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June 23, 2015

The States that Allow Nurse Practitioner Autonomy

If you’ve visited a doctor’s office recently, you may have noticed a trend. Doctors are busy. This doesn’t just apply to your doctor’s office, though. The U.S. is in the middle of a doctor shortage, and the problem is only getting worse.

One trend that has emerged in the past decade or so is supplementing the doctor shortage with nurse practitioners, who can offer the same care as a primary care physician. However, operating as an autonomous nurse practitioner without the supervision or sponsorship of a physician is only legal in certain states.

What is a Nurse Practitioner?

A nurse practitioner is a nurse who has received nursing education beyond that of a registered nurse (RN), like the programs offered at Maryville University, making him or her an advanced practice registered nurse (APRN). Nurse practitioners are skilled general practitioners and can diagnose and treat most conditions without much or any help from a physician. In many states, it’s legal for nurse practitioners to have their own practice, without the need for sponsorship from a physician. As the shortage of doctors worsens, more and more states are beginning to consider following suit and legalizing nurse practitioner practices in their own borders.

The States Where Nurse Practitioners Have Autonomy

Some states allow nurse practitioners to have full autonomy, while others still require a doctor to write prescriptions.

Full Autonomy States:

  • Washington
  • Oregon
  • Idaho
  • Nevada
  • Arizona
  • New Mexico
  • Montana
  • North Dakota
  • Colorado
  • Wyoming
  • Nebraska
  • Minnesota
  • Iowa
  • Maine
  • New York
  • Vermont
  • New Hampshire
  • Connecticut
  • Rhode Island
  • Washington, D.C.
  • Alaska
  • Hawaii

Partial Autonomy States:

  • Utah
  • South Dakota
  • Kansas
  • Wisconsin
  • Illinois
  • Indiana
  • Ohio
  • Kentucky
  • West Virginia
  • Pennsylvania
  • Maryland
  • Delaware
  • New Jersey
  • Arkansas
  • Louisiana
  • Mississippi
  • Alabama

In the borders of any state not listed, a nurse practitioner requires a doctor’s permission to diagnose and treat patients, as well as prescribe medication.

The Future of Nurse Practitioner Autonomy

In a time when so many people are becoming insured and more willing to seek health care, nurse practitioners will be a valuable addition to the health care workforce. According to Kaiser Health News, many of the states listed here only began allowing nurse practitioner autonomy within the last few years because there is such a high demand and such a low supply of available physicians.

In the end, the demands of the people seeking out health care and the shortage of physicians are likely to encourage more states to allow nurse practitioners to freely practice without a doctor’s sponsorship. In states where autonomous nurse practitioners are already legal, nurses have set up general practices and even make house calls according to Medpage Today, a practice abandoned by most physicians.

Only time will tell if nurse practitioners gain the freedom to work for themselves in big states like California, Texas, and Florida. One thing is for certain, the demand for health care is growing, and the supply will have to grow to match it.


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