Maryland is the latest state to allow nurse practitioners (NPs) to practice without requiring the oversight of a physician.
The American Association of Nurse Practitioners (AANP) applauded the legislation, calling it a “right-sizing” of the regulations governing NPs that will allow better coverage across less populated areas. "The legislative leadership we've seen in states like Maryland illustrates how lawmakers are increasingly rallying behind nurse practitioners as essential providers, especially equipped to meet the health care needs of constituents," said AANP president Ken Miller, PhD, RN, CFNP, FAAN, FAANP, in a statement.
With Maryland in the mix, 21 states now allow full-practice rights to nurse practitioners, although the specific practice parameters can vary from state to state. Nebraska enacted similar legislation in March.
Advanced practice registered nurses, including NPs, serve crucial roles in long-term care settings, an environment where care needs to be delivered 24/7, but a physician is often not present. According to a 2014 Long-Term Living readership survey, almost half of respondents worked at a site where a physician visited less than twice a week.
Settling the state-based battles over the practice definitions and limitations for NPs can come none too soon, since the scope of NP roles across residential care and home care are expanding rapidly. The Bureau of Labor Statistics job outlook for 2012-2022 predicts the number of advanced practice registered nurse jobs to rise by almost a third, a rate the bureau calls “much faster than average.”