Regulation of Nurse Practitioners

Attorney Alex Fisher recently had another opportunity to sit down with Erin Tolbert, the creator of MidlevelU, an online resource for health care providers such as nurse practitioners and physician assistants, and discuss how nurse practitioners are regulated as a profession. The original article and video, published on MidlevelU, can be found here.

Erin and Alex discuss:

Who is in Charge of Nurse Practitioners?

In some states nurse practitioners are regulated by the Board of Medical Examiners, while in other states nurse practitioners are regulated by the Board of Nursing. The American Association of Nurse Practitioners has a helpful breakdown of the regulation of nurse practitioners in each state that can be found here.

How Does the Way You are Regulated Affect Your Practice?

In theory, the Board that regulates you should not matter if the regulations are fairly consistent from state to state, but in reality, the Board that regulates a nurse practitioner can have a significant impact on their practice. For example, if a provider is in a state like Tennessee where nurse practitioners are regulated by the Board of Nursing, and if the provider is brought before the Board on a complaint related to prescribing, some of the Board members who will be determining whether that individual is disciplined or not will likely be registered nurses who have never written a prescription before or dealt with prescribing in their own practice.

Who is Responsible?

It’s often difficult to determine who is responsible, or ‘where the buck stops’ when a complaint is made about a nurse practitioner’s actions when the supervising physician is regulated by the Board of Medical Examiners and the nurse practitioner is regulated by the Board of Nursing. The bottom line is that a nurse practitioner is responsible for his or her own actions, particularly when it comes to prescribing. Writing a prescription is like signing a contract–which is why it is so important that nurse practitioners document each time a prescription is written.

How Can Nurse Practitioners Improve Relationships with their Supervising Physicians?

I recommend that nurse practitioners develop written protocol with their supervising physicians. Having protocol in writing will clarify expectations for all parties.

As a young nurse practitioner, ask questions and seek mentorship as you are developing your own medical judgment. You as an nurse practitioner are responsible for your own actions, so make sure you have a good support system in place to ensure that you are providing the best possible care to your patients.