5 Worst States for Nurse Practitioner Practice

States are increasingly passing laws allowing nurse practitioners more freedom in their practice. Some legislators are even running marketing campaigns attempting to lure NPs from other states within their boarders on the basis of more favorable scope of practice legislation. But, some states lag behind in the NP independent practice movement (ahem, Deep South, we’re looking at you).

Which states fall notoriously short when it comes to granting nurse practitioners freedom in their practice?

1. Florida

If you want to work in healthcare, Florida should be at the bottom of your list of dream destinations. Yes, the Sunshine State may have palms, sun, and sand, but state laws may make your day job a less than illuminating experience.

Florida’s nurse practitioner supervision laws are among some of the strictest in the nation. State law requires that nurse practitioners work under the supervision of a physician when it comes to practice and prescribing. Even when working within a physician supervision agreement, NPs practicing in Florida are not allowed to prescribe controlled substances. This is a major setback, especially considering the state is facing a significant shortage of primary care providers.

2. Alabama

With the highest rate of obesity in the nation and over 25 percent of its residents smokers, you would think Alabama could use nurse practitioners more than ever. Unfortunately, the state’s legislators don’t feel the same. Not only must nurse practitioners work in collaboration with a physician, the physician must be physically on site with the NP ten percent of the time.

Prescribing laws in Alabama are similarly strict for nurse practitioners. NPs working in Alabama may only prescribe Schedule III, IV and V medications limiting their utility in certain settings.

3. North Carolina

While known for its predictably strong college basketball teams, laws concerning NPs in North Carolina are far from a slam dunk. Like our prior two picks, nurse practitioners practicing in North Caorlina must work in collaboration with a physician. Not only does North Carolina require a collaborative agreement with an MD, nurse practitioners are also restricted within this arrangement. For example, nurse practitioners may only refill certain controlled substances a limited number of times. Complex rules and regulations when it comes to prescribing and supervision limit NPs ability to practice in the Tar Heel State. 

4. Georgia

The last state to grant nurse practitioners the ability to prescribe, Georigia still lags perilously behind when it comes to scope of practice laws. NPs practicing in the Peach State are not allowed to prescribe Schedule II controlled substances. Nurse practitioners in Georgia must also practice under a so called “delegating physician”. Georgia may be one of the fastest growing states in the nation, but it’s view of nurse practitioners remains limited.  

5. Oklahoma

Oklahoma is as all-American as they come. Famous for cowboys, Tornado Alley, and outlaws, the Sooner state has an adventurous spirit. Unfortunately, these ideals do not extend to laws governing nurse practitioners. NPs practicing in Oklahoma are prohibited from prescribing Schedule II controlled substances not to mention, they must be supervised by a physician in order to prescribe. Sorry Sooner’s, the NP scope of practice in Oklahoma leaves something to be desired.

While the West might be best when it comes to nurse practitioner scope of practice laws, the South presents a pretty sorry picture. How do scope of practice laws in your state affect your practice?

 

You Might Also Like: 6 Best States for Nurse Practitioner Practice