Currently, Nurse Practitioners (NPs) are supervised by physicians regardless of their education and experience. The statutes governing nurse practitioner practice have not been updated since 1973. Virginia is one of only 12 states that require physician supervision. Research shows that Nurse Practitioners provide safe, high quality care with excellent outcomes and patient satisfaction. Senate Bill 263 seeks to remove the supervision regulations and allow Nurse Practitioners to practice independently under the Board of Nursing.
Need for change
The current standard has allowed for the modification of policies and procedures that negatively impact patients’ access to care from Nurse Practitioners. For example, some offices and clinics have been forced to close due to the lack of a “supervising” physician. In some areas, these Nurse Practitioners may have been the only health-care providers available making it increasingly difficult for patients to receive health care services and medications.
Another alarming problem with the existing regulations is that for a NP to have prescriptive rights, their supervising physician must only oversee a maximum of four NPs and must “regularly practice” in each of the same settings. These strict limitations hinder the autonomy of NPs and shrink their scope of practice. In addition, if the physician is unable to provide regular services, patients will be unable to receive their medications in a timely manner.
Since the regulation of NPs has not been updated in the recent years, it is in critical need of modernization. In Virginia, the Boards of Nursing and Medicine jointly license and regulate NPs. Virginia is one of only 7 states that require joint regulation. There is no evidence to support the necessity of dual regulation. Due to the differences in nurse and physician education and practice, the Board of Nursing is better equipped to regulate NPs than the Board of Medicine.
Solutions
SB 263 would allow the Board of Nursing to develop guidelines for Nurse Practitioners to perform within their scope of practice and optimally function as a member of the interdisciplinary healthcare team. Ideally, changes in regulation will allow Nurse Practitioners to function as an equal partner rather than under a physician’s supervision. These provisions will enable effective, safe, and timely care to patients. Additionally, Nurse Practitioners would be able to prescribe drugs and devices consistent with their education and certification governed by regulations developed by the Board of Nursing in consultation with the Board of Pharmacy.
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