Name
Chamberlain University
NR-506: Healthcare Policy
Prof. Name
Date
In the state of Florida, nurse practitioners (NPs) operate under restricted practice regulations, meaning they require physician oversight to deliver patient care (AANP, 2020). While NPs are recognized as essential providers, their ability to practice autonomously has historically been limited. However, in 2020, Governor Ron DeSantis signed legislation allowing qualified nurse practitioners who have completed at least 3,000 supervised clinical hours to practice independently without direct physician supervision (Thomas, 2020). This marked a significant step toward expanding NP authority in the state.
Florida law grants nurse practitioners the ability to prescribe medications, including controlled substances, but with certain restrictions. Prescriptive authority requires a written supervisory agreement with a physician. For Schedule II controlled substances, NPs may prescribe only a seven-day supply, with the exception of psychiatric medications, where no such limit applies. Importantly, only psychiatric nurse practitioners are permitted to prescribe mental health medications to patients under the age of 18 (American Medical Association, 2017).
Additionally, nurse practitioners are mandated to complete three hours of continuing education every two years on the safe prescribing and monitoring of controlled substances to maintain prescriptive privileges. This regulation ensures NPs remain up to date with evolving medication safety practices.
Although advanced practice registered nurses (APRNs) can perform key functions—such as diagnosing illnesses, ordering diagnostic tests, and developing treatment plans—these activities must occur under a physician’s supervision. Florida law requires a written protocol between the NP and supervising physician, detailing the scope of duties and responsibilities. While the physician does not need to be physically present, they must be available by telephone for consultation.
Despite these restrictions, Florida legally recognizes nurse practitioners as primary care providers (PCPs), acknowledging their role in improving access to healthcare.
To qualify for NP licensure in Florida, candidates must:
| Requirement | Details |
|---|---|
| Registered Nurse (RN) License | Must hold an active RN license in Florida. |
| National Certification | Proof of national certification from a recognized specialty board is required. |
| Clinical Experience | Completion of clinical training hours as per specialty board standards. |
| Academic Requirements | Master’s or doctoral degree in nursing with a focus on advanced practice. |
| Standardized Examination | Passing a national certification exam is mandatory. |
| Background Check | Applicants must undergo fingerprinting and criminal background screening. |
| Continuing Education | Completion of a 2-hour course on prevention of medication errors is required. |
| Liability Insurance | NPs must carry malpractice/liability insurance. |
The National Organization of Nurse Practitioner Faculties (NONPF) established nine core competencies essential for all nurse practitioners upon program completion (NONPF, 2012). These competencies ensure NPs are fully equipped for independent clinical practice:
Scientific Foundation – Evidence-based decision-making.
Leadership – Influencing healthcare systems and policies.
Quality – Improving patient outcomes.
Practice Inquiry – Translating research into practice.
Technology and Information Literacy – Using digital tools to enhance care.
Policy – Engaging in health policy advocacy.
Health Delivery Systems – Understanding healthcare structures.
Ethics – Applying ethical principles in decision-making.
Independent Practice – Managing patients autonomously.
These competencies ensure NPs possess the knowledge, skills, and judgment necessary to provide safe and effective care.
Although nurse practitioners deliver safe and high-quality care comparable to physicians, restrictive regulations continue to hinder their ability to practice to the full extent of their training. Florida has more than 18,000 nurse practitioners, with an additional 300–500 graduating each year (Florida Association of Nurse Practitioners, 2020).
If allowed to practice without limitations, NPs could reduce healthcare costs significantly and improve accessibility, especially for vulnerable populations. However, existing restrictions disproportionately impact Medicaid recipients and rural communities, where access to primary care physicians is already limited. These barriers increase healthcare costs and perpetuate disparities.
Expanding access to nurse practitioners has the potential to reduce healthcare disparities across Florida. Many individuals—particularly those in rural, underserved, and uninsured populations—lack consistent access to physicians. Nurse practitioners play a critical role in preventive care, chronic disease management, and patient education, helping to reduce avoidable hospitalizations and improve long-term health outcomes.
By serving in both urban and rural communities, NPs bridge healthcare gaps, ensuring patients receive timely, affordable, and comprehensive care. Their role in reducing disparities demonstrates the importance of granting them broader practice authority.
American Association of Nurse Practitioners. (2020). State practice environment: Florida. Retrieved from https://www.aanp.org/advocacy/florida
American Medical Association. (2017). State law chart: Nurse practitioner prescriptive authority. Retrieved from https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/specialty%20group/arc/ama-chart-np-prescriptive-authority.pdf
Florida Association of Nurse Practitioners. (2020). The advanced practice nurse solution. Retrieved from https://www.flanp.org/page/TheAPRNSolution
Florida Nurse Practitioners Gain Full Practice Authority. (2020). Daily Nurse – The Pulse of Nursing. Retrieved from https://dailynurse.com/florida-grants-advanced-nps-full-practiceauthority/
Nursing Licensure.org. (2020). Advanced registered nurse practitioner requirements in Florida. Retrieved from https://www.nursinglicensure.org/np-state/florida-nursepractitioner.html
National Organization of Nurse Practitioner Faculties. (2012). Nurse practitioner core competencies. Retrieved from https://www.nursepractitionerschools.com/faq/what-are-the-np-core-competencies/
Thomas, K. (2020). Florida legislation expands NP autonomy. Retrieved from https://scopeofpracticepolicy.org/states/fl/
