.

Full, reduced, or restricted practice: Restricted

Autonomous practice restriction: Nurse practitioners cannot independently diagnose and treat patients without physician involvement.

Primary care provider: State statute does not define whether nurse practitioners can be primary care providers.

Ability to prescribe medication: Nurse practitioners in Florida may only prescribe certain drugs as specified in a protocol.

2. Georgia

Georgia's rural communities lack access to healthcare, and the state is currently experiencing a shortage of nurse practitioners.

Full, reduced, or restricted practice: Restricted

Autonomous practice restriction: Nurse practitioners cannot independently diagnose and treat patients without physician involvement.

Primary care provider: State statute does not define whether nurse practitioners can be primary care providers.

Ability to prescribe medication: Nurse practitioners in Georgia may only prescribe based on the specialty of their collaborating physician and the Georgia Composite Medical Board's authority.

3. Tennessee

Tennessee doctors have fought back against expanding scope of practice laws for nurse practitioners, even amid a statewide physician shortage.

Full, reduced, or restricted practice: Restricted

Autonomous practice restriction: Nurse practitioners cannot independently diagnose and treat patients without physician involvement.

Primary care provider: State statute does recognize that nurses can act as primary care providers.

Ability to prescribe medication: Nurse practitioners may prescribe a limited amount of drugs with pre-authorization.

4. Texas

Nurse practitioners in Texas must work under the supervision of a physician within a 75-mile radius.

Full, reduced, or restricted practice: Restricted

Autonomous practice restriction: Nurse practitioners cannot independently diagnose and treat patients without physician involvement.

Primary care provider: State statute does recognize that nurses can act as primary care providers.

Ability to prescribe medication: Nurse practitioners may prescribe certain drugs after completing an educational requirement in advanced pharmacotherapeutics.

5. North Carolina

In February, North Carolina introduced a bill that would give nurse practitioners more autonomy.

Full, reduced, or restricted practice: Restricted

Autonomous practice restriction: Nurse practitioners cannot independently diagnose and treat patients without physician involvement.

Primary care provider: State statute does not define whether nurse practitioners can be primary care providers.

Ability to prescribe medication: Depending on their education and certification, nurse practitioners may prescribe limited amounts of legend drugs and controlled substances.

6. Michigan

Michigan nurse practitioners are not explicitly recognized as primary care providers under state law.

Full, reduced, or restricted practice: Restricted

Autonomous practice restriction: Nurse practitioners cannot independently diagnose and treat patients without physician involvement.

Primary care provider: State statute does not explicitly recognize nurse practitioners as primary care providers.

Ability to prescribe medication: Nurse practitioners can prescribe certain drugs under the authority of their collaborating physician and may only prescribe a limited amount of opioids in hospitals.

7. Missouri

Missouri now allows physicians to supervise nurse practitioners virtually.

Full, reduced, or restricted practice: Restricted

Autonomous practice restriction: Nurse practitioners cannot independently diagnose and treat patients without physician involvement.

Primary care provider: State statute does not define whether nurse practitioners can be primary care providers.

Ability to prescribe medication: Nurse practitioners in Missouri are only authorized to prescribe hydrocodone combination products.

8. Virginia

In April, Virginia Gov. Ralph Northam gave nurse practitioners with five years of full-time clinical experience the ability to get approval to practice without physician supervision.

Full, reduced, or restricted practice: Restricted

Autonomous practice restriction: Nurse practitioners cannot independently diagnose and treat patients without physician involvement.

Primary care provider: State statute does not define whether nurse practitioners can be primary care providers.

Ability to prescribe medication: Nurse practitioners can't prescribe opiates and other drugs unless they complete an educational requirement in pharmacology or pharmacotherapeutics and tell the patient they're a nurse practitioner.

9. South Carolina

Full, reduced, or restricted practice: Restricted

Autonomous practice restriction: Nurse practitioners cannot independently diagnose and treat patients without physician involvement.

Primary care provider: State statute does not define whether nurse practitioners can be primary care providers.

Ability to prescribe medication: Nurse practitioners may prescribe certain drugs as long as they sign the prescription and provide their prescriptive authority number, the location of their practice, and the collaborating physician's information.

10. Louisiana

Louisiana law implies, but does not outright state, nurse practitioners can be officially listed as primary care providers.

Full, reduced, or restricted practice: Reduced

Autonomous practice restriction: Nurse practitioners cannot independently diagnose and treat patients without physician involvement.

Primary care provider: State law implies, but does not explicitly state, that nurse practitioners can be listed as a primary care provider, according to MidlevelU.

Ability to prescribe medication: Nurse practitioners cannot prescribe opiates and other drugs used to treat chronic pain, intractable pain, or obesity.



 
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Articles in this issue:

Masthead

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    Editor-in Chief:
    Kirsten Nicole

    Editorial Staff:
    Kirsten Nicole
    Stan Kenyon
    Robyn Bowman
    Kimberly McNabb
    Lisa Gordon
    Stephanie Robinson

    Contributors:
    Kirsten Nicole
    Stan Kenyon
    Liz Di Bernardo
    Cris Lobato
    Elisa Howard
    Susan Cramer

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