Nursing Scope of Practice
What Can You Do With a Master’s in Nursing?
If you are considering a career as a family nurse practitioner (FNP), you will need to understand the ways in which different variables — from education level to clinical experience to state laws and regulations — will affect your practice. Questions like, “Can nurse practitioners prescribe?” refer to scope of practice, which describes the types of services and procedures that clinical professionals are legally allowed to administer or perform.
A number of factors influence scope of nursing practice, including your clinical qualifications and location.
Clinical qualifications, like your level of education and board certifications, play an important role.
For instance, someone who plans to become a nurse practitioner (NP) will need to earn a Master of Science in Nursing (MSN), accrue more clinical experience and qualify for more advanced certifications than someone who intends to become a registered nurse (RN). As a result, NP scope of practice is broader than RN scope of practice.
Location — where you practice — also matters. States, not the federal government, legislate and regulate scope of practice, so the type of care NPs are allowed provide varies from state to state.
As of 2018, 22 states and the District of Columbia have granted NPs full scope of practice authority.1 The U.S. Department of Veterans Affairs also recently recognized NP practice authority, granting NPs direct access to patients in 2017.
Scope of Practice Terms and Concepts
Whether you are contemplating a career as an FNP or already pursuing one, here are some key terms and concepts to help you navigate today’s multifaceted regulatory and clinical environment.
Full Scope of Practice
NPs practicing in states that recognize full scope of practice have Full Practice Authority (FPA), which enables them to practice at the top of their licensure and to the full extent of their capabilities.2 In accordance with their education and training, these nurses may prescribe medication and maintain an independent practice.
Although no physician oversight is required, NPs in states with full scope of practice frequently collaborate with other clinicians, like physicians, and caring professionals, like social workers, as part of an integrated care team.
Reduced Scope of Practice
In states that abide by reduced scope of practice laws, at least one element of NP practice is limited, and NPs are considered partially independent.
To deliver care in certain settings or perform clinical tasks that fall under the reduced element or elements of practice, NPs must enter into what is known as a collaborative practice with another health care provider. The provider, usually a physician, is responsible for overseeing or authorizing care provided by the NP.
Restricted Scope of Practice
In states that have passed or upheld Restricted Scope of Practice laws, the types of care Family Nurse Practitioners may provide — and the settings in which they provide it — are more limited. NPs in these states are non-independent, meaning they cannot engage in at least one element of NP practice.
For instance, certain states restrict the extent to which an FNP can prescribe medication. Some of these states limit the types of medication an FNP can prescribe, while others require physician oversight or preauthorization.
In states with full scope of practice, an FNP may engage in autonomous practice, meaning they can practice independently and even manage their own clinic. States with reduced or restricted scope of practice laws, on the other hand, require NPs to enter into a collaborative agreement with another health provider, such as a physician.
Primary Care Provider
Some states, including several with restricted scope of practice laws, formally recognize NPs as primary care providers (PCP). When it comes to primary care, nurse practitioners play an important role in protecting individual patients, families and entire communities.
A PCP is the first line of defense for most patients. They provide continuing care that includes identifying, diagnosing and treating a wide range of health concerns. They also work with other providers to deliver preventive care, like screenings.
In this capacity, PCPs play a critical role in alleviating future health care costs that can result from untreated or undiagnosed chronic conditions, like heart disease, diabetes or cancer.
Nurse Practitioner Job Outlook
As populations and individuals across the country grapple with critical, widespread health challenges — rising health care costs, an aging population, higher rates of chronic disease and public health issues like the opioid epidemic — the demand for primary care services is growing.3
These challenges have forced health care systems and providers to redefine traditional parameters of care, especially as they apply to vulnerable and underserved communities. Tomorrow’s providers need more than biomedical expertise: They must understand the complex ways in which social, psychological, environmental and behavioral factors affect the health of individuals and families across the life span.
As a result, the need for family nurse practitioners, especially ones with a grasp of these nuanced issues, is greater than ever.
In 2019, U.S. News & World Report named Nurse Practitioner the No. 7 best job in America — due, in part, to the rising demand.4 Between 2016 and 2026, the U.S. Bureau of Labor Statistics projects that NP employment will grow by 36 percent, or more than 56,000 NPs.5
In keeping with heightened demand, the median family nurse practitioner salary is increasing, too. In 2018, the median annual wage for nurse practitioners was $107,030.6
Learn more about the growing field for NPs who graduate with a master’s in nursing (MSN).
Advance Your Nursing Career With USC
Beyond promising growth and salary opportunities, a career as an FNP can be deeply rewarding and position you to improve health outcomes in a range of settings.
Nursing@USC, the online Master of Science in Nursing from USC Suzanne Dworak-Peck School of Social Work Department of Nursing, offers a Family Nurse Practitioner (FNP) program that will prepare you to:
- Provide high-quality physical and behavioral care to individuals and families across the life span.
- Address the social, environmental, psychological and economic factors that affect the health and well-being of communities and populations.
- Lead positive social change and advocate for more equitable health care for all.
Earn your Master of Science in Nursing (MSN) degree to become a FNP.
Take the Next Step
If you are an RN seeking advancement opportunities, discover how Nursing@USC can prepare you to take the next step in your career.
1 https://www.aanp.org/advocacy/state/state-practice-environmentReturn to footnote reference
2 https://www.aanp.org/news-feed/ranks-of-nurse-practitioners-grow-to-meet-primary-care-demandReturn to footnote reference
3 https://bhw.hrsa.gov/health-workforce-analysis/primary-care-2020Return to footnote reference
4 https://money.usnews.com/money/careers/slideshows/the-25-best-jobsReturn to footnote reference
5 https://www.bls.gov/ooh/healthcare/nurse-anesthetists-nurse-midwives-and-nurse-practitioners.htmReturn to footnote reference
6 https://www.bls.gov/ooh/healthcare/nurse-anesthetists-nurse-midwives-and-nurse-practitioners.htm#tab-5Return to footnote reference