Nurse Practitioner Scope of Practice: Louisiana
You’ve got to love Louisiana. Immediately upon arriving in this deep southern locale you are swamped with culture. From cajun cuisine and jazz playing on the street to lazy, alligator-laden bayous, Louisiana’s rich atmosphere is one to appreciate. While Louisiana has a lot to offer in terms of culture, unfortunately, this ambience of abundance does not extend to nurse practitioners practicing in the state.
Louisiana is one of the more restrictive states when it come to laws regulating nurse practitioner practice. Although more than half of the state’s population lives in areas federally designated as Health Professional Shortage Areas, attempts to change scope of practice laws in the Pelican State have been rejected by lawmakers. In 2012, the Louisiana House committee voted strongly against House Bill 951 which proposed allowing nurse practitioners to practice free of physician oversight. What do current laws regulating nurse practitioner’s ability to practice in Louisiana look like?
Louisiana’s Nurse Practitioner Supervision Laws
Nurse practitioners practicing in Louisiana must work under a collaborative practice agreement with a physician. The collaborative practice agreement between the NP and MD must outline the nurse practitioner’s prescriptive authority, a plan for patients requiring admission, arrangements for diagnostic testing, and a plan for documentation of patient visits and interactions. A copy of the collaborative practice agreement must be kept on site and reviewed and signed by the nurse practitioner and physician at least annually.
In Louisiana, the collaborating physician is not required to practice on-site, or within a certain distance of, the nurse practitioner. However, the collaborating physician must be available by phone or another method of communication to consult with the NP at all times if needed. The collaborative practice agreement is required to outline this arrangement. A secondary “back-up” physician may also be designated in case the primary collaborating physician cannot be reached. In the event that the NP is unable to reach a collaborating MD, the Louisiana Nurse Practice Act prohibits the nurse practitioner from prescribing for that period of time.
If the nurse practitioner will be prescribing controlled substances, an addendum to the collaborative practice agreement specifically addressing this ability to prescribe is required. The Louisiana State Board of Nursing provides the collaborative practice agreement to be signed by the NP and MD.
Louisiana’s Nurse Practitioner Prescribing Laws
Nurse practitioners in Louisiana have the authority to prescribe medications, including controlled substances, as long as the this is outlined in the parameters of the collaborative practice agreement. For every encounter where the NP prescribes a medication, a history and physical exam must be performed and documented as well as a diagnosis made. The plan for treatment must be discussed with the patient as well as a plan for follow-up care. Prescriptions written by nurse practitioners in Louisiana must state not only the NP’s name, but also the name, address and phone number of the collaborating physician.
Regulations surrounding nurse practitioners prescribing controlled substances in Louisiana are strict. Nurse Practitioners may not prescribe controlled substances for treatment of chronic pain or obesity. They are also prohibited from writing prescriptions for controlled substances for themselves or family members. Before the NP can request the privilege to prescribe controlled substances, he/she must have completed at least 500 hours of practice with a collaborating physician immediately preceding the request. An application to prescribe controlled substances must be submitted to the Louisiana Board of Nursing before the privilege is granted.
Each year, to maintain the ability to prescribe, nurse practitioners working in Louisiana must obtain six continuing education hours in pharmacology within their specialty of practice.
Other Scope of Practice Laws in Louisiana
Louisiana State Law implies, but does not outright state, that nurse practitioners can be officially listed as primary care providers. NPs are allowed to sign handicap parking permits and workers comp claims but are not permitted to sign death certificates.
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