Nurse Practitioner Scope of Practice: Georgia

Georgia may be one of the nations’s fastest growing states, but unfortunately, laws pertaining to nurse practitioners in the Peach State aren’t headed in the same direction.  Georgia lags perilously behind when it comes to granting NPs freedom in their practice and is one of the states with the most restrictive nurse practitioner scope of practice laws.  What does the nurse practitioner role look like in Georgia?

Georgia’s Nurse Practitioner Supervision Laws

Nurse practitioners practicing in Georgia must work under physician supervision.  NPs and their physician supervisors must work together under a “nurse protocol”.  The nurse protocol is a written document in which the physician gives the NP authority to perform medical acts and also agrees to be available for immediate consultation with the nurse practitioner.  Georgia state law refers to this supervising physician as a “delegating physician”.

Delegating physicians in Georgia are required to be immediately available for consultation with the NP.  Should the physician not be available, a substitute may be designated as part of the nurse practice agreement.  Delegating physicians are also responsible for conducting a review of medical records for patients treated by the NP as well as observe the nurse practitioner onsite at least quarterly.  Aside from this quarterly visit, the physician does not need to practice onsite with the NP, just be available for consultation.  In Georgia, the delegating physician is held legally responsible for all medical acts performed by the NP.

In a practice with multiple physicians and/or multiple nurse practitioners, a nurse protocol agreement must be agreed upon and signed by one NP and one MD.  Each nurse practitioner in the practice is required to have his/her own protocol agreement. While only one MD is to sign the agreement, there is no limit to the number of physicians who can be designated to consult with the NP. A delegating physician may not enter into a nurse protocol agreement with more that four nurse practitioners at one time.

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Georgia’s Nurse Practitioner Prescribing Laws

Nurse practitioners were not given the right to prescribe medication until 2006, the last state to grant NPs prescribing ability.  Currently, in Georgia, a nurse practitioner’s ability to prescribe must be outlined in the nurse protocol agreement between the NP and MD.  Regardless of the terms outlined in the nurse protocol agreement, NPs in Georgia are not allowed to prescribe Schedule II controlled substances. Nurse practitioners are allowed to signs their own prescriptions in Georgia and do not need an MD co-signature.

Other Georgia Scope of Practice Laws

In Georgia, nurse practitioners are allowed to sign handicap parking permits but are not permitted to sign death certificates.

While life for NPs certainly improved with Georgia’s legislation granting nurse practitioners the ability to prescribe, the state remains behind most others when it comes to nurse practitioner independence.

 

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6 thoughts on “Nurse Practitioner Scope of Practice: Georgia”

  1. In Georgia, can you practice as a nurse practitioner before having a protocol agreement with a physician if your licensure and NPI numbers are all active? Or do you need to protocol to do anything at all as a NP at an outpatient office?

    Thanks!

  2. Norma Roberts Nobles

    Can a NP/Certified Nurse Midwife “order” Schedule II drugs and then physician countersign the order later in Georgia?

  3. Sebrina King Taylor

    In Georgia , can you practice as a nurse practitioner while waiting on your protocol agreement to return from the Georgia composite board if you have a NPI number?

  4. You can begin writing prescriptions under your own name as soon as the protocols are signed – even though they won’t be ‘reviewed’ by the Board more than 1X/mo. I googled do I need a designated MD in GA, and up popped the FAQ’s.

    I’m currently becoming well versed in the GA delegating/designating MD question, as I work for a solo Ped, who will be my delegating MD, but she can’t drag up a ‘designated MD’ – even though all they have to do is be available by telephone PRN.

    To make sure I’m not over-reading the designated doc thing, I wrote to the BOM. Currently waiting for their reply.

    No designated means no job! I really like this job, and don’t want to lose it!

  5. Can NPs working in the hospital or ER setting order schedule 2 drugs for patients in the hospital or ER? I am aware we cannot prescribe but is there a difference in ordering say a one time Norco for a patient in the hospital vs writing a prescription (which I am aware NPs are not able to do).
    Thanks

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