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My name is RB, and I am passionate about acute care bedside nursing. I became a registered nurse to provide the best possible care to each patient I work with. I am also interested in understanding disease mechanisms and improving safe patient care. Laws governing nurse practitioner (NP) practice set the limits on NPs’ independence. Full practice enables NPs to perform assessments, make diagnoses, provide treatments, and prescribe without any supervision by a physician. Reduced practice restricts at least one of these activities and commonly necessitates a physician partnership through a collaborative agreement. Restricted practice means a doctor must oversee or delegate the performing of essential tasks like prescribing medications (Li et al., 2025). Full practice authority may possibly increase access to care and decrease disparities when compared with limited settings.

I am currently practicing in Washington DC at the moment where NPs have full practice rights. NPs in DC are allowed to take control of drugs and with the appropriate DEA and local registration prescription, documenting prescriptions in patient records, and being the sole under the nursing board’s guidelines in managing patient care are some of their functions. This full anatomy supports my passion for acute care bedside nursing as I am allowed to do fast clinical decisions and manage treatment plans without the presence of a physician who has to supervise (Ryskina et al., 2024).

The degree of NP autonomy varies in other states. In Texas, a restricted practice state, NPs have to build a collaborative agreement with a physician and get a separate license for prescriptive authority, which results in limited independent prescribing and decision-making. NPs are allowed to diagnose and manage patient care. New York is a reduced practice state which means they are still obliged to collaborate with physicians for certain prescribing and practice functions. Restrictive laws can result in limited NP autonomy and consequently, limited access to care as opposed to full practice states (McMichael et al., 2025).

References

Li, C.â€‘Y., Tahashilder, M. I., Graves, L., Cram, P., & Kuo, Y.â€‘F. (2025). Variation in patient outcomes across nurse practitioner scope of practice levels. Innovation in Aging. https://doi.org/10.1093/geroni/igaf122.4044

McMichael, B. J. (2025). The impact of nurse practitioner scopeâ€‘ofâ€‘practice laws on preventable hospitalizations. Journal of Health Economics, 103, 103044. https://doi.org/10.1016/j.jhealeco.2025.103044.

Ryskina, K. L., Liang, J., Ritter, A. Z., Spetz, J., & Barnes, H. (2024). State scope of practice restrictions and nurse practitioner practice in nursing homes: 2012â€“2019. Health Affairs Scholar, 2(2), qxae018. https://doi.org/10.1093/haschl/qxae018.

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