Nurse Practitioner Scope of Practice: Oklahoma

Famous for cowboys, tornados, and oh yes, a timeless musical, Oklahoma's got an all-American spirit. The Sooner State is home to country singer Garth Brooks and the setting of movie "Twister", not to mention a key player in the land rush of the 1800's. When it comes to nurse practitioners, however, the state lacks such an enterprising spirit. 

Laws governing nurse practitioners in Oklahoma aren't the worst in the nation, but they certainly leave something to be desired. The scope of practice for Oklahoma's NPs is so noticeably lacking that Governor Susan Martinez of neighboring New Mexico launched a 2013 marketing campaign directed at Oklahoma's nurse practitioners. The campaign's goal? To encourage the Sooner State's NPs to relocate to New Mexico where scope of practice laws are more favorable

Oklahoma's Nurse Practitioner Supervision Laws

Nurse practitioners practicing in Oklahoma are not required to have physician supervision to practice, but rather to prescribe. So, although Oklahoma technically allows NPs to diagnose patients independently, in practice nearly all nurse practitioners in the state work under the supervision of an MD. 

Oklahoma's nurse practice act also specifies that nurse practitioners must practice in a way consistent with their specialty of licensure. For example, a pediatric NP is not authorized to provide care for adults. National certification through a certifying body is required for NPs practicing in Oklahoma. 

Oklahoma's Nurse Practitioner Prescribing Laws

Nurse practitioners practicing in Oklahoma must obtain prescriptive authority from the state board of nursing prior to prescribing medications. In order to obtain prescriptive authority, NPs must hold a current license to practice as a nurse practitioner and have completed continuing education contact hours, or academic credit hours, in pharmacology prior to application. The number of contact hours and/or academic credit hours depends on if the NP has been previously granted prescriptive authority in another state, or if he/she is applying for initial prescriptive authority. Nurse practitioners obtaining an initial certification must complete at least 45 contact hours in pharmacology, or three academic credits, within the three year period prior to application. NPs who have previously been awarded prescriptive authority must complete 15 contact hours, or one academic credit hour, in the two-year period prior to application. 

Physician supervision is required in order for nurse practitioners to prescribe in Oklahoma. The supervision arrangement must be outlined in a written agreement. The physician is to be available for consultation, assistance, or patient referral through direct contact, by phone, or other means of communication but is not required to be physically present with the NP. In order to prescribe controlled substances, nurse practitioners are required have a DEA number

Even with prescriptive authority, nurse practitioners in Oklahoma may not prescribe Schedule II medications. NPs are permitted to prescribe only Schedule III to V drugs as a thirty day supply without refills. 

Other Scope of Practice Laws

Nurse practitioners practicing in Oklahoma are allowed to sign handicap parking permits but are not permitted to sign death certificates

Are you an NP practicing in Oklahoma? How do the state's restrictive laws affect your practice?

 

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Comments

Just today my employer, Concentra Occupational and Urgent Care, has stated we are no longer allowed to order medications in our clinic to be dispensed from our clinic. We now are only allowed to write prescriptions for the patient to have filled elsewhere. Also, we are not allowed to give an MA an order for injections in our clinic. Tdap, anti-inflammatory, steroid). Also they are asking attorney if we are allowed to sign off on DOT exams which we have been doing for many years and the FMCSA allows us to do. They are citing Oklahoma State Board of Pharmacy??? This was a huge surprise today and will affect our practice and hireabilty significantly. Thank you

Sheryl Standage