Legislative letter

Legislative letter: APRNs ability to practice independent of physicians in the state of Virginia

Tracy Brown

University of Mary Washington






Legislative letter: APRNs ability to practice independent of physicians in the state of Virginia

April 5, 2015

The Honorable Robert J. Wittman

2454 Rayburn House Office Building

Washington D.C. 20515




Dear Representative Wittman,


My name is Tracy J. Brown, I am a registered Nurse currently working at two area Emergency Department in Northern Virginia and reside in Stafford County Virginia. I am also currently a full time student pursing my degree as an Advanced Practice Registered Nurse (APRN). I am writing you today to seek you support for as Legislative Bill such as 916 for the state of Virginia which, if enacted, would remove the requirement for APRN’s to have an integrated Practice Agreement (IPA) with physician as outlined in sec 38-2310 of the Nurse Practitioner Act.

An Advanced Practice Registered Nurse (APRN) is a nurse who has a master’s, post-masters, or doctoral degree in a nursing specialty and can generally practice medicine without the supervision of a physician. APRNs help meet the demand for primary and specialty healthcare practitioners, especially in rural and other areas (“Advanced Practice Registered Nursing Defined,” n.d.). Advanced Practice Registered Nurses are qualified to provide a range of both primary and acute health care services. Much like physicians, APRN’s can diagnose and treat medical conditions and perform many of the same tasks, including writing prescriptions.

Currently in the state of Virginia, Advanced Practice Registered Nurses practice under a law that was placed in 2012 that states that the role of the physicians changed from supervisors of APRN’s to leaders of the health care teams. This means that APRN’s no longer practice under the supervision of a duly licensed physician, but in collaboration and consultation with a patient care team physician (Blake, 2013, para. 2). Still, nurse practitioners only practice as part of a patient care team and cannot practice independently from a physician.

This legislation is important because as healthcare evolves, Advanced Practice Registered Nurses will play key roles in improving health outcomes within all populations of the state. With the decrease in the number of physicians and rapid increase of population in the state, having APRN’s work independently would help the community received the healthcare it needs. As the nation has felt the effects of the primary care physician shortage, several states have passed laws for advanced Registered Nurses to practice independently and there are several that are considering expanding their independence as well. I hope that Virginia truly considers making this change for the betterment of healthcare for the state of Virginia.


Tracy J. Brown, RN

68 Glacier Way

Stafford, Va. 22554




Advanced Practice Registered Nursing Defined. (n.d.). Retrieved from http://www.graduatenursingedu.org/aprn-definition/

Blake, V. (2013, June 2013). Scope of Practice in Team-Based Care: Virginia and Nationwide. AMA Journal of Ethics, 15, 518-521. Retrieved from http://journalofethics.ama-assn.org/2013/06/hlaw1-1306.html

Virginia Board of Nursing. (2013). Title 18 professional and occupational licensing. Virginia Register of Regulations, 29(20).


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