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Department: Guest Editorial

Policy brief tackles scope of practice laws and their impact

Editor(s): Brassard, Andrea PhD, FNP-BC, FAANP

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doi: 10.1097/01.NPR.0000516116.46631.11
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In many parts of the country, Americans find it hard to get healthcare when and where they need it. Instead of getting the care they need, patients often get caught up in the restrictions that limit NPs from providing all the services they have been educated to offer. The latest issue of Charting Nursing's Future, a series of policy briefs on topics of interest to nurses published by the Robert Wood Johnson Foundation (RWJF), delves into the matter in a sweeping, state-by-state look at scope-of-practice (SOP) laws in the United States and their repercussions.1

Although 22 states and the District of Columbia allow NPs full practice authority, 28 states still apply restrictions to advanced practice registered nurses (APRNs).2 In the issue “The Case for Removing Barriers to APRN Practice,” readers will find a glossary, a primer, and a call to action regarding laws in some states that hinder these highly educated professionals and cause public delays in care.1 Among other features are:

  • Links to four recent studies that suggest consumers receive high-quality care at a lower cost when states remove practice restrictions
  • Stories showing the impact that state laws have on individuals and how the laws govern each of the four APRN roles
  • A look at “collaborative agreements,” with a focus on transition-to-practice periods, a political compromise
  • A number of common myths about nurses' care with the facts that policymakers—and the public—need to know.

The issue includes fundamentals as well, covering a description of all four APRN roles, including education, clinical training, certification, licensure, and numbers. There is also a graph that indicates how graduation rates of NPs have exponentially increased.

Providing care for more Americans

Lifting restrictions so NPs can provide more Americans more care was a key recommendation of the Institute of Medicine's 2010 report The Future of Nursing: Leading Change, Advancing Health. The report gave rise to the cause I work for, the Future of Nursing:Campaign for Action, an initiative of AARP Foundation, AARP, and RWJF.

Earlier this year, an editorial in The Nurse Practitioner journal gave a nod to our efforts on the legal front, pointing to a webinar we hosted that laid out the evidence that better laws mean improved healthcare in the major categories of access, quality, and cost.3 The Campaign for Action has compiled its own SOP resources in those three categories.4

The organizations backing the Campaign for Action are among many working to modernize laws for the sake of better access and better health, including the Federal Trade Commission, the National Governors Association, the American Enterprise Institute, the American Hospital Association, and The Heritage Foundation. That level of support is just one of many facts reported in the latest issue of Charting Nursing's Future. Because it is such a comprehensive overview, “The Case for Removing Barriers to APRN Practice” should be required reading for APRN students, faculty, and most important, policymakers.1

Taking action

If reading about the history, breakthroughs, and challenges in improving access to care for Americans moves you to want to take action (as it should), the staff at AARP's Center to Champion Nursing in America—an initiative of AARP Foundation, AARP, and RWJF—are happy to help. We can connect you with participating organizations in your state, such as a state affiliate of the Campaign for Action or an AARP state office that is working to remove barriers to APRN practice and care. We can also provide guidance, talking points, and assistance with letters of support, opinion pieces, and testimony. We look forward to hearing from you!


Andrea Brassard, PhD, FNP-BC, FAANP



1. Robert Wood Johnson Foundation. Charting Nursing's Future. 2017.
2. American Association of Nurse Practitioners. State practice environment. 2017.
3. Newland J. A new beginning: stay informed! Nurse Pract. 2017;42(1):6.
4. Campaign for Action. Improving access to care: what you need to know. 2016.
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