With the fourth highest rate of obesity in our nation and over 25 percent of its residents smokers, you would think Alabama needs nurse practitioners more than ever to help combat chronic disease. However, notorious for laws limiting the NP scope of practice, Alabama is missing out on the advantages nurse practitioners have to offer. How do laws in Alabama regulate NPs?
Alabama’s Nurse Practitioner Supervision Laws
NPs practicing in Alabama are required to have a written collaborative practice agreement with a physician. One physician may collaborate with no more than three full-time nurse practitioners, or 120 NP collaboration hours per week. Interestingly, collaborative agreements for nurse practitioners working in health departments are exempt from the one physician to three NPs rule. Collaborating physicians must also have at least one year of experience practicing medicine.
Alabama State Law requires that a collaborating physician be readily available to the NP for consultation either in person or by phone. The collaborating physician must be present on site with the nurse practitioner at least ten percent of the time and review at least ten percent of the NP’s charts.
Alabama’s Nurse Practitioner Prescribing Laws
Nurse practitioners practicing in Alabama have limited authority to prescribe. They are allowed to do so only with physician collaboration. The name, practice site address and phone number of the collaborating physician must be present on each prescription written by the NP. Nurse practitioners are not allowed to prescribe for themselves, immediate family members or individuals who are not patients of their practice.
Recently, nurse practitioners were granted increased ability to prescribe certain substances under Alabama State Law. NPs are now allowed to prescribe schedule III, IV and V medications but are still not allowed to prescribe schedule II drugs including narcotic pain medications.
Other Scope of Practice Laws in Alabama
Strict laws regulating nurse practitioners in Alabama extend beyond supervision and prescribing. For example, NPs in Alabama can perform but not sign sports physicals. They cannot sign death certificates or sign handicap parking permits. NPs practicing in Alabama are also not formally recognized as primary care providers.
Nurse practitioners in Alabama have some significant hurdles to overcome. Hopefully legislators will continue to loosen regulations surrounding NPs allowing them to practice to their full ability.