N.Y. Education Law § 6902: Definition of practice of nursing

§ 6902. Definition of practice of nursing. 1. The practice of the

profession of nursing as a registered professional nurse is defined as

diagnosing and treating human responses to actual or potential health

problems through such services as casefinding, health teaching, health

counseling, and provision of care supportive to or restorative of life

and well-being, and executing medical regimens prescribed by a licensed

physician, dentist or other licensed health care provider legally

authorized under this title and in accordance with the commissioner's

regulations. A nursing regimen shall be consistent with and shall not

vary any existing medical regimen.

2. The practice of nursing as a licensed practical nurse is defined as

performing tasks and responsibilities within the framework of

casefinding, health teaching, health counseling, the application of

topical fluoride varnish, and provision of supportive and restorative

care under the direction of a registered professional nurse or licensed

physician, dentist or other licensed health care provider legally

authorized under this title and in accordance with the commissioner's

regulations.

3. (a) (i) The practice of registered professional nursing by a nurse

practitioner, certified under section six thousand nine hundred ten of

this article, may include the diagnosis of illness and physical

conditions and the performance of therapeutic and corrective measures

within a specialty area of practice, in collaboration with a licensed

physician qualified to collaborate in the specialty involved, provided

such services are performed in accordance with a written practice

agreement and written practice protocols except as permitted by

paragraph (b) of this subdivision. The written practice agreement shall

include explicit provisions for the resolution of any disagreement

between the collaborating physician and the nurse practitioner regarding

a matter of diagnosis or treatment that is within the scope of practice

of both. To the extent the practice agreement does not so provide, then

the collaborating physician's diagnosis or treatment shall prevail.

(ii) Prescriptions for drugs, devices and immunizing agents may be

issued by a nurse practitioner, under this paragraph and section six

thousand nine hundred ten of this article, in accordance with the

practice agreement and practice protocols except as permitted by

paragraph (b) of this subdivision. The nurse practitioner shall obtain a

certificate from the department upon successfully completing a program

including an appropriate pharmacology component, or its equivalent, as

established by the commissioner's regulations, prior to prescribing

under this paragraph. The certificate issued under section six thousand

nine hundred ten of this article shall state whether the nurse

practitioner has successfully completed such a program or equivalent and

is authorized to prescribe under this paragraph.

(iii) Each practice agreement shall provide for patient records review

by the collaborating physician in a timely fashion but in no event less

often than every three months. The names of the nurse practitioner and

the collaborating physician shall be clearly posted in the practice

setting of the nurse practitioner.

* (iv) The practice protocol shall reflect current accepted medical

and nursing practice and may be updated periodically. The commissioner

shall make regulations establishing the procedure for the review of

protocols and the disposition of any issues arising from such review.

* NB Effective until July 1, 2030

* (iv) The practice protocol shall reflect current accepted medical

and nursing practice. The protocols shall be filed with the department

within ninety days of the commencement of the practice and may be

updated periodically. The commissioner shall make regulations

establishing the procedure for the review of protocols and the

disposition of any issues arising from such review.

* NB Effective July 1, 2030

(v) No physician shall enter into practice agreements with more than

four nurse practitioners who are not located on the same physical

premises as the collaborating physician.

* (b) Notwithstanding subparagraph (i) of paragraph (a) of this

subdivision, a nurse practitioner, certified under section sixty-nine

hundred ten of this article and practicing for more than three thousand

six hundred hours shall not be required to comply with the requirements

of paragraph (a) of this subdivision relating to collaboration with a

physician, a written practice agreement and written practice protocols.

* NB Effective until July 1, 2030

* (b) Notwithstanding subparagraph (i) of paragraph (a) of this

subdivision, a nurse practitioner, certified under section sixty-nine

hundred ten of this article and practicing for more than three thousand

six hundred hours may comply with this paragraph in lieu of complying

with the requirements of paragraph (a) of this subdivision relating to

collaboration with a physician, a written practice agreement and written

practice protocols. A nurse practitioner complying with this paragraph

shall have collaborative relationships with one or more licensed

physicians qualified to collaborate in the specialty involved or a

hospital, licensed under article twenty-eight of the public health law,

that provides services through licensed physicians qualified to

collaborate in the specialty involved and having privileges at such

institution. As evidence that the nurse practitioner maintains

collaborative relationships, the nurse practitioner shall complete and

maintain a form, created by the department, to which the nurse

practitioner shall attest, that describes such collaborative

relationships. For purposes of this paragraph, "collaborative

relationships" shall mean that the nurse practitioner shall communicate,

whether in person, by telephone or through written (including

electronic) means, with a licensed physician qualified to collaborate in

the specialty involved or, in the case of a hospital, communicate with a

licensed physician qualified to collaborate in the specialty involved

and having privileges at such hospital, for the purposes of exchanging

information, as needed, in order to provide comprehensive patient care

and to make referrals as necessary. Such form shall also reflect the

nurse practitioner's acknowledgement that if reasonable efforts to

resolve any dispute that may arise with the collaborating physician or,

in the case of a collaboration with a hospital, with a licensed

physician qualified to collaborate in the specialty involved and having

privileges at such hospital, about a patient's care are not successful,

the recommendation of the physician shall prevail. Such form shall be

updated as needed and may be subject to review by the department. The

nurse practitioner shall maintain documentation that supports such

collaborative relationships. Failure to comply with the requirements

found in this paragraph by a nurse practitioner who is not complying

with such provisions of paragraph (a) of this subdivision, shall be

subject to professional misconduct provisions as set forth in article

one hundred thirty of this title.

* NB Effective July 1, 2030

(c) Nothing in this subdivision shall be deemed to limit or diminish

the practice of the profession of nursing as a registered professional

nurse under this article or any other law, rule, regulation or

certification, nor to deny any registered professional nurse the right

to do any act or engage in any practice authorized by this article or

any other law, rule, regulation or certification.

(d) The provisions of this subdivision shall not apply to any activity

authorized, pursuant to statute, rule or regulation, to be performed by

a registered professional nurse in a hospital as defined in article

twenty-eight of the public health law.