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In accordance with the state board of nursing’s exclusive authority over licensing, nurse practitioners (NPs) with full practice authority (FPA) are permitted to assess children, make a diagnosis, interpret test results, and start and oversee treatment options, including the medication.

There are more NPs available in states with supportive practice settings, notably those with less onerous SOP restrictions. Because NP and physician time spent on supervision requirements is eliminated, it is believed that the NP FPA helps patients and healthcare systems by expanding the number of hours that healthcare providers are available to work and lowering healthcare expenditures. After states adopted the NP FPA, longitudinal research analyzing the causal impact from 1970 to 2012 showed improved patient self-reported health status, increased use and quality, and decreased hospitalization rates for general practice issues across groups (Moore et al., 2020).

As the American population ages, hospital services are needed more and more. NPs who work in inpatient settings prioritize the length of stay and the outcomes of interventions, whereas NPs who work in outpatient settings prioritize patient access to care and shorter wait times. Care coordination and transitions are essential to the effectiveness of hospital treatment for all patients, regardless of age. NPs who use FPA can provide patients rapid access to all of the treatments they are qualified to deliver. FPA for NPs allows them to provide patients immediate access to all of the services that NPs are capable of offering.

As an NP with an increased position, FPA may anticipate long hours. This may lead to chronic weariness and make it difficult to plan family time and pursue other hobbies. Due to the lack of nurses and doctors, nurse practitioners frequently see many patients daily. Stress and anxiety can result from overwork. Many NPs claim that payer policies significantly affect their capacity to exercise their licensing and training to the utmost degree possible(Kleinpell et al., 2022). Payer policies frequently relate to state practice laws and license requirements. The capacity of NPs to work autonomously may be restricted by payer regulations with a narrower scope of practice. They are effectively compelled to work as employees of doctor’s offices, hospitals, or other organizations. Payment guidelines for commercial health plans might differ, and they frequently do not classify NPs as primary care physicians.

Additionally, these payers can be reluctant to certify or pay NPs directly for their services. This approach can restrict practice locations to just those connected to doctors. Some public and private payers prevent NPs from working independently of a doctor by withholding payment or providing reimbursement at a lower rate.



Kleinpell, R., Myers, C. R., Likes, W., & Schorn, M. N. (2022). Breaking Down Institutional Barriers to Advanced Practice Registered Nurse Practice. Nursing Administration Quarterly46(2), 137–143.

Moore, C., Kabbe, A., Gibson, T. S., & Letvak, S. (2020). The Pursuit of Nurse Practitioner Practice Legislation: A Case Study. Policy, Politics, & Nursing Practice21(4), 222–232.

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