Scope of Practice

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Updated 9/30/2016
On May 25, 2015, the Department of Veterans Affairs (VA) published a proposed rule to standardize the practice of advanced practice registered nurses (APRNs) in the VA system.

  • The proposed rule would allow APRNs to practice to the full extent of education, training and certification without regard to individual State practice regulations concerning requirements such as clinical supervision or mandatory collaboration with physicians.
  • VA proposed to accomplish this standardization through Federal preemption of State nursing licensure laws to the extent that such State laws conflict with the full practice authority as defined by VA.

Comments on the proposed rule were accepted until July 25th.

VA has now finished their internal review of the comments and developed a final rule. On September 28th, the final rule was submitted for review to the Office of Management and Budget (OMB), Office of Information and Regulatory Affairs (OIRA).

ANA will continue to monitor this process and provide additional updates as more information is received. Please visit for more information.

Determining Scope of Practice
Is something within your scope of practice? Find out by reading our guidelines for determining scope of practice. For information about prescribing controlled substances, visit our FAQ. Guidance for CNPs and CNSs is also found an article from the Nov. 2014 American Nurse Today.

Protecting Scope of Practice
Protecting the scope of practice for nurses, particularly advanced practice registered nurses, is a major initiative at ANA. ANA is working together with our Constituent Member (State) Associations to help remove geographic and practice setting limitations for APRNs. We are still working state by state to ensure that state laws affecting Advanced Practice Registered Nurses are both fair and consistent across the country, and that your scope of practice is not unfairly limited. In addition to this work, we have a number of projects that ANA collaborates on to keep APRNs working to the full potential of their training.

  1. Team-Based Care: New Model or Trojan Horse? - This toolkit was created in response to organized medicine's campaign of "Physician-led team-based care," which has been used in an effort to halt Full Practice Authority (FPA) legislation in some states.
  2. Coalition for Patient's Rights (CPR) - ANA is a founding member of CPR. This coalition of over 35 organizations underscores the fact that our work to protect the nurses' scope of practice is not a doctor v. nurse "turf war," but is critical to building effective patient-centered interdisciplinary teams.
  3. Robert Wood Johnson Institute of Medicine report, Future of Nursing - The report's #1 recommendation has focused attention on scope of practice issues.
  4. Consensus Model for APRN Regulation - The Consensus model is referenced and included as Appendix D in the Future of Nursing Report. ANA is active in efforts to implement the Consensus Model, in which the APRN is defined as an "independent practitioner," to be licensed "with no regulatory requirements for collaboration, direction or supervision ."
  5. Legal Action - ANA weighs in on legal issues to protect nurses' ability to provide the full range of services defined by law.