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Each individual state in the United States has the ability to determine the scope of treatment capacity which nurses can provide when seeing patients.  There are currently 18 states, including the District of Columbia, which allow Nurse Practitioners the authority to provide full practice care to patients.   When Nurse Practitioners are granted rights to full practice care, they essentially provide care equivalent to a physician.  According to the American Association of Nurse Practitioners full practice is when, “State practice and licensure laws provide for nurse practitioners to evaluate patients, diagnose, order and interpret diagnostic tests, initiate and manage treatments—including prescribe medications—under the exclusive licensure authority of the of the state board of nursing.”  With primary care physician shortages anticipated into the foreseeable future, it is very likely that there will be additional states prompted to broaden the patient care authority of NP’s out of sheer necessity.  At this time most states require NP’s to work with physicians under a written practice agreement, or in other terms they are practicing at reduced or restricted levels of practice.

The Affordable Care Act will provide insurance to millions of previously uninsured Americans.  The increase in the number of insured patients, coupled with the dwindling numbers of primary care physicians, has left a fairly sizable gap in the number of capable medical professionals available to handle the sudden influx of patients requiring care.  Although a debatable topic, many believe Nurse Practitioners are the most likely remedy to address this issue, unless states or the U.S. Government can create a quick solution to the ever expanding shortfall in Primary Care physicians now and in the future.

The 18 states which currently grant Nurse Practitioners full practice treatment authority and licensing are as follows:

1. Alaska
2. Arizona
3. Colorado
4. Hawaii
5. Idaho
6. Iowa
7. Maine
8. Montana
9. Nevada
10. New Hampshire
11. New Mexico
12. North Dakota
13. Oregon
14. Rhode Island
15. Vermont
16. Washington
17. Wyoming
18. District of Columbia

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