There are some interesting trends in the nurse practitioner job market across the country. Some of these trends are to be expected, while reasons behind others don’t appear as obvious. Among the more easily identified, cities with few NP programs are generally in greater need of providers. On the other hand, locations like Nashville, TN, home to multiple nurse practitioner programs, are saturated with new grads making jobs hard to come by. One effect on the job market for nurse practitioners that can be difficult to pinpoint is scope of practice laws.
Scope of Practice and the Overall Job Market
If you’re looking for an NP job and can’t seem to find many positions listed in your area, scope of practice rules and regulations may be to blame. Employers don’t find nurse practitioners as useful in states with restrictive scopes of practice and as a result they hire fewer NPs opting instead for physician assistants or physicians. This trend can be seen in Alabama and Florida, states with restrictive rules guiding nurse practitioner’s practice. Both states have prohibitive prescribing laws and require that NPs be supervised by a physician making employing nurse practitioners in these states logistically difficult. Many hospitals and clinics choose to avoid the hassle completely opting for physician-only practices.
Relocating isn’t an option for everyone, but if you’re considering multiple locations in your job search, look into scope of practice laws for your areas of interest. Not only will this potentially open up your job search but also have favorable implications in your job.
Scope of Practice and Experience Requirements
Employers aren’t always seeking experienced nurse practitioners for the clinical knowledge they bring to the table. Graduated scope of practice laws in some states place restrictions on nurse practitioners until they have logged a specified number of practice hours. In Colorado, for example, NPs are not granted full prescribing authority until they have 3600 hours of experience (a current bill, SB15-197, proposes reducing this to 1000 hours-stay tuned). Some practice settings require NPs to practice autonomously and can’t accommodate a nurse practitioner without the ability to prescribe or practice to their full scope.
Looking for a job as a new grad NP in a state with graduated scope of practice laws is difficult. Not only are you trying to convince an employer to hire you despite a lack of clinical experience, you must advocate for yourself as a prospective employee who will enter practice in a limited capacity.
Scope of Practice and State Licensing Processes
The licensing process for nurse practitioners in some states can be long and complex. Nurse practitioners cannot work unless licensed so a lengthy process pushes back your job start date. As a result, many employers choose to interview only NPs holding active state licenses. To further complicate the issue, some states require that nurse practitioners name a collaborating physician on their licensing paperwork. This means the NP must land a job before getting licensed.
In Texas, for example, the Board of Nursing is notoriously slow when it comes to completing the nurse practitioner licensing process. The state also requires an additional license, a DPS, in order for NPs to prescribe controlled substances. To apply for this license to prescribe, the nurse practitioner must have a collaborating physician sign off on required paperwork. This process makes landing a job difficult in the state as new grads or relocating NPs must identify prospective employers willing to wait on the complicated licensing process.
Researching scope of practice laws can have a major impact on your job search. If you have options when it comes to the state where you will practice, selecting a location with independent practice laws will be to your advantage. If you find yourself in a position where you will be practicing in a state with a restricted scope of practice, be proactive. Apply as early as possible for your license and submit required paperwork in a timely manner to avoid delays in employment and make yourself more marketable.
Have you noticed scope of practice laws affecting your job search?
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