The primary care physician (PCP) shortage in the country leaves nearly 80 million Americans with inadequate primary care access, according to the U.S. Department of Health & Human Services. By 2030, the American Association of Medical Colleges expects the problem to worsen, projecting a PCP shortage of between 14,800 and 49,300. Studies have consistently shown that good access to primary health practitioners and facilities not only reduces health costs, but more importantly, improves patient health outcomes. Not resolving this issue will likely harm communities and hurt the economy.
The expanding role of nurse practitioners to include more aspects of primary care delivery can help solve this growing problem. Today, nurse practitioners handle tasks once exclusively designated to doctors. With a high level of training and clinical knowledge, nurse practitioners can assess patients, order and interpret tests, and start treatment plans. Can nurse practitioners prescribe medication? The answer to that is yes. By obtaining the proper credentials, nurses can treat patients in ways not possible in the past.
Career-driven nurses inspired by the opportunity to expand their scope of practice may want to consider earning a Master of Science in Nursing (MSN) or a post-master’s certificate to gain the skills and knowledge needed to broaden their roles as practitioners.
Prescriptive Authority
Nurse practitioners can apply their skills and knowledge to primary care by prescribing medication.
Prescriptive Authority for Nurse Practitioners in the US
Prescriptive authority is a complex issue for nurse practitioners and the medical community. The extent to which and the circumstances under which nurse practitioners can prescribe medication depends on their practice location―states have varying regulations.
The following regulatory structures indicate the general scope of a nurse’s practice:
- Full practice. Nurse practitioners in the District of Columbia and 22 states have full practice status. This means they can evaluate, diagnose, and order diagnostic tests. They can also independently prescribe “without limitation, legend (prescription) and controlled drugs, devices, adjunct health/medical services, durable medical goods, and other equipment and supplies,” according to Medscape.
- Reduced practice. Sixteen states, plus the U.S. territories of Puerto Rico, American Samoa, and the U.S. Virgin Islands, reduce the prescriptive authority of nurse practitioners. A reduced practice environment may require nurse practitioners to collaborate with other health care providers when prescribing medication, and it may limit the settings of at least one element of a nurse practitioner’s practice.
- Restricted practice. Nurse practitioners in 12 states work in restricted practice environments. This regulatory structure requires oversight from other health care providers when nurse practitioners diagnose, treat, and prescribe medications.
Each state has its own Nurse Practice Act (NPA), which details the professional conduct expected of nurses and their scope of practice. An NPA can serve as an important resource to nurse practitioners, clarifying what they can and can’t do in practice, as well as their overall responsibilities regarding issues such as licensure and education requirements.
For example, some nurse practitioners must apply for prescriptive authority, while others receive it at the time of licensure. Different states require different levels and types of education in pharmacology and pharmacotherapeutics. In addition, states vary in how much supervision they require nurse practitioners to undergo in their prescribing practice before qualifying for independent prescriptive authority. Currently, the Consensus Model for APRN Regulation strives to create uniformity in state regulations.
The medical community doesn’t agree on whether to expand nurse practitioners’ prescriptive authority. Those in support of an expansion point to decades of research that concludes nurse practitioners deliver cost-efficient, quality care to patients. Proponents say the graduate education in pharmacology, clinical diagnosis, pathophysiology, treatment, and physical assessment that nurse practitioners have makes them sufficiently qualified to handle the responsibility of prescriptive authority. In addition, proponents say it can help address the PCP shortage.
As more communities face inadequate primary care access, having prescriptive authority would enable nurse practitioners to provide medications and devices to those who might otherwise not have access. Those opposing the expansion raise concerns regarding the importance of respecting the roles designated by one’s training and education. They argue that while nurses play a critical part in health care delivery, physician-led care provides the highest-quality care. Opponents also argue that comprehensive health care requires a team of professionals and that clinicians shouldn’t work independently of one another.
How Nurse Practitioners Ensure Quality of Care
Nurse practitioners provide quality care in many ways and they perform a wide range of duties. Responsibilities include assessing patient health they also educate patients on how to optimize their health. In addition to diagnosing and treating patients for primary, acute and specialty care, nurse practitioners develop evidence-based and cost aware treatment plans in consultation with their patients. Sometimes treatment plans require some sort of prescription. Prescriptive authority, which includes prescribing medications, health care services, equipment, devices, and other supplies, can add to the ability of nurse practitioners to improve the quality of care for patients and communities.
The Potential of Post-Master’s Certificates
Post-master’s certificate programs teach nurses specialized knowledge in different health care areas. The programs provide nurse practitioners with excellent opportunities to increase their autonomy and expand into areas such as pediatrics, family health, women’s health, and adult-gerontology.
Not all MSN programs lead to nurse practitioner certification. MSN-prepared nurses who aren’t nurse practitioners can complete a post-master’s certificate to qualify to become nurse practitioners. Regis provides such a track for students earning a post-master’s certificate, enabling those with MSN degrees to become nurse practitioners in as few as 20 months. MSN-prepared nurses who are currently nurse practitioners can pursue a post-master’s certificate and expand into other areas.
Learn More
With the critical PCP shortage, nurse practitioners can prescribe medication, create treatment plans, and help optimize the health of underserved communities. Explore how earning a Regis MSN or post-master’s certificate can enable nurses to pursue advanced practitioner roles and make meaningful differences in health care.
Recommended Reading
What Are the Steps to Creating a Nursing Care Plan for Dementia Patients?
Using Nursing Skills to Provide Primary Care
Telehealth: Mental Health Care, Delivered Through the Internet
Sources
American Association of Nurse Practitioners, Nurse Practitioner Prescriptive Privilege
American Association of Nurse Practitioners, Standards of Practice for Nurse Practitioners
Association of American Medical Colleges, New Findings Confirm Predictions on Physician Shortage
Barton Associates, “NP Scope of Practice vs. Independent Practice: What’s the Difference?”
Bureau of Health Workforce, Health Professional Shortage Areas (HPSAs)
Health Affairs, “Empowering Nurses to Innovate at the Bedside, Then Spread Their Innovations”
MD Magazine, “Can Nurse Practitioners Fill the Void in Primary Care?”
Medscape, “APRN Prescribing Law: A State-by-State Summary”
NCSBN, APRN Consensus Model
RealClearHealth, “A Solution for America’s Primary Care Shortage”
Regis College, Online Master of Science in Nursing
Regis College, Online Post-Master’s Certificates
U.S. National Library of Medicine, “Assessing Progress on the Institute of Medicine Report The Future of Nursing”
U.S. News & World Report, “Can Nurse Practitioners Help Ease the Growing Physician Shortage?”