States with Full Practice Authority for Nurse Practitioners

Earning a nurse practitioner degree and becoming a nurse practitioner (NP) is a rewarding career path for many nurses. However, some states grant NPs much more autonomy than others do. While some states grant NPs partial autonomy, others offer full practice authority (FPA), which enables them to practice without the oversight of a physician.
For nurse leaders, this means that they have both more opportunities and options to provide care to patients and the authority to take on senior-level roles and the higher salaries that accompany them. By earning an advanced degree that prepares students for an NP role, nurses working in states with full practice authority for nurse practitioners are able to gain the wealth of knowledge they need to treat patients and take on more responsibility while working toward their professional goals.
What Do Nurse Practitioners Do?
The roles and responsibilities of nurse practitioners are constantly evolving. In the United States, there is a demand for skilled medical professionals and a lack of doctors or nurses to meet it. In advanced training programs such as a Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP), nurses can pursue additional training and take on a more advanced role in healthcare, handling tasks such as prescribing medication that would normally require the input or supervision of a physician.
Some common duties of nurse practitioners include:
- Performing physical examinations and observations
- Ordering and analyzing diagnostic tests
- Consulting with other health professionals and referring patients to other medical or counseling options
- Administering medications
- Monitoring and administering medical treatment
In states with full practice authority for nurse practitioners, their scope of practice can involve additional tasks such as diagnosing illness and prescribing medication or treatment plans, as well as follow-up or long-term care. The work of nurse practitioners is both incredibly challenging and, through caring for others during their most difficult times, intensely fulfilling.
Can Nurse Practitioners Practice Independently?
Nurse Practitioner Practice Regulations
- Full Practice Autonomy: State licensure allows NPs to evaluate patients including examination, diagnosis, ordering and interpretation of diagnostic tests, establishing a treatment plan, and prescribing medication.
- Reduced Practice Autonomy: NPs are limited in at least one area of patient evaluation and must collaborate with other medical professionals, such as physicians, to care for patients. They are not permitted to provide all levels of care independently, often including prescribing controlled substances, and must coordinate with other medical professionals.
- Restricted Practice Autonomy: State practice authority limits the ability of NPs to provide patient care and requires them to work under the delegation or team management of another medical professional throughout their career. NPs in restricted practice autonomy states must have the direction of a medical supervisor, such as a leading physician, to deliver care to patients.
States with full practice authority for nurse practitioners allow nurses to streamline care for patients. While the healthcare system does not function without collaboration and teamwork between medical professionals, granting additional authority to NPs allows them to provide direct care to patients, eliminating some of the backlog for physicians and increasing the efficiency of care delivery. With advanced certifications, NPs can provide optimal long-term care to their patients.
States Where NPs Can Practice Independently
1. Alaska
2. Arizona
3. Colorado
4. Connecticut
5. Delaware
6. District of Columbia
7. Hawaii
8. Idaho
9. Iowa
10. Maine
11. Maryland
12. Massachusetts
13. Minnesota
14. Montana
15. Nebraska
16. Nevada
17. New Hampshire
18. New Mexico
19. North Dakota
20. Oregon
21. Rhode Island
22. South Dakota
23. Vermont
24. Washington
25. Wyoming
Demand for NPs with FPA Continues to Grow
As more doctors choose to pursue lucrative specialties rather than family medicine or primary care, the demand for NPs with FPA continues to increase rapidly. Experienced NPs in states that offer the most practice autonomy may pursue rewarding careers and become valuable members of the healthcare system.
Created with the busy professional in mind, the fully online curriculum and multiple start dates offered by the online nurse practitioner programs at Maryville University are designed to give you the flexibility to begin an exciting new career in nursing. Learn from industry professionals and choose from five specialties that can prepare you with the skills required to become a leader in nursing. Visit the Maryville nurse practitioner programs page to learn more about this fast-growing field and the opportunities it offers.
Sources
American Association of Nurse Practitioners, Issues at a Glance: Full Practice Authority
American Association of Nurse Practitioners, State Practice Environment
Campaign for Action, “Delaware Becomes 24th State to Recognize Full Practice Authority for APRNs”
Betterteam, Nurse Practitioner Job Description
Massachusetts Coalition of Nurse Practitioners, FAQs About FPA for MA NPs