States with Full Practice for NPs

“Where is the best place for me to practice?”  This is a question I frequently receive. While this has been discussed before, that was in 2012. Obviously it’s time to update the post.

(There have been so many legislative changes so far this year, that this post is updated for the 2nd time since posting to say congratulations to Minnesota!)

When an NP looks to see which state he or she wishes to practice, there are obviously a lot of variable to consider – family life, cost of living, job or practice opportunities to name a few. However, many NPs want to practice where they can use their education and skills to the fullest. Thus many of us look for states where the fewest barriers to practice exists.

At the time of this post, there are 19 states* plus the District of Columbia where nurse practitioners can practice autonomously. A few of these states have some qualifying criteria, but once met, you are on your own.

By the way, the 19 states – that number is poised to change shortly as there is pending legislation in several states. Follow us, along with AANP on social media to keep up to date as this changes.

So which states have qualifying criteria?

• Colorado:  NPs must have 3600 hours of experience
• Connecticut:  The bill passed today 4/29/2014 and I am not sure when it will go into effect. NPs will need 3 years of practice working under a collaborative practice prior.
• Maine:  NPs are required to have 2400 hours of physician or supervising NP involvement
• Maryland:  Full practice is available as long as there is an attestation on fill stating the NP will obtain collaboration when needed (I don’t think I need to comment on this one).
• Minnesota:  NPs must have 3600 hours of experience.
• Nevada:  NPs must have 2 years or 2000 hours of clinical practice
• New York State:  Effective Jan 2015, NPs will have to have 3600 hours of collaborative experience. Rules are still being written.
• Vermont:  NPs are required to have 2400 hours and 2 years of a practice agreement.

I fully expect to update this post in the next month or so with even more states!  I’d love hear your experience in your state (even if you are not on this list). What’s working? What’s not? How hard or not is it to get credentialed or reimbursed? Share below.

Resources used:

• AANP
• Phillips, Susanne J., 26th Annual Legislative Update: Progress for APRN authority to practice, 2014 The Nurse Practitioner Journal
• Various state practice acts
• Nurse Practitioners