Understanding Full Practice Authority Leads to Career Success for NPs

Reach your full potential by understanding the scope of practice allowable by the state and hospital system in which you practice.

For career success and job satisfaction, a Nurse Practitioner (NP) should understand the scope of practice allowable by the state and hospital system in which he or she practices. This means understanding the concept of Full Practice Authority, having knowledge of hospital bylaws, and making a personal commitment to practice to the full scope of your authority.

Defining Full Practice AuthorityImage of gavel and stethoscope

“Full Practice Authority” refers to state practice laws that grant licensure to nurse practitioners. Each state legislates the degree to which NPs are permitted to practice. According to the American Association of Nurse Practitioners, full practice means that the laws allow nurse practitioners to evaluate patients, diagnose, order and interpret diagnostic tests, initiate and manage treatments—including prescribing medications.1

As of early 2017, Full Practice Authority has been adopted by 22 states and the District of Columbia. In other states, nurse practitioners operate in a restricted or reduced capacity and may require supervision by an outside health discipline to practice. For a map of state practice environments, see the website of the American Association of Nurse Practitioners.2

A Nationwide Movement for Improved Quality of Care

The Institute of Medicine (IOM) supports Full Practice Authority, stating that advanced practice registered nurses should be permitted to practice to the full extent of their training3 in a 2010 report.

Other studies, documented by the Rand Corporation,4 show that in states where NPs have full practice authority, patient access to care improves, healthcare costs decrease, and efficiency of care delivery is improved.

The movement toward nationwide adoption of Full Practice Authority is encouraging and empowering for NPs. It also puts a responsibility on NPs to take every opportunity to partner with hospital leadership, physicians, and other healthcare providers in redefining healthcare. Jill Gilliland, President of Melnic Consulting Group, coaches job seekers to: “Know your worth and measure it; know your role and communicate it; and know your scope and practice it.”

Understanding Scope of Practice for Career Success

As important as it is to understand the scope of practice permitted by your state, it is also critical to understand the bylaws and policies of your current, or prospective, employer. Bylaws can vary depending on the institution, so different hospitals may have different guidelines for the credentialing and privileging process for NPs. It is possible that hospital bylaws could restrict your scope of practice, even in a state with Full Practice Authority.

For your personal career development and job satisfaction, you owe it to yourself to fully understand your allowable scope of practice. Many professional organizations offer resources to guide your research, such as the American Nurses Association webpage: Determining Scope of Practice for Advanced Practice Registered Nurses.5 Above all, don’t be afraid to seek clarification or ask questions until you fully understand what Full Practice Authority means for you.

Melnic is here to support you, if there is anything we can do to help you advance your career, including a complementary resume review, interview tips or career advice, please do not hesitate to reach out to us.

  1. American Association of Nurse Practitioners. Issues at a Glance: Full Practice Authority. https://www.aanp.org/images/documents/policy-toolbox/fullpracticeauthority.pdf. Updated August 6, 2015. Accessed April 22, 2016.
  2. American Association of Nurse Practitioners website. State Practice Environment: States Categorized by Type.  https://www.aanp.org/legislation-regulation/state-legislation/state-practice-environment/66-legislation-regulation/state-practice-environment/1380-state-practice-by-type. Accessed April 22, 2016.
  3. Institute of Medicine. The Future of Nursing: Focus on Scope of Practice. https://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2010/The-Future-of-Nursing/Nursing%20Scope%20of%20Practice%202010%20Brief.pdf. Updated October 2010. Accessed April 22, 2016.
  4. Rand Corporation. The Impact of Full Practice Authority for Nurse Practitioners and Other Advanced Practice Registered Nurses in Ohio.  http://www.rand.org/pubs/research_reports/RR848.html. Accessed April 22, 2016.
  5. American Nurses Association. Determining Scope of Practice for Advanced Practice Registered Nurses (APRNs). http://www.nursingworld.org/EspeciallyForYou/AdvancedPracticeNurses/Scope-of-Practice-2/Scope-of-Practice. Accessed April 22, 2016