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Nurse Practitioner in Alabama

Level of independence
There is no single scope of practice for nurse practitioners in the USA. Each state
regulates that level of independence of nurses. Alabama is a reduced practice state. Nurse
practitioners cannot conduct many procedures or take various actions without the collaboration
of a physician (Scope of Practice Policy, 2020). Thus, nurse practitioners are not able to work to
the full extent of their education or training.
Prescribing authority
As a reduced practice state, nurse practitioners in Alabama have limited prescribing
authority. They can only prescribe medications to patients with the collaboration of a physician.
For every prescription that a nurse practitioner makes, they have to include the contact details of
the collaborating physician such as the name of the physician, their phone number, and practice
site address (Scope of Practice Policy, 2020). Nurse practitioners cannot prescribe for persons
who are not their patients, immediate family members, or even themselves.
Other limitations of practice
In addition to prescription limitations, nurse practitioners in Alabama face multiple other
limitations to their practice. For instance, the state does not formally recognize them as primary
care providers. They cannot also sign handicap permits. Neither can they sign death certificates
(Scope of Practice Policy, 2020).
Education and certification

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To become a nurse practitioner in Alabama one needs to have either Master’s degree or a
higher level of education from a nurse practitioner program that is approved. They then need to
take an examination related to the specialty that they need a certificate for. Their nurse
certification is not from Alabama, it needs to be from a national certifying body that the Alabama
Body of Nursing recognizes (Alabama Board of Nursing, 2020).
Process of getting nurse practitioner license in Alabama
To get a nurse practitioner license in Alabama, nurses who meet the required
specifications can make applications electronically. All the information provided should be
accurate for the application to be successful. In making the application, nurses are required to
submit signed copies of Quality Management Plan and Standard Protocol for each of the
collaboration that they are involved in. Since the state is a limited practice one, nurse
practitioners have to also present Commencement for Collaborative Practice and show evidence
of payment of required fees from the physicians that they will be collaborating with (Alabama
Board of Nursing, 2020).
Impact of Alabama’s reduced practice state of nurse practitioners on the state’s healthcare
The limitations placed on nurse practitioner practice in Alabama has had largely negative
effects on the healthcare of the state. Due to shortages of primary care physicians, primary care
costs have been rising. The shortage of primary care physicians has also made access to
important healthcare services difficult, particularly for rural populations in the state.
Another result of the shortage has been use of emergency departments as primary care
facilities. This has led to overcrowding in the emergency departments with the consequences felt
by both staff and patients. For instance, there is increased length of stay for patients, raised

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patient mortality, medical errors, and waiting times. A bigger problem associated with limiting
the scope of practice for nurse practitioners has been increasing healthcare disparities between
the rich who can afford physicians and the poor who cannot as well the urban populations that
have access to many physicians and rural populations that have no such access.
The problems associated with shortages of physicians could be solved by increasing the
scope of practice of nurse practitioners. By giving nurse practitioners more independence they
will be able to offer primary care to more people and at lower costs because they are generally
cheaper than physicians. Residents of Alabama will, therefore, be able to get better healthcare
services with an increase in independence of nurse practitioners.

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References

Alabama Board of Nursing (2020). Become a Nurse in Alabama – Licensure and Requirements.
Retrieved on 26 th March, 2020 from
http://scopeofpracticepolicy.org/states/al/#practitioner-behavioral-health-providers.
Alabama Scope of Practice (2020). Alabama Scope of Practice Policy: State Profile. Retrieved
on 26 th March, 2020 from https://nursinglicensemap.com/states/alabama-nursing-license/