VCNP Guide to Practice as a Nurse Practitioner in the Commonwealth of Virginia

Welcome to Virginia!

This guideline is intended to assist Nurse Practitioners (NPs) in understanding the licensure and regulatory aspects of practice in the Commonwealth of Virginia.

To practice in Virginia a Nurse Practitioner must have:

  1. Three licenses:
    1. Registered Nurse (Virginia is a compact state)
    2. Licensed Nurse Practitioner
    3. Prescriptive Authority license (requires a Practice Agreement)
  2. Practice Agreement for Prescriptive Authority
  3. Practice Protocol

The Practice Agreement for Prescriptive Authority designates which schedules of controlled substances a NP can prescribe. NPs in Virginia have full prescriptive authority (schedules II-VI) but this may be limited by the supervising physician in the Practice Agreement. This form is available from the Board of Nursing and, when completed, is filed with the Board of Nursing.

The Practice Protocol is developed with your supervising physician using your own format. There is no official form and it is not filed with the Board of Nursing. It is kept in your practice setting and may be developed in any format that works for the practice. It should include the following elements taken from the definitions in the NP Licensure Regulations:

http://www.dhp.state.va.us/nursing/leg/Nurse%20practitioners%2011-18-06.doc

"Protocol" means a written statement, jointly developed by the collaborating physician(s) and the licensed nurse practitioner(s), that directs and describes the procedures to be followed and the delegated medical acts appropriate to the specialty practice area to be performed by the licensed nurse practitioner(s) in the care and management of patients.

"Medical direction and supervision" means participation in the development of a written protocol including provision for periodic review and revision; development of guidelines for availability and ongoing communications which provide for and define consultation among the collaborating parties and the patient; and periodic joint evaluation of services provided, e.g., chart review, and review of patient care outcomes. Guidelines for availability shall address at a minimum the availability of the collaborating physician proportionate to such factors as practice setting, acuity, and geography.

The following is a stepwise outline to help you become licensed and practice in Virginia.

  1. Obtain Virginia licensure as an RN
    • If you are licensed in a compact state (e.g., MD) you are also licensed to practice in Virginia
    • If you are NOT licensed in a compact state, you need to be licensed by endorsement. This can be done online through the Board of Nursing at http://www.dhp.state.va.us/nursing/default.htm
  2. Graduate from an accredited Nurse Practitioner program and Pass the certification exam under your specific area of practice
    • Depending on your area of practice, the certifying bodies are primarily the American Nurses' Credentialing Center (ANCC), the American Academy of Nurse Practitioners (AANP) or other specialty certification boards
  3. Apply for Licensure as a Nurse Practitioner via www.dhp.state.va.us/nursing/nursing_forms.htm, or contact the Virginia Board of Nursing at 804-662-9909
  4. Once you have a job as a Nurse Practitioner
    • Download and fill out the Practice Agreement form: www.dhp.state.va.us/nursing/nursing_forms.htm
      • This document authorizes your prescriptive authority (schedules II-VI)
      • You may have up to four other physicians, other than your supervising physician sign this form. (Your supervising physician may limit, allow, or select specific drug categories)
    • Develop a Practice Protocol with your supervising physician. The practice protocol is intended to reflect, describe, and outline your practice. The protocol should have the following elements included:
      • provision for periodic review and revision
      • development of guidelines for availability and ongoing communications which provide for and define consultation among the collaborating parties and the patient
      • periodic joint evaluation of services provided, e.g., chart review, and review of patient care outcomes
      • Guidelines for availability shall address at a minimum the availability of the collaborating physician proportionate to such factors as practice setting, acuity, and geography

Resources:
Virginia Council of Nurse Practitioners: http://www.vcnp.net
Virginia Board of Nursing: http://www.dhp.state.va.us/nursing/default.htm
Virginia Prescription Monitoring Program: http://www.dhp.state.va.us/dhp_programs/pmp/


Virginia Council of Nurse Practitioners
2209 Dickens Road
Richmond, VA 23230-2005
804-565-6360
804-282-0090 fax

General VCNP Information:  vcnp@vcnp.net
Membership Information:  vcnpmembership@vcnp.net