Nurse Practitioner Scope of Practice: Colorado

Is anyone else itching for ski season to begin?  There's nothing quite like a mid-winter trip to Colorado's slopes.  I prefer to spend morning hours gliding across fresh powder at dangerously high speeds only to be matched by a cozy afternoon lounging fireside with a good book and a glass of red wine.  My love for Colorado's famed winter destinations led me to think, what is life like for nurse practitioners practicing in this great state?Nurse practitioners in Colorado enjoy a great amount of freedom in their practice.  Like other states in the west, Colorado's laws regulating nurse practitioner practice are quite progressive.

Colorado's Nurse Practitioner Supervision Laws

To practice in Colorado, nurse practitioners must complete a nationally accredited nurse practitioner program as well as pass the national nurse practitioner certification exam.  With these requirements completed, nurse practitioners in Colorado are free to diagnose and treat patients as well as give advance directives for end-of-life care.  As of 2010, nurse practitioners practicing in Colorado are not required to collaborate with or work under physician supervision.  Although nurse practitioners are not required to practice with physician supervision, prescribing laws do place some limitations on NPs, especially in the beginning of their careers.

Colorado's Nurse Practitioner Prescribing Laws

Nurse practitioners in Colorado are free to prescribe medications without physician supervision after an initial supervision period has been completed.  In order to obtain the ability to prescribe freely nurse practitioners must first complete an 1800 hour preceptorship and an 1800 hour mentorship both in collaboration with a physician.

Upon starting a career an as NP, nurse practitioners in Colorado must complete an 1800 hour preceptorship in order to prescribe.  This preceptorship works similarly to collaboration agreements in other states and can be completed while working.  It does not need to occur as part of a nurse practitioner program.  The physician overseeing the preceptorship must interact with the NP at least weekly.  Another advanced practice nurse may also assist in overseeing the new NP as part of the preceptorship.  If another nurse practitioner is responsible for precepting the new NP, a physician must take part in at least one meeting each month.  Once this 1800 hour preceptorship is complete, the nurse practitioner is granted provisional prescriptive authority.

Following the 1800 hour preceptorship, nurse practitioners in Colorado are required to complete an 1800 hour mentorship with a physician.  The physician and the nurse practitioner must outline a plan for ongoing interaction and discussion or prescriptive practices throughout the mentorship.  Once the mentorship is complete, an Articulated Plan for Safe Prescribing outlining a quality assurance plan and a mechanism for consultation, collaboration and referrals to other providers must be signed by the NP and the physician mentor.

Other Scope of Practice Laws in Colorado

Nurse practitioners in Colorado are formally recognized as primary care providers.  They are allowed to sign handicap parking permits but are not permitted to sign death certificates.

Colorado has achieved what few states have been able do effectively.  Colorado allows nurse practitioners the ability to diagnose, treat and prescribe independently while creating an initial period of supervision for NPs in the beginning stages of their career.  This system is more favorable to those who oppose independent nurse practitioner practice but also offers NPs in Colorado greater freedoms than in many other states.

 

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Comments

New legislation (Senate Bill 197) was passed and signed by Colorado's Governor in May 2015, which eliminated the 1800 hour preceptorship (provisional prescriptive authority is now granted with APN licensure). The 1800 hour mentorship period was reduced to 1000 hours total and upon completion, the NP qualifies for independent prescriptive authority.
See http://www.coloradoapn.org/current-legislative-status/

Anne, ACNP student

Does the 1800 hours requirement apply to experienced NPs moving to Colorado from another state?

FNP Student, CEN

Colorado never has an issue attracting nursing because of the weather and outdoor activities for which many nurses will opt to bypass higher paid positions. The flow of travelers into this state is very seasonal!

colorado aprn

I'm not sure why but I find Colorado salaries much lower than other states as well. It's always an interesting situation with a Medical University nearby!

PN, FNP, PNP

Your report is very accurate. I have recently moved here to Colorado Springs after graduating as a FNP in Nashville, TN last May. I has been two months of intense search for an NP-intership or a job that facilitates the required 1800 hours after graduation preceptorship with a physician in order to obtain prescriptive authority rights. The process has been rather slow and even though right now I continue to interview with two potential employers, these programs are hard to find and usually require you to work for low pay rate.

YoYa