Why Running an Independent Nursing Practice Varies Greatly from State to State
When most people hear the word nurse they think “hospital.” The truth is that getting a nursing degree— particularly with additional endorsements— can open many doors. Nurse practitioners are granted a significant amount of autonomy, allowing them to act in much the same way as a general practitioner.
There’s a catch: State regulations vary tremendously. If you want to open an independent nursing practice, you must first understand the laws in your community.
In this article, we take a look at how nursing can vary based on where you live.
What is an Independent Nursing Practice?
An independent nursing practice is any business in which a registered nurse is able to provide health advice and administer care to patients without the direct supervision of a physician. In further headings, we will discuss how the level of independence can vary significantly based on location.
Perhaps the most common example is that of the Nurse Practitioner. In many states, Nurse Practitioners are able to function in much the same capacity as general practitioners. They can make diagnoses, prescribe medications, and perform general examinations.
There are many benefits to allowing nurse practitioners to enjoy a high level of independence.
- It gives patients more options. Patients frequently experience narrow care options. In some parts of the country, where healthcare resources are limited, patients may only have a couple of physicians to choose from. If they aren’t responding well to the options they have, they are forced to either travel far for care or suck it up. NPs provide a greater level of care diversity.
- Nurse practitioners declutter the healthcare system. Because NPs can perform many tasks formerly reserved for doctors, they are a great way to de-clog an overworked healthcare system. Hospitals that lack resources are often booked out for months in advance. More personnel makes it easier to offer a high level of care to a wider range of people.
- It provides entrepreneurial opportunities to nurses. High levels of NP autonomy also provide nurses with an outstanding entrepreneurial opportunity. In states where NPs are allowed to work without doctor supervision, they can maintain offices and see hundreds of patients independently, providing the opportunity for a rewarding and lucrative career.
Unfortunately, these opportunities are not available everywhere. In some states, NPs are required to jump through hoops to administer care. Below, we take a look at what restrictions NPs might face, and how they impact their ability to work as an independent care provider.
Regulations
The most common regulation NPs encounter is the requirement for physician supervision. While the specific requirements can vary even within strict states, the basics are this: Before NPs perform any functions traditionally done by doctors, they must have their findings signed off on by a doctor.
For example, if an NP is seeing a patient and they determine that they require a prescription, they must first get a doctor to endorse that recommendation. Similarly, if they have determined a diagnosis for a patient, a doctor must review the NP’s findings and approve them before said diagnosis becomes official.
Naturally, this stipulation makes it impossible for NPs to function independently. You can’t run your own office if you have to seek approval from a physician for every decision.
Currently, only around 20 states allow NPS complete autonomy. The rest may vary considerably in how they regulate the profession. It’s always a good idea to brush up on local law before you sign on for an NP program.
Why Do States Impose Strict Regulations?
While strict regulations can be frustrating it is important to keep in mind that the ultimate objective is patient safety. General practitioners go through significantly more training than nurse practitioners. While it isn’t easy to become an NP, the disparity is obvious when you look at the educational requirements.
It takes eleven years minimum to become a general practitioner. It takes only about six years to become a nurse practitioner. In certain cases, you can cut that number back even further by bundling your graduate and undergraduate degrees.
Five years of extra training obviously makes a meaningful difference. Strictly from the patient’s perspective, most people will prefer to see a professional with deeper credentials.
The reason some states allow NPs autonomy in the first place is because general practitioners primarily deal with entry-level health scenarios. When something goes wrong, they generally refer a patient to a specialist. That’s something NPs should be able to do just as well as a general practitioner, right?
However many serious diseases display subtle first signs. Maybe labs show that the white blood cell count is just moderately off. This can be an early indication of cancer. If it’s caught soon enough, the patient may experience much higher odds of recovery.
NPs are highly qualified professionals. They work hard. They take patient care seriously. Still, the question of whether they can fully replace a general practitioner is challenging. Diversity of choice and more robust community access to healthcare are great, but should they come at a cost to quality?
So far, there hasn’t been a clear answer to that question. Independent nursing practices are largely very successful, and on the flip side, general practitioners can still make mistakes. A recent study indicated that NPs achieve patient healthcare outcomes comparable to the quality of general practitioners in 90% of cases.
Is it Worth Becoming a Nurse Practitioner in States with Lots of Regulations?
Becoming a nurse practitioner is rewarding regardless of where you live. It allows you to make more money, provide a higher level of care, and interact more deeply with a discipline that you are (presumably) passionate about.
High levels of oversight or regulation can be naturally frustrating for nurse practitioners. If you are considering this career path, it is certainly a good idea to know ahead of time what regulatory guidelines you will encounter once you graduate.
