California Nurse Practitioner Scope of Practice

     In California the current level of practice for Nurse Practitioners is set forth under a collaborative agreement with a physician and/or surgeon that specifies standardized procedures that defines the scope of practice (Buppert, 2018). Under the standardized procedures, California Nurse Practitioners are authorized to prescribe durable medical equipment, certify disability, and amend or add to home health care plans (Buppert, 2018). In respect to furnishing drugs and devices, California NPs must practice to the extent of their education and competency under the standardized procedures coordinated with the supervising physician (Buppert, 2018). Additionally, the standardized procedures must specify the furnishing in respect to the circumstances and are reviewed according to the collaborative agreement. California NPs must meet requirements for furnishing of drugs and devices and must register with the Drug Enforcement Agency (DEA) to furnish controlled substances under the supervision of a physician and/or surgeon. Physicians and surgeons may supervise no more than four NPs at one time. Standardized procedures are completed in writing and detail their development, approval, and revision specifics. The scope of NP supervision is also required for the standardized procedure performance and must specify the training, education, and experience required for the procedure (CBRN, 2023).

California Assembly Bill 890

In 2020, California Governor Gavin Newsom signed the Assembly Bill 890 that specifies two new NP categories that can function without the standardized procedures provided the NP meets the criteria (CBRN, 2020). To meet the criteria for 103 NP, the NP must be certified as  by the California Board of Registered Nursing and have practiced full-time for three years or completed 4600 hours in 5 years (CBRN, 2020). NPs may practice in a group setting under the guises of their certification with at least one physician and/or surgeon (CBRN, 2020). 

Nurse Practitioners practicing in good standing for three full years or have completed 4600 patient care hours may apply for the 104 NP. The 104 NP may practice in a group setting without standardized procedures; however, the NP must not practice beyond the scope of their certification, training, experience, education, and knowledge (CBRN, 2020).  

Nurse Practitioner Practice Barriers

Although California has made great strides toward full practice authority for Nurse Practitioners, collectively the state of California has not come to a consensus regarding the rights of Nurse Practitioners to practice without barriers. It is hoped future legislation will remove the remaining barriers so Nurse Practitioners may practice to the full extent of their education, experience, and training.

References

Buppert, C. (2018). Nurse practitioner's business practice and legal guide, 6th ed. Jones and Bartlett Learning, LLC. ISBN: 978-1284117165

California Board of Registered Nursing (2020). Assembly Bill 890
(Wood, Chapter 265, Statutes of 2020). Retrieved from: https://www.rn.ca.gov/practice/ab890.shtml#:~:text=is%20AB%20890%3F-,In%20September%202020%2C%20Governor%20Gavin%20Newsom%20signed%20Assembly%20Bill%20(AB,of%20practice%20without%20standardized%20procedures.

California Board of Registered Nursing (2023). NURSE PRACTITIONERS: LAWS & REGULATIONS Division 2. Healing Arts; Chapter 6. Nursing; Article 8. Nurse Practitioners. Retrieved from: 

https://www.rn.ca.gov/pdfs/regulations/bp2834-r.pdf