NP Scope of Practice Hindered in Many States

January 10th, 2012

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By , BSN, RN

In an addition to yesterday's post about nurse practitioners facing challenges on both the east and west coasts, let's add the Sunshine State into the mix. In an effort to broaden the scope of practice for NPs in Florida one state representative, Daphne Campbell-D, has filed House Bill 1195, which would allow nurse practitioners to initiate involuntary psychiatric examinations under the state's Baker Act.

In Florida, not just physicians, but even physician assistants and counseling professionals can involuntarily commit patients who are suicidal or homicidal; nurse practitioners cannot.

Campbell, herself a registered nurse, has previously submitted bills which would allow NPs to practice at their "full scope" as they do in 48 other states but the bills have met strong opposition from the Florida Medical Association.  "As primary care providers, nurse practitioners often see patients who are suicidal and need immediate care," said Susan Lynch, a nurse practitioner and spokeswoman for the Florida Council of Advance Practice Nurses. "By amending the current statute, patients who are experiencing a mental health crisis will be able to obtain more comprehensive and timely care in a compassionate manner."

The trend in this country is toward easing restrictions state's place on NP's scope of practice. The 2010 Institute of Medicine(IOM) report specifically targets regulatory barriers. Other organizations, including the Robert Wood Johnson Foundation (RWJF) and the Macy Foundation support broader scope of practice boundaries. Support is also coming from consumer groups. The AARP ( (formerly the American Association of Retired Persons), has come out in support an expanded role for nurse practitioners in primary care.

The Affordable Care Act promises to add 32 million Americans to the rolls of the insured at a time when there is a shortage of primary care providers. Letting nurse practitioners do what they are trained and licensed to do seems a step necessary to helping ease that shortage.

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