Professional Issues: NP Regulation

The legal authority of a nurse practitioner’s scope of practice is defined by:

A. The organization that grants NP certification. 

B. The NP’s employer. 

C. The law of the state where the NP practices.    

D. Federal law.

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Transcript

Welcome to NP Certification Q&A presented by Fitzgerald Health Education Associates. This podcast is for NP students studying to pass their NP certification exam. Getting to the correct test answers means breaking down the exam questions themselves. Leading NP expert Dr. Margaret Fitzgerald shares her knowledge and experience to help you dissect the anatomy of a test question so you can better understand how to arrive at the correct test answer. So if you're ready, let's jump right in. 

The legal authority of a nurse practitioner’s scope of practice is defined by:

A. The organization that grants and recertification.
B. The NP's employer.
C. The law of the state where the NP practices.
D. Federal law.  

 Where do you start?  

 You want to determine what kind of question this is. This is a professional issues question. While, most questions on the NP boards are focused on clinical practice issues, occasionally, questions on NP practice are included. You might ask why. At the same time, knowledge of NP practice in its regulation is key to your professional development. 

 NP Scope of practice describes the who, what, why, when and how of NP practice, and informs us on what the NP can do legally once certified and licensed. Scope of practice, often abbreviated as SOP is influenced by the professional licensure and state laws.  

Some state laws are more limiting than others. In describing the NPS scope of practice, while other states grant NPS full practice authority. And full practice authority, abbreviated FPA, is the authorization of nurse practitioners to evaluate patients, diagnose, order, and interpret diagnostic tests and initiate and manage treatments, including prescribing medications under the exclusive licensure authority of the State Board of Nursing.  

While practice acts vary, the requirements of the NP to sit for certification are professional qualifying exam are consistent across the United States and the District of Columbia as well as the U.S. territories.  

Let's take a look at the options. And would the legal authority for the NP’s scope of practice be defined by:  

A. The organization that grants NP certification. 

That's incorrect. The nationally recognized certification is an important part of NP licensure but does not dictate scope of practice.  

 Option B: The NP’s employer.  

 The NP’s role must be consistent with the NP Practice Act, where the nurse practitioner owner is employed. Keep in mind the employer cannot dictate that the NP’s role exceeds the legally sanctioned scope of practice.  

Option C: The law of the state where the NP is licensed and practices.  

That's the correct answer. Legal authority for the NP to practice is defined by the state where the nurse practitioner is licensed and practices. I will add, please ensure you are familiar with the scope of practice and the regulation for NPs in a state where you are seeking to practice. It does vary widely across the United States and we are at a point now where the majority of states and the U.S. territories do in fact grant nurse practitioners full practice authorities; however, the majority of NPs still practice in states with less than full practice authority, which has simply to do with population variations across the United States. I now practice in a state that offers NPs full practice authority. I personally would never go back to practicing in a state with a more, more restricted practice environment.  

Let's take a look down at the last choice here. Federal law. 

That's incorrect, obviously, federal oversight and input into NP practice is actually quite limited. One exception is prescriptive authority for controlled substances, including products like opioids and benzos, where the oversight by the DEA is the rule for all health care providers, not just NPs, but anybody who has the ability to prescribe a scheduled medication, whether it's M.D., D.O., Dentists, nurse midwives, etc., etc. Any of us who can get granted a DEA license.  

Key takeaway: knowledge of NP regulation, including scope of practice, is key to your professional development and NP board success. Your State, NP organization, and our national organization, the American Association of Nurse Practitioners are great resources for this information.  

Thank you for listening to NP Certification Q&A presented by Fitzgerald Health Education Associates. Please rate, review, and subscribe to this podcast. And for more NP resources, visit FHEA.com.