Nurse Practitioner Scope of Practice: Virginia

By ThriveAP Team Member Leonel Cabrera

Virginia, “birthplace of our nation”, homeland to eight of the country’s presidents and the site of over half of Civil War battles is on the forefront of history.  However, this spirit of nationalism and freedom changes when it comes to regulations governing nurse practitioner scope of practice.Consistent with it’s historical leadership, Virginia has recently experienced new legislation surrounding NP practice.  In 2012, laws passed in Virginia attempted to revolutionize the nurse practitioner-physician relationship redefining it’s role.  Let’s take a look at the scope of practice for nurse practitioners in Virginia.

Virginia’s Nurse Practitioner Supervision Laws

Nurse practitioners in Virginia do not have the freedom to practice independently; they must work under the supervision of a licensed physician.  As of 2012, Virginia State Law defines this NP-physician relationship as a “Patient Care Team” requiring both consultation and collaboration between the nurse practitioner and physician.

The physician and the nurse practitioner are required to create a written protocol which includes periodic evaluation of services provided by the NP such as patient care outcomes and case reviews.  Other elements include making guidelines for both the physician’s and NP’s availability as well as communicating and consulting with one another.

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Fortunately, the nurse practitioner and physician are not required to be physically present in order to practice.  Use of phone and/or e-mail communication is acceptable for consultation, improving the efficiency of both providers.  Virginia Law states that one physician is allowed to collaborate with up to six nurse practitioners.

Virginia’s Nurse Practitioner Prescribing Laws

For a nurse practitioner to prescribe drugs in Virginia he/she must have this outlined in a written practice agreement with a licensed  physician in addition to a written protocol.  The nurse practitioner’s collaborating physician must “regularly practice” where the NP exercises prescriptive authority.  Also, the Board of Medicine and the Board of Nursing may require that the NP shows evidence of prescriptive authority in the practice agreement at any time.  Nurse practitioners in Virginia are allowed to prescribe Schedule II to VI medications.

The Virginia Board of Nursing requires that NP’s must complete eight hours of continuing education in pharmacology or pharmacotherapeutics every other year to maintain prescriptive authority.  Nurse practitioners in Virginia are not allowed to prescribe medication to themselves or family members except in cases of emergency or isolated settings where there is no other qualified practitioner.  Additionally, the law does allow for the NP to prescribe one course of medication for an acute illness to self or family members. A record of this interaction must be kept.

Other Virginia Scope of Practice Laws

Nurse practitioners enjoy other privileges in Virginia; one is the ability to sign a death certificate.  Patients applying for disabled license plates or placards may do so with nurse practitioner authorization.

Virginia gives nurse practitioners a moderate amount of freedom allowing for loose collaboration with the physician.  There are many benefits compared to other states for NP’s planning to practice in Virginia.


2 thoughts on “Nurse Practitioner Scope of Practice: Virginia”

  1. Just open up shop next door in DC and practice independently and live in the cheaper state of VA. As the nations birth place it is amazingly not innovation friendly. Strong medical lobby. Common VA join the modern era.

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