Can Nurse Practitioners Prescribe?
The ability to prescribe drugs is a vital part of providing quality healthcare.
Although highly educated and trained, the power to autonomously prescribe meds for NPs (nurse practitioners) in the US varies from state to state.
Whether NPs require a physician’s supervision depends on each state’s practice laws.
Some states mandate NPs to have additional supervision and training to prescribe meds, while others grant them full prescriptive authority.
Currently, only about 20 states have full prescriptive authority, which allows NPs to prescribe meds to their patients without the supervision of a physician.
States with partial or no prescriptive authority have seen NPs rallying for full prescriptive authority. In fact, over the last couple of years, NPs in some states have secured victories.
As an NP in some states, you must enroll in the CSRS (Controlled Substances Reporting System) and/or PDMP (Prescription Drug Monitoring Program).
That said, let’s discuss which states give NPs full, partial, or no prescriptive authority and some of the drugs they can prescribe.
Who Regulates Nurse Practitioners’ Prescriptive Authority?
Can Nurse Practitioners Prescribe? – Who Regulates Nurse Practitioners’ Prescriptive Authority?
The AANP (American Association of Nurse Practitioners) indicates that prescriptive authority is given and solely regulated by each state’s BON (board of nursing) per the NP’s education, certification, and role.
Since this is not a federal mandate, each state can define prescriptive authority slightly differently. There are three different categories of a nurse practitioner’s prescriptive authority, and they include:
Full Practice
State practice and licensure laws allow all NPs to examine patients, including ordering, diagnosing, and interpreting diagnostic tests.
Full practice also includes managing treatments, including prescribing controlled substances and meds under the exclusive licensure authority of the specific state’s BON.
Full practice has been endorsed by the NAM (National Academy of Medicine) and the NCSBN (National Council of State Boards of Nursing).
Reduced Practice
State practice and licensure laws restrict NPs’ ability to participate in at least one aspect of NP practice.
State laws require nursing practitioners to be in regulated collaborative agreements with a physician to administer patient care.
Restrictive Practice
States require that a physician supervise an NP for the entirety of their career.
Under this category, nurse practitioners are barred from participating in at least one aspect of healthcare practice, such as prescribing meds on their own.
Which US States Give NPs Full Prescriptive Authority?
The designation of full prescriptive authority for nurse practitioners is FPA (full practice authority).
Although progress is slow, the United States has come a long way from 1994, when only five states gave NPs full prescriptive authority.
Alaska, Iowa, Montana, New Mexico, and Oregon are the states that paved the way for NPs to practice without supervision.
The other states that allow NPs full practice include:
Arizona,
Colorado,
Connecticut,
Delaware,
Hawaii,
Idaho,
Kansas,
Maine,
Maryland,
Massachusetts,
Minnesota,
Nebraska,
Nevada,
New Hampshire,
North and South Dakota,
Rhode Island, Vermont,
Washington,
Wyoming.
Which US States Give NPs Partial Prescriptive Authority?
Can Nurse Practitioners Prescribe? – Which US States Give NPs Partial Prescriptive Authority?
The designation of partial prescriptive authority for nurse practitioners is RPA (reduced practice authority).
The states that give nurse practitioners PPA (partial practice authority) include;
Alabama,
Arkansas,
Illinois,
Indiana,
Kentucky,
Louisiana,
Mississippi,
New Jersey,
New York,
Ohio,
Pennsylvania,
Utah,
West Virginia,
Wisconsin.
Some US territories, including Puerto Rico, Samoa, and the Virgin Islands (all US states), also give nurse practitioners partial practice authority.
Which US States Give NPs No Prescriptive Authority?
Fortunately, the states where nurses have the most prohibitive restrictions are few. Nurse practitioners in these states have no autonomous prescriptive authority.
Note that California is passing laws to allow NPs to practice independently.
The remaining ten states where NPs have no prescriptive authority include;
Florida,
Georgia,
Michigan,
Missouri,
North and South Carolina,
Oklahoma,
Tennessee,
Texas,
Virginia.
Which Meds Can NPs Prescribe?
Can Nurse Practitioners Prescribe? – Which Meds Can NPs Prescribe?
Antibiotics
With their APRN credentials, NPs can prescribe antibiotics in all 50 US states as well as the District of Columbia.
Since antibiotics are not controlled substances in the United States, they don’t pose a risk of abuse or addiction.
Antidepressants
The DEA has indicated that antidepressants don’t pose a risk of abuse or addiction, so they are not classified in the same category as narcotics.
NPs can prescribe antidepressants in all 50 US states as well as the District of Columbia.
Birth Control
The DEA doesn’t also deem birth control pills as addictive or habit-forming so that nurse practitioners can prescribe them within the laws of their state’s practice authority.
Final Thought
The battle to attain full prescriptive authority for NPS has been long and at times discouraging.
But for now, if you’re an NP in a state with restrictive or no prescriptive authority you need to be are what meds you can prescribe so as not to contradict your state’s laws.
See Also
How to Deal With Rude Patients
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