In 2018, Virginia passed a bill which expanded the scope of practice for APRNs. The House Bill 793 established a transitional licensing model where APRNs with at least 5 years (or 9000 hours) of work equivalence in their area of certification and practice can apply for an autonomous practice license. Therefore, although the state is not supportive of full practice autonomy for NPs, it does offer this transitional route. Those NPs without the experience necessary for autonomous practice still maintain a wide scope of scope of practice but Virginia uses a restrictive approach requiring practice agreements (Smith et al., 2020).
Based off this scope of practice, APRNs in Virginia have the ability to prescribe Schedule II through Schedule IV substances independently if they have achieved the autonomous licensing and 5 years of experience. Those who do not meet the practice requirements, can prescribe controlled substances only with an authorized practice agreement with a patient care team physician. All controlled substance prescriptions have to be signed by the physician as outlined in the legal practice agreement (Virginia Law, n.d.).
In Virginia, nurse practitioners have relative freedom in terms of basic practice including taking health history, performing physical exams, and diagnosing patients. APRNs have the ability to treat common and chronic conditions and decide treatment plans. Nurse practitioners can also offer patient counseling, education, and preventive care (VHWDA, n.d.). This applies to all NPs, not just the ones that achieved the autonomous practice requirement. The only barrier arises is when prescribing medication or potentially certain diagnostic tests where NPs may need physician sign off before proceeding. Overall, Virginia is a restrictive state in terms of APRN practice but does offer some flexibility. With the input of experts and nursing organizations, the state is moving forward towards a more autonomous model of practice.
References
Smith, S., Buchanan, H., & Cloutier, R. (2020). Virginia NP scope of practice. The Nurse Practitioner, 45(2), 33–37. Web.
VHWDA. (n.d.). Nurse practitioner. Web.
Virginia Law. (n.d.). § 54.1-2957. Licensure and practice of nurse practitioners. Web.