Since the mid-1960s, nurse practitioners have taken on select health care roles normally fulfilled by physicians. Although nurse practitioners work in all 50 U.S. states, the scope of their care varies greatly among individual states. While most nurse practitioners work independently of physicians, sixteen states including the District of Columbia require NPs to work in collaboration with a physician or another health care provider.
Most states also require nurse practitioners to possess a master degree, as well as approval by their intended state of practice. The licensing and certification process are normally handled by a state board of nursing, with each board having its own criteria.
Standard practice dictates completion of a graduate degree program in nursing as well as board certification from an accrediting body.
Nurse Practitioner vs. Physician Assistant: What’s the Difference?
Many people often mistake a nurse practitioner for a physician assistant. However, the differences become clear once they’ve been explained. Nurse practitioners are registered nurses (RNs) with previous health care experience, graduate-level education (in the form of a master degree) and accreditation from the state board.
NPs work alongside a health care team or independently to diagnose and manage a wide variety of illnesses, including chronic illnesses. Most NPs focus primarily on preventative and acute medical care for patients of all ages.
Physician assistants work collaboratively with physicians to deliver preventative, therapeutic and diagnostic health care services. PAs work, alongside other team members, to perform basic health care tasks, including examinations, medical histories and treatment. PAs are also tasked with ordering and interpreting x-rays and laboratory tests, as well as recording progress notes.
Missouri: Nurse Practitioners at-a-glance
Number of NPs: 4,044
NPs per 100,000 populations: 67
Who governs/grants licenses to NPs: Missouri Board of Nursing
Do you need to be an RN? Yes
Do you need a Master of Science in Nursing to become a NP?
Yes, a Missouri nurse practitioner is required to possess a Master of Science Nursing degree from an accredited institution’s advanced nursing education program.
Are there other requirements?
Yes, a Missouri nurse practitioner must also have certification from a national organization or three graduate hours in pharmacology and 1500 hours of advanced clinical practice.
How much can a Nurse Practitioner earn in Missouri?
NPs earn $92,000 per year (Salaries vary based on the employment setting, geographic location, educational background and years of experience).
Do NPs need a physician’s supervision for diagnosis and treatment?
Yes. Physicians must review at least 10% of total patients seen by Missouri nurse practitioners, and 20% of cases where controlled substances are subscribed by NPs. Not only are physicians restricted to collaborating with no more than three nurse practitioners, at one time, within 50-miles of them, they must also pay physicians sizable fees for collaboration.
Do NPs need a physician’s supervision to prescribe medication? Yes
Is there some drug classifications NPs cannot prescribed? If so, provide details:
Nurse practitioners were given the authority to prescribe Schedule III through Schedule V controlled substances by the Missouri Legislature. However, this authority cannot be carried out until the state of Missouri’s drug control board enacts its own rules regarding these substances.
Missouri: Nurse Practitioner Outlook
When it comes to progress on certain policy options, Missouri has a long way towards making the grade, according to the healthcare reform advocacy group, Community Catalyst. According to the report, “Greater NP autonomy increases consumer access to primary care while freeing up physicians to manage more complex patient cases.
States can support consumer access to health care by passing legislation that eases restrictions on NP scope-of-practice.” The state legislature was poised to unveil legislation that removed the collaboration requirement, but said the legislature has yet to see the light of day.