Scope of Practice and Patient’s Healthcare Accessibility

Every state has a Board of Nursing that regulates licensure, the scope of practice, and the general practice of nurses. This discussion focuses on the board of nursing regulations for the Nurse Practitioners in Virginia and their impacts on access to healthcare and healthcare disparities.

In Virginia, nurse practitioners are only allowed to practice freely after being under supervision for at least five years. They must work under licensed physicians in collaboration and consultation within a relationship called the patient care team. The two must have a written protocol whereby the nurse practitioner is evaluated regularly through case reviews and patient care outcomes. After five years of supervised experience, the nurse practitioners adopt full practice authority. The nurse practitioners allowed to practice in Virginia include nurse anesthetists, nurse midwives, nurse aides, clinical nurse specialists, and medication aides (Board of Nursing, n.d).

Licensure in Virginia is both by examination and endorsement. Nurse practitioners from the state take the NCLEX examinations, while the Board of Nursing endorses nurses from other states if they have an existing license. Licensed nurse practitioners prescribe schedule II-VI drugs. However, they cannot prescribe certain controlled substances unless they have to prescribe authorization from the board. Licensed nurse practitioners only practice on the scope of their training, experience, and knowledge.

The full practice authority in the state has improved patient access to healthcare. It has helped increase access to primary care for patients in the state. Licensed nurses open private healthcare facilities closer and more easily accessible. Nurse practitioners are best positioned to provide primary care to the community (Neff et al., 2018). Also, full practice authority encourages the employment of more nurse practitioners who would have otherwise been kept away by the scope of practice regulations. The presence of many healthcare providers, especially in rural areas, improves access to healthcare.

Access to Nurse Practitioners reduces healthcare disparities, especially in rural areas where healthcare institutions are not easily accessible. Better Health outcomes in special populations, especially in rural areas, are realized in primary care provided by nurse practitioners (Ortiz et al., 2018).

The full practice authority for NPs in Virginia eases the accessibility of healthcare for the patients. It has also helped reduce the health disparities of special populations, especially in rural areas. Boards of nursing should lift the scope of practice restrictions in their states to improve Patients’ healthcare accessibility.


Board of Nursing. (n.d). Virginia Department of Health Provisions. Accessed 1st June 2022 from

Neff, D. F., Yoon, S. H., Steiner, R. L., Bejleri, I., Bumbach, M. D., Everhart, D., & Harman, J. S. (2018). The impact of nurse practitioner regulations on population access to care. Nursing Outlook66(4), 379-385.

Ortiz, J., Hofler, R., Bushy, A., Lin, Y. L., Khanijahani, A., & Bitney, A. (2018, June). Impact of nurse practitioner practice regulations on rural population health outcomes. In Healthcare (Vol. 6, No. 2, p. 65). Multidisciplinary Digital Publishing Institute.

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