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What is a nurse practitioner鈥檚 scope of practice?

This article was updated on May 1, 2024.

Michael Feder

Written by Michael Feder

Raelene Brooks, Dean, College of Nursing

This article was reviewed by Raelene Brooks, Dean, College of Nursing.

Nurse practitioner smiling, talking to a patient

础听nurse practitioner听(NP) maintains a wide variety of responsibilities. Trained and licensed as听registered nurses, NPs provide comprehensive care with an emphasis on disease prevention and education. A nurse practitioner will often order, perform and interpret diagnostic tests, update health records and communicate with patients and their families.

What does a nurse practitioner do?

As an NP, your scope of practice is defined in each state鈥檚 laws, rules and regulations and听can vary based on several factors, including your education and training, employer and the state you鈥檙e practicing in. Here, we explore some of the roles and responsibilities that are generally inherent to working as an NP.

Assessment

Nurse practitioners gather information about a patient during the assessment process. Depending on the nature of the assessment, nurses often ask questions about medical history and the length of time since a patient first experienced a particular symptom or ailment.

Assessments are instrumental in analyzing a patient鈥檚 physical, mental and emotional state. With the right questions and assessment strategies, NPs can quickly gauge a patient鈥檚 condition and make recommendations for treatment.

Nurse practitioners tailor a patient鈥檚 assessment according to their condition and the reason for the evaluation. For example, assessments might include a physical examination to gauge response to a simple stimulus. In other cases, an NP might ask questions to evaluate mental status. Part of the assessment is reviewing and updating patient records.

Diagnostic and lab tests

Diagnostic tests are a urine analysis, an electrocardiogram (ECG), a pulmonary function test and an ultrasound done in the office. In most cases, nurse practitioners will order diagnostic tests, such as blood work, X-rays, ultrasound, magnetic resonance imaging (MRI) or computed tomography (CT).

By contrast, some patient concerns require more complicated diagnostic tests. For example, pregnant, at-risk patients might need prenatal tests to continually track fetal growth.

If nurse practitioners cannot perform a specific diagnostic examination, they order tests for further examination. A laboratory often handles tests on blood or other fluids, and then delivers the results to the nurse practitioner for analysis. Just as with blood tests, a nurse practitioner may need to send a patient out for an X-ray or MRI to evaluate an internal condition.听

Prescribing medication and treatment

After performing an assessment, NPs can prescribe medication to alleviate symptoms, ease pain, treat infections or improve recovery. . This ability offers efficiencies for patients.

A nurse practitioner can also develop treatment plans for patients and help them implement the plans. For example, an NP might outline a road map to help a patient manage a chronic condition such as diabetes, hypertension or obesity. Sometimes, treatment plans include medication and some form of mental or physical therapy deployed together to assist in holistic patient recovery.

Patients understandably have questions whenever medication or therapy is prescribed. Nurse practitioners work hard to educate patients on the details of their treatment plans and to update the plans as patients progress toward their goals.

If a patient requires a more complicated treatment plan or a specialized service that the nurse practitioner cannot provide, NPs can make referrals to medical specialists. For example, an NP might refer a patient to an allergist or immunologist for recommendations on preventing further allergic reactions.

Coordinating care

Nurse practitioners play an important role in coordinating care and referring patients to specialists when needed. Collaborating with other healthcare team members about care provides the best path forward for patients. Referring to specialists helps patients get the specialized care they need for a specific ailment.

To best coordinate patient care, nurse practitioners should maintain strong communication with their team and patients. Clear communication among patients, nurse practitioners and care teams helps eliminate misunderstandings and lost time between a diagnosis and the beginning of treatment.

Working as a healthcare advocate

Nurse practitioners are advocates for patients. This means improving patients鈥 access to healthcare services, treatment or resources to aid recovery or rehabilitation.

NPs also show patients how simple lifestyle adjustments in diet, activity and other areas can lead to improved outcomes. They may work to integrate lifestyle adjustments as a portion of a treatment plan. For example, they might prescribe medication to improve blood pressure but also advocate for daily exercise to enhance the medication鈥檚 efficacy.

Nurse practitioners advocate for patients on a legislative level too. For example, they 听might address local, state or federal legislative bodies on their patients鈥 behalf to advocate for additional resources. This approach is essential when serving a community of patients facing socioeconomic challenges.

