Currently, South Carolina advanced practice registered nurses (APRNs)—including nurse practitioners, clinical nurse specialists and certified nurse midwives—practice under the supervision of a physician. This supervising physician delegates the medical tasks that the APRN may perform. The relationship is formalized using a written practice agreement that lays out what is authorized. Under H 3580, APRNs would no longer need a physician to oversee their practice once certain conditions are met.

Initially, APRNs would still practice pursuant to a written scope of practice agreement with an overseeing physician. However, once the APRN completes 2,000 hours of clinical experience and possesses malpractice insurance coverage, they can apply to the board of nursing for full practice authority. Once they are approved for full practice authority, the APRN would be able to perform the following tasks without a practice agreement:

1. Ordering and interpreting diagnostic data, assessment, diagnosing, prescribing medications, interventions and therapies under the APRN licensure, and delegating and assigning therapeutic measures to assistive personnel;
2. Prescribing medication, treatments, and therapies as authorized by law
3. Performing non-medical acts considered to be the practice of registered nursing or advanced practice, such as population health management, quality improvement or research projects within a health care system, and analysis of data and corresponding system recommendations, revisions, developments or informatics; and
4. Performing acts included under full practice authority as described in National Council State Boards of Nursing Model Practice Act, national scope of practice and standards for advanced practice nursing as published by the national nursing organizations for advanced practice nursing and recognized by the board for advanced practice registered nurses.

The majority of states allow nurse practitioners to practice independently. Most states have begun to provide reduced oversight or more flexibility but still retain the physician oversight. H 3580 would solidly go along with this trend in providing independence for APRNs. If you would like additional information, to read the language of the bill or to contact the sponsors or committee, you can find the information you need through these links H 3580 and S 45.