In California, nurse practitioners (NPs) are allowed to practice independently. The California Nurse Practice Act (NPA) provides that a registered nurse has completed the necessary and additional education and training. They have the authority to provide primary, acute, and specialty care independently. They can diagnose, order tests, and manage treatments without being supervised by physicians or others (California Board of Registered Nursing, n.d.). Without meeting these requirements, they must follow standardized protocols and procedures developed and approved by a doctor or a midwife.
Given California’s restrictions, one possible barrier to NP practice is the inconsistency and lack of clarity in the procedures and protocols these professionals must follow. Even though NPs are allowed to operate independently, they lack clear guidance on collaborative agreements with healthcare facilities (Aguilera, 2020). Additionally, the professionals can only order drugs and medical devices if they have a furnishing number issued by the DEA and the Board of Registered Nursing. These issues can limit the NPs’ ability to offer timely and appropriate care to patients
In California, it is clear from the NPA that NPs must abide by the standardized procedures and protocols established. If they do not follow these guidelines, they must be certified as nurse practitioners in independent practice (NPIPs)in a given setting (Ljungbeck et al., 2021). Therefore, they do not necessarily require formal collaboration or supervisory agreement with a physician. However, they will require some degree of coordination with these professionals.
NPs in California who want to practice independently must have “residency” hours. This transition-to-practice period is supposed to last at least 4,600 hours, or 3 years, under the supervision of an NPIP or a physician. It must also include at least 50 hours of continuing education in a given area(California Board of Registered Nursing, n.d.). As an NP, I support these residency hours because I think it is essential for these individuals to gain experience and confidence before caring for patients.
References
Aguilera, E. (2020). Facing doctor shortage, will California give nurse practitioners more authority to treat patients?
California Board of Registered Nursing. (n.d.). Nursing Practice Act.
Ljungbeck, B., Forss, K. S., Finnbogadóttir, H., & Carlson, E. (2021). Content in nurse practitioner education–A scoping review. Nurse Education Today, 98.