Educated NPs serving as healthcare advocates learn to speak productively with decision-makers to improve the healthcare system as a whole. Whether听 communicating with local stakeholders, municipal representatives or treatment facility coordinators, nurse practitioners learn how to advocate for solutions that can help address the health challenges facing their community.

Accountability for professional practice

An NP is primarily accountable to the patients they serve. The decisions made, and the treatment plans, implemented, directly affect the health of patients. It鈥檚 important for all NPs to maintain transparency and trust with patients through the assessment, diagnosis and care-plan phases of treatment.

Nurse practitioners are encouraged to follow, and may be required to adhere to, the , a guide set by the that dictates appropriate nurse conduct in the workplace. States regulate the practice of nursing, including all nurse practitioners through each state鈥檚 laws and regulations, sometimes referred to as a state鈥檚 Nurse Practice Act. These state Boards of Nursing develop and maintain robust and statewide nursing standards.听听

When an NP violates these accountability standards, they also violate the trust between practitioner and patient. Violations can lead to a loss of licensure and even criminal charges, particularly when patient outcomes suffer as a result.

Nurse practitioner education requirements

It鈥檚 important to understand the steps involved in becoming a nurse practitioner before starting your nursing credentials journey. This includes obtaining the specific to become an NP.

First, you鈥檒l need a bachelor鈥檚 degree in nursing or in a closely related field. To prepare for licensure as a nurse practitioner, RNs must obtain an appropriate nursing graduate degree, such as a Master of Science in Nursing/Family Nurse Practitioner. This graduate program teaches new and advanced practice theories and skills such as advocacy, nursing practice, problem-solving and research application.

Even after becoming an NP, you will likely need to regularly update your certification (depending on the state) by satisfying . Nurse practitioners are expected to stay updated with medical practices as they evolve. Some NPs return to the classroom to pursue a doctorate in nursing practice鈥攁 program for working nurses seeking a higher degree for advanced practice.

Earn a degree in nursing at 爱污传媒

If you鈥檙e interested in becoming a nurse practitioner, a听Master of Science in Nursing/Family Nurse Practitioner听can help prepare you for this career. This program will teach you skills in nursing practice, advocacy, planning, problem-solving and research application. However, as mentioned, you first need to become a registered nurse and obtain a BSN before applying for this program. Learn more about our听online nursing degrees听here:

  • RN to Bachelor of Science in Nursing (Competency-Based)听鈥 This program is designed for working professionals who have an Associate Degree in Nursing, an unencumbered RN license and one year of professional experience. It encompasses business management, critical thinking, holistic nurse care and more.
  • Master of Science in Nursing/Psychiatric Mental Health Nurse Practitioner听鈥擳his program prepares a nurse for a role as an advanced practice registered nurse (APRN) specializing in neuropsychiatric care and treatment. Learn skills such as neuropsychiatric disorder prevention, assessment, self-care management, psychotherapeutic intervention, pharmacological management, and addiction services. Gain knowledge to treat psychiatric disorders in various healthcare settings and in diverse patient populations.
  • Doctor of Nursing Practice听鈥 Enhance your career and advance the discipline of nursing with our Doctor of Nursing Practice (DNP). This program is designed for working nurses who require a doctorate for advanced practice or nurses who desire their terminal degree. It does not prepare students for professional certification or state licensure as a nurse or as an advanced practice nurse.
Headshot of Michael Feder

ABOUT THE AUTHOR

A graduate of Johns Hopkins University and its Writing Seminars program and winner of the Stephen A. Dixon Literary Prize, Michael Feder brings an eye for detail and a passion for research to every article he writes. His academic and professional background includes experience in marketing, content development, script writing and SEO. Today, he works as a multimedia specialist at 爱污传媒 where he covers a variety of topics ranging from healthcare to IT.

Headshot of Raelene Brooks

ABOUT THE REVIEWER

Dr. Raelene Brooks, dean of the College of Nursing, has been a registered nurse for more than 25 years and practiced extensively in the areas of ICU, trauma and critical care. Her publications include a focus on nursing education, critical care and diversity, equity and inclusion. She is a leader in creating, guiding and launching innovative curriculum.

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