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Requirements and rules for nurse practitioners may vary in some parts of the U.S. For example, independent practice, supervisory agreement, and residency hours may or may not be obligatory in some states, and restrictions and barriers can also be different. In California, NPs are now not able to practice independently. However, there is a new regulation that went into effect this year, and starting from 2023, nurse practitioners will receive this possibility.
Overall, it is possible to say that in California, nursing practice is taken rather seriously. According to Spetz & Muench (2018), it is reported that there are some barriers to NP practice. For example, some nurse practitioners mentioned that scope-of-practice restrictions were a barrier to providing high-quality care (Spetz & Muench, 2018, p. 1472). Another barrier is that many physicians are against providing NPs with the possibility of independent practice. These limitations can lead to reduced use of primary care services and poorer access to quality care. Therefore, it is good news that it will be addressed in 2023, and nurse practitioners will be able to work without physician oversight.
Nowadays, it is required in California that NPs get written collaboration agreements and standardized protocols with physicians. It is also the only western state to have a requirement for physician oversight (California Health Care Foundation, 2019, p. 1). Currently, it is only known that California will require residency hours with a physician or NP before the nurse practitioner can work without the physicians oversight. However, the exact number of hours is not yet determined. As for me, I do support having residency hours as a requirement for independent practice because it will provide NPs with more experience and prepare them for working with no supervision.
Reference
California Health Care Foundation. (2019). Expanding the role of nurse practitioners in California: Physician oversight in other states [PDF document].
Spetz, J., & Muench, U. (2018). California nurse practitioners are positioned to fill the primary care gap, but they face barriers to practice. Health Affairs, 37(9), 1466-1474.
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