Whenever I think of New York, the Jay-Z song ‘Empire State of Mind’ immediately starts playing on repeat in my head… “New Yooork, concrete jungle where dreams are made of, there’s nothin’ you can’t do, now you’re in New York”. Contrary to Jay-Z’s lyrical declaration, there are actually a few things NP’s can’t do in New York. Let’s take a look at the scope of practice governing nurse practitioners in the Empire State.
New York’s Nurse Practitioner Supervision Laws
Nurse practitioners practicing in New York are not allowed to practice with complete independence, they must work in collaboration with a physician. The New York State Board of Nursing emphasizes that NP’s must collaborate with a physician but this does not mean they are under physician supervision. NP’s are responsible for their own acts. Although collaboration is required in New York, the specifications of these arrangements are looser than in many other states. The collaborating physician is not required to co-sign any of the NP’s orders, records or charts. The collaborating physician is required to review the nurse practitioner’s patient records in a timely fashion, no less than every three months. New York State Law does not specify the number of charts to be reviewed or require a physician signature on reviewed charts. Decisions regarding number of and extent of chart reviews are left up to the nurse practitioner and collaborating physician. NP experience and the physician’s knowledge of the NP’s abilities should be taken into account.
Nurse practitioners and collaborating physicians in New York must have a written practice agreement as well as written practice protocols. A sample practice agreement is located on the New York State Board of Nursing website. If the nurse practitioner works for multiple physicians within a facility or practice, only one collaborative practice agreement is necessary.
Nursing advocates have lobbied heavily to state legislators for completely independent nurse practitioner practice in New York State. Attempts in 2008, 2010 and 2012 were struck down by lawmakers.
New York’s Nurse Practitioner Prescribing Laws
Unlike collaborative practice laws in the Empire State, nurse practitioners in New York enjoy completely independent prescriptive privileges. Although a collaborative practice agreement is required to enter NP practice, prescriptions are written only under the nurse practitioner’s name. Nurse practitioners in New York State have the authority to write prescriptions for schedule II to IV drugs.
Other New York Scope of Practice Laws
Nurse practitioners in New York State enjoy many small freedoms within their practice. They are, for example, allowed to sign death certificates as well as handicap parking permits.
NP’s in New York have it pretty good. Although required to practice in collaboration with a physician, strict supervision is not mandated. Freedom in prescribing as well as in more trivial areas leaves New York’s nurse practitioners nearly independent in their practice.
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