Advanced Practice Registered Nurses Overview

Advanced Practice Registered Nurses (APRNs) are licensed nurses with post-graduate education and training in nursing. They provide primary and/or specialty nursing and medical care in ambulatory, acute and long-term care settings. APRNs may practice autonomously and/or in coordination with health care professionals and other individuals. Masters, post-masters or doctoral preparation and national board certification is required for entry-level practice. There are four types of APRNs. These include: nurse practitioners, certified nurse midwives, certified registered nurse anesthetists and clinical nurse specialists. This site currently features policy information for nurse practitioners and certified nurse midwives.

Nurse practitioners (NPs) are registered nurses with specialized, advanced education and clinical practice competency to provide health care for diverse populations in a variety of primary care, acute and long-term care settings.
Certified nurse midwives (CNMs), also referred to as nurse midwives, specialize in the provision of care during pregnancy, childbirth and the postpartum period; sexual and reproductive health; gynecologic health; and family planning services, including preconception care.

The links to the right lead to maps showing a comparison of all states and territories for the following policy areas:

Nurse practitioner practice authority
Certified nurse midwife practice authority (shown below)
Nurse practitioners identified as primary care providers
Nurse practitioners authority to sign provider orders for life-sustaining treatment (POLST) forms

Choose a tab to explore different options. For more detailed information, please click on a state or territory.

Advanced Practice Registered Nurses:
Nurse Practitioner Authority to Sign POLST Forms

Mobile users can use this dropdown of states if the map is too small.

LEGEND

NPs are authorized to sign POLST forms
NPs are not explicitly authorized to sign POLST forms
Information is not currently available

Provider orders for life-sustaining treatment (POLST) are medical orders that outline emergency interventions for a patient. These orders can be sent to health care facilities and other providers, including emergency medical services. POLST differ from advance directives in that they are specific medical orders from a provider instead of directions and wishes from a patient. The purpose of POLST forms is to ensure that an order is in place, upon discussion with the patient, to allow a provider to give specific treatments during an emergency. POLST forms are meant to complement, not replace, advance directives. Terminology for POLST may vary across states (e.g., medical orders for life-sustaining treatment, medical order for scope of treatment, transportable physician orders for patient preference, etc.).

States are moving to make these medical orders portable between providers and facilities if a person chooses to switch providers. Historically, physicians were the only medical provider allowed to fill out and sign POLST forms. States are examining allowing advanced practice registered nurses to have authority to sign POLST form to ensure people in rural and underserved areas have access to these orders.

Policy areas for Advanced Practice Registered Nurses

Certified Nurse Midwife Practice Authority

Nurse Practitioner Practice Authority

Nurse Practitioner Authority to Sign POLST Forms

Nurse Practitioner as a Primary Care Provider

Practitioner Scope of Practice