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One of the significant challenges affecting the progress of NPs is the existence of different legal requirements in various states in the U.S., which either limit the scope of practice for the professionals or bring stringent standards that affect the practices of the nurses (Xue et al., 2018). The scope-of-practice (SOP) regulations in various states control various aspects of NPs practice such as conducting diagnoses, medication prescriptions, and administrations, making referrals, and managing treatments, among others, by either allowing NPs to undertake a few of these activities or be under physician supervision during practice (Xue et al., 2018). These restrictions prevent NPs from offering clinical services to the full extent of their expertise and qualification, which limits their effectiveness. Studies by Xue et al. (2018) and Barnes et al. (2017) show that more NPs work in primary care settings and rural areas in states where they are allowed full SOP compared to those with restrictions. Eliminating the SOP restrictions in these states is important in ensuring more PMH-NPs are actively involved in providing primary care services, especially in rural areas and underserved populations.
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