Nurse Practitioner - Scope of Practice

Scope of Practice

In the United States, because the profession is state-regulated, care provided by NPs varies widely. Some nurse practitioners work independently of physicians while, in other states, a collaborative agreement with a physician is required for practice. The extent of this collaborative agreement, and the role, duties, responsibilities, medical treatments, pharmacologic prescriptions, etc. afford an NP to perform and prescribe again varies widely amongst states of licensure/certification. practice.

The scope of practice for NPs globally varies even more widely than the state-by-state discrepancies in the United States. The International Council of Nurses outlines the following general characteristics of advanced practice nursing: · Integrates research, education, practice and management · High degree of professional autonomy and independent practice · Case Management/personal case load · Advanced health assessment skills, decision-making skills and diagnostic reasoning skills · Recognized advanced clinical competencies · Provision of consultant services to other health providers · Plans, implements and evaluates programs · Recognized first point of contact for clients

The "Pearson Report" provides a current state-by-state breakdown of the specific duties a nurse practitioner may perform in the state. A nurse practitioner's role may include the following:

• Diagnosing, treating, evaluating and managing acute and chronic illness and disease (e.g. diabetes, high blood pressure)
• Obtaining medical histories and conducting physical examinations
• Ordering, performing, and interpreting diagnostic studies (e.g., routine lab tests, bone x-rays, EKGs)
• Prescribing physical therapy and other rehabilitation treatments
• Prescribing drugs for acute and chronic illness (extent of prescriptive authority varies by state regulations)
• Providing prenatal care and family planning services
• Providing well-child care, including screening and immunizations
• Providing primary and specialty care services, health-maintenance care for adults, including annual physicals
• Providing care for patients in acute and critical care settings
• Performing or assisting in minor surgeries and procedures (with additional training and/or under physician supervision in states where mandated; e.g. dermatological biopsies, suturing, casting)
• Counseling and educating patients on health behaviors, self-care skills, and treatment options