Can a Nurse Practitioner Prescribe Medication? NP Prescriptive Authority
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Nurse practitioners are advanced practice registered nurses who have completed a master’s of science in nursing, doctor of nursing practice, or post-master’s certificate program. This advanced education provides them with the necessary skills and training to provide independent care to patients. They can work in various settings, including primary care, acute care, family practice, women’s health, anesthesia, psychiatry, and more.
However, the degree to which their practice is independent varies depending on the practice authority in the state where they are licensed. In some states, nurse practitioners must be directly supervised, while in others, they must have a collaborative agreement with a physician in place, but supervision may be less direct. On the other hand, many states allow nurse practitioners to have a fully independent practice.
One area of independent practice that varies widely from state to state is the ability to prescribe medications. Nurse practitioners can prescribe medication in all 50 states. What medications they can prescribe and how they can prescribe will vary. Many states restrict the kind of medications nurse practitioners can prescribe, especially when it comes to controlled substances. Other states require that nurse practitioners, who may otherwise be allowed to practice independently, have an agreement with a physician to prescribe medications. Some states allow nurse practitioners complete independence to prescribe the medications they see fit.
It is important for aspiring and currently practicing nurse practitioners to understand their state’s scope of practice and laws surrounding prescriptive authority.
Below are five examples of how prescriptive authority for nurse practitioners varies by state. To learn more about NP practice and prescriptive authority, check out the NP licensure state pages.
Five Examples of State Nurse Practitioner (NP) Prescriptive Authority
Nurse practitioners in Alaska are licensed and regulated by the Alaska Board of Nursing. Upon licensure, NPs are awarded a full independent practice, and they do not need to be under the supervision of a physician.
To have the privilege to prescribe medications, licensed nurse practitioners must complete the Authorization to Prescribe and Dispense Legend Drugs and Controlled Substances application. This application costs between $100 and $200, depending on the types of drugs the practitioner wants to prescribe. The applicant must also have a DEA registration number.
In Colorado, nurse practitioners are licensed by the Board of Nursing. There are no requirements for physician supervision of nurse practitioners in this state. Receiving prescriptive authority requires a few additional steps.
First, nurse practitioners must apply for and receive Provisional Prescriptive Authority (RXN-P). While holding provisional authority, they must earn 750 hours of mentorship supervision from a physician or nurse practitioner with full prescriptive authority. After completing the 750 hours, they can apply for Full Prescriptive Authority (RXN) and practice without supervision or mentorship.
The Delaware Board of Nursing licenses and oversees nurse practitioners in this state. Nurse practitioners are automatically awarded prescriptive authority for all medications except controlled substances when their state license is issued.
In order to be able to prescribe controlled substances, nurse practitioners must complete an application for controlled substance registration (CSR). To be eligible for CSR registration, applicants must complete the one-hour Mandatory Course training on Delaware law, regulation, and programs on prescribing and distribution of controlled substances.
Georgia nurse practitioners are licensed by the Georgia Board of Nursing. All nurse practitioners in this state must have a protocol agreement with a practicing physician that specifies parameters under which delegated medical acts may be performed.
Nurse practitioners may prescribe medications so long as they are outlined in the protocol agreement and the prescriptions have both the name of the nurse practitioner and the supervising physician. Under no circumstances can nurse practitioners prescribe schedule II controlled substances or medications used for a pharmacological abortion.
The Maryland Board of Nursing is responsible for licensing nurse practitioners in the state. Prescriptive authority is awarded when a nurse practitioner license is issued. In order to prescribe controlled substances, nurse practitioners must register with the Maryland Prescription Drug Monitoring Program (PDMP).