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What Does a Family Nurse Practitioner Do?

Nurses who earn advanced practice degrees, like La Salle University's online Master of Science Nursing Family Nurse Practitioner (MSN FNP), gain expanded clinical responsibilities and duties upon licensure and certification. Although practice authority is determined state-by-state, nurse practitioners enjoy greater autonomy when examining, diagnosing and treating patients.

Here's an overview of common job responsibilities and a primer on the FNP scope of practice for Pennsylvania and surrounding states:

What Does an FNP's Workday Entail?

While FNPs are employed in a variety of settings, many fill clinical roles in physician-led practices and freestanding clinics. Primary job responsibilities often include:

  • Ordering, conducting and interpreting diagnostic tests such as x-rays and lab work
  • Performing patient examinations including physicals
  • Diagnosing and treating acute and chronic illness and injury
  • Prescribing medications, physical therapy and other treatments
  • Providing counseling and education on disease management and prevention

Roseann Velez, a family nurse practitioner in Maryland, has experience in family medicine, orthopedics and preoperative care in addition to serving in research and preceptor roles in academia. Currently, she sees patients of all ages in an urgent care clinic. "[My] primary responsibility is to provide patients evidence-based compassionate care [that aligns with] the Nurses Code of Ethics," says Velez.

After patients are screened by a medical assistant, Velez performs a history and physical. "Patients present with concerns that are most often addressed during the office visit [though some] are referred to the emergency department," she says. "I prescribe medications, order and interpret x-rays and point-of-care screening tests, provide education, perform physicals … and refer to a primary clinician for follow-up."

What Are Scope of Practice Classifications?

Each state determines the overall authority given to nurse practitioners, dictating the extent to which FNPs can independently interact with patients. The American Association of Nurse Practitioners (AANP) provides detailed explanations of the three scopes of practice. A summary break down is outlined below:

Full Practice
  • FNPs are considered licensed independent professionals.
  • They may open their own practices.
  • Oversight is provided by the state board of nursing.
Reduced Practice
  • FNPs must have a collaborative agreement in place with a supervising physician.
  • At least one element of the FNP's scope of practice is limited or has additional requirements, such as supplementary pharmacological education for full prescription privileges.
Restricted Practice
  • FNPs must have a collaborative agreement in place with a supervising physician.
  • At least one element of the FNP's scope of practice is prohibited, such as the authority to prescribe Schedule II controlled substances.

How Does FNP Authority Differ Between States?

Since La Salle's MSN FNP program is available to nurses residing in Pennsylvania, Delaware, New Jersey and Maryland, a brief review and comparison of FNP regulations in those states may be helpful:

Pennsylvania: Pennsylvania is a reduced practice state requiring a collaborative agreement with a supervising physician. FNPs diagnose medical conditions, create and administer treatment plans, order tests and prescribe drugs including Schedule II through V controlled substances.

Delaware: Delaware is a reduced practice state where a collaborative agreement is required only if the FNP has practiced less than two years or fewer than 4,000 hours. Full practice authority is granted once those prerequisites are satisfied.

New Jersey: Although New Jersey is a reduced practice state, FNPs are considered independent professionals and no general collaborative agreement is required. Instead, FNPs enter into a joint protocol with a physician for prescribing purposes only and are not otherwise supervised by a physician.

Maryland: Maryland is a full practice state where FNPs have the legal right to practice independently without physician oversight. Of the four states, Maryland FNPs have the greatest autonomy in terms of patient care, medical decision-making, developing treatment plans and prescribing medications.

Expanding Your Horizons

Though the scope of practice may fluctuate, family nurse practitioners enjoy expanded responsibilities and clinical authority. From ordering diagnostic testing to prescribing controlled substances, FNPs frequently fill community-based primary care roles with a focus on preventive measures, disease management and wellness education.

Learn more about La Salle University's Family Nurse Practitioner MSN Online.


Sources:

American Association of Nurse Practitioners: State Practice Environment

American Association of Nurse Practitioners: What's a Nurse Practitioner (NP)?

Delaware Board of Nursing: Advanced Practice Registered Nurse License

New Jersey State Nurses Association: Fact Sheet on APNs

Nurse Practitioner Association of Maryland: Legislative/Clinical Practice Summary

Pennsylvania Coalition of Nurse Practitioners: Scope of Practice

Velez, R. (2019, July 15). Email interview.


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