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Virginia Nurse Practitioners

Career News September 19, 2013

Nurse practitioners are registered nurses who have received advanced training to provide high-quality preventative and acute health care services for individuals of all ages. Nurse practitioners work in all 50 states and the District of Columbia; sixteen states and the District of Columbia do not require nurse practitioners to have a supervisory relationship with another health care provider. This means that they may work both independently and collaboratively with another health care team.

The majority of states, including Virginia, require a Master’s of Science in Nursing and board certification by an accrediting body in order to become a nurse practitioner. After earning a Master’s degree in Nursing, nurse practitioner candidates should submit their credentials for approval to the State Board of Nursing, which regulates the licensing and certification criteria. While not every state specifically requires a master degree for nurse practitioners, the majority of states do.

Virginia Nurse Practitioner vs. Physician Assistant: What’s the Difference?

Nurse practitioners (NPs) and physician assistants (PAs) work in hospitals, clinics and rural practices as important members of the health care team. While NPs and PAs can both treat patients, prescribe medications and counsel patients, key differences lie in their background and training.

Nurse practitioners must first hold a nursing degree and substantial nursing experience prior to enrolling in a graduate program. On average, NPs have 10 years of nursing experience before pursuing their graduate degree. A Master of Science in Nursing degree prepares nurses for advanced practice. NPs may specialize in a specific area, although they generally focus on disease prevention and patient counseling.

Physician assistants hold a Master’s Degree and may specialize in a specific type of health care, such as primary care, pediatrics or general surgery. The Physician Assistant Education Association provides nine to 15 months of supervised training. However, unlike NPs, PAs may pursue their degree right out of school; overall, they have less medical experience than NPs do when entering a degree program.

While NPs are considered independent from a specific medical practice, PAs must practice directly under a physician. PAs can act on behalf of a physician, providing diagnostic service, treating minor injuries, interpreting laboratory testing and X-rays, and prescribing a course of treatment.

Virginia: Nurse Practitioners At-A-Glance

Number of NPs: There are 6,561 NPs in Virginia, according to the Kaiser Family Foundation.

NPs per 100,000 populations: There are 81 NPs in Virginia per 100,000, according to the Kaiser Family Foundation; there are 58 NPs in the United States per 100,000.

Who governs/grants licenses to NPs: Virginia 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, Virginia nurse practitioners must hold a graduate degree from an accredited advanced nursing education program.

Are there other requirements?

Yes, for prescriptive authority, Virginia NPs must have a current license as a nurse practitioner or evidence of certification as a nurse practitioner. Virginia NPs must also:

(1) complete a graduate level course in pharmacology as part of NP program within 5 years prior to the submission of application; or
(2) practice as an NP for no less than 1,000 hours and 15 continuing education units related to the area or practice for each of the 2 years prior to submission of the application; or
(3) complete 30 hours of education in pharmacology acceptable to the boards taken within 5 years prior to submission of the application.

How much can a Nurse Practitioner earn in Virginia?

On average, NPs earn $96,000 per year. However, 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, to practice in Virginia, an NP must hold three licenses (RN, NP and Prescriptive Authority licenses). A Practice Agreement for Prescriptive Authority and Practice Protocol is also required.

The Practice Protocol includes provisions for periodic reviews; guidelines for joint patient evaluations and chart reviews; and guidelines for the availability of the collaborating physician, including geography and practice setting.

Do NPs need a physician’s supervision to prescribe medication?

Yes. General authority to prescribe is outlined by the collaborative practice agreement in Virginia. Prescriptions must include the state-issued Rx number. NPs can prescribe Schedule II-VI. However, the supervising physician may limit this prescribing authority in the Practice Agreement for Prescriptive Authority.

Virginia: Nurse Practitioner Outlook

According to Community Catalyst, a national advocacy group for health care reform, Virginia misses the mark when it comes to providing quality health care. By expanding the scope of practice guidelines, the state could expand the role of NPs, increase their autonomy, and free up physicians to manage more complex cases.

“States can support consumer access to health care by passing legislation that eases restrictions on NP scope-of-practice,” says the Community Catalyst report. Additionally, both the nursing and medical boards are required to regulate NPs. Community Catalyst argues that using two regulatory boards creates confusing and inefficient oversight structure.

A discussion about how the health care system can evolve to meet patient needs, including patients in Virginia, should include an unbiased look at expanding the role of NPs and simplifying regulations.

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