Understanding the Nurse Practitioner Scope of Practice

nurse practitioner scope of practice

If you are in healthcare, you have no doubt heard the term “silver tsunami” to refer to the growing population of seniors in the United States. As Baby Boomers age, they are creating an expanding need for healthcare. With a looming shortage of physicians, advanced practitioners are filling provider gaps in a wide range of healthcare environments. What does a nurse practitioner scope of practice encompass, and how does it differ from that of a physician assistant?

NPs and PAs: An Increase in Providers

The American Association of Nurse Practitioners (AANP) reports that there are more than 270,000 nurse practitioners (NPs) licensed to practice in the United States. 

Nurse practitioners practice in a broad cross section of healthcare environments. For example, the AANP reports that the majority of NPs (72.6%) provide primary care in the following settings: 

  • 24.2%: Private practice 
  • 14.5%: Hospital outpatient clinics
  • 12.1%: Inpatient hospital units 
  • 3.1%: Emergency rooms 
  • 4.3%: Urgent care 
  • 8.1%: Community health centers and Federally Qualified Health Centers 

A study by Penn State reported an increase in those specializing in nursing home care of 33.7% between 2012 and 2015. The study said, “Most of these specialists were advanced practitioners, physician assistants and nurse practitioners, delivering post-acute care.” 

The benefits offered by advanced level practitioners to practice is well documented as well. An analysis by Medical Group Management Association (MGMA) found that “Primary care practices that had a higher non-physician provider to physician ratio reported greater revenue after operating costs compared to practices with provider ratios of 0.20 or lower.” The study also found, “Physician-owned practices earned about $100,749 more after operating expenses per physician and hospital-owned practices earned $131,770 more.” 

Nurse Practitioner Scope of Practice

What exactly is the scope of practice for nurse practitioners? This scope is broad and covers nearly every type of clinical practice, but functions are dependent on the state in which you are licensed to practice.

In terms of accountability, the AANP states in its scope of practice: “Each NP is accountable to patients, the nursing profession, and the state board of nursing. NPs are expected to practice consistent with an ethical code of conduct, national certification, evidence-based principles, and current practice standards.”

Nurse practitioners practice in the following healthcare environments: 

  • Clinics
  • Hospitals
  • Veterans Affairs and Indian healthcare facilities
  • Emergency rooms
  • Urgent care sites
  • Private physician or NP practices
  • Nursing homes
  • Schools
  • Colleges
  • Retail clinics
  • Public health departments
  • Nurse managed clinics
  • Homeless clinics
  • Home health

The nurse practitioner scope of practice includes a number of different tasks. Nurse practitioners are qualified to perform the following: 

  • Assessment
  • Ordering, performing, supervising, and interpreting diagnostic and laboratory tests
  • Diagnose and management of acute and chronic disease 
  • Treatments including prescribing medications 
  • Coordination of care and patient education 

Who do nurse practitioners serve? They may care for patients in a wide range of demographics, in a range of specialties: 

  • Families
  • Pediatrics and neonatal care
  • Women’s health
  • Adult medicine
  • Geriatrics
  • Psychiatric mental health 

Like physicians and other practitioners who specialize, nurse practitioners must take a board certification exam in order to earn the credentials in their chosen specialty. BoardVitals offers online question banks in most of these specialties to help NP’s pass their exams. 

Nurse practitioners allow for patients to receive the quality care they need and deserve. This vital role will only continue to grow in importance as the population ages and faces new health challenges.