Prior to the autonomous practice law, nurse practitioners could practice in Florida pursuant to a collaborative/supervisory protocol as defined by Florida Statute 464.012. Florida Statute 464.0123 allows the Florida Board of Nursing to register an individual as an advanced practice registered nurse or as an autonomous advanced practice registered nurse if the nurse practitioner meets the following criteria:
(a) Holds an active, unencumbered license to practice advanced nursing under s. 464.012.
(b) Has not been subject to any disciplinary action as specified in s. 456.072 or s. 464.018 or any similar disciplinary action in another state or other territory or jurisdiction within the 5 years immediately preceding the registration request.
(c) Has completed, in any state, jurisdiction, or territory of the United States, at least 3,000 clinical practice hours, which may include clinical instructional hours provided by the applicant, within the 5 years immediately preceding the registration request while practicing as an advanced practice registered nurse under the supervision of an allopathic or osteopathic physician who held an active, unencumbered license issued by any state, jurisdiction, or territory of the United States during the period of such supervision. For purposes of this paragraph, “clinical instruction” means education provided by faculty in a clinical setting in a graduate program leading to a master’s or doctoral degree in a clinical nursing specialty area.
(d) Has completed within the past 5 years 3 graduate-level semester hours, or the equivalent, in differential diagnosis and 3 graduate-level semester hours, or the equivalent, in pharmacology.
(e) The board may provide additional registration requirements by rule.
There are additional eligibility requirements for a nurse practitioner to qualify for autonomous practice, including “demonstrate[ing] to the satisfaction of the board and the department financial responsibility to pay claims and costs ancillary thereto arising out of the rendering of, or the failure to render, nursing care, treatment, or services[.]” Fl. Stat. 464.0123(2).
The autonomous practice law does not allow nurse practitioners to engage in unrestricted practice, but specifically allows autonomous practice “in primary care practice, including family medicine, general pediatrics, and general internal medicine, as defined by board rule.” The rule is limiting regarding surgical procedures as follows: “An advanced practice registered nurse engaging in autonomous practice under this section may not perform any surgical procedure other than a subcutaneous procedure.” Fl. Stat. 464.0123(3)(c). For those interested, this last provision may leave open more flexibility for nurse practitioners performing medical spa treatments.
The Florida Board of Nursing has passed the following rules relevant to autonomous practice that should be read in conjunction with the law. The first rule is within Administrative Code Section 64B9-4.021, which outlines the Standards for Autonomous Practice and states in full: “Advanced practice registered nurses who are registered pursuant to Section 464.0123, F.S., shall engage in autonomous practice only in a manner that meets the General Standard of Practice. The General Standard of Practice shall be that standard of practice, care, skill, and treatment which, in light of all relevant surrounding circumstances, is recognized as acceptable and appropriate by reasonably prudent similarly situated, educated, and licensed Advanced Practice Registered Nurses.” Administrative Code Section 64B9-4.020 includes a registration requirement for all APRNs who wish to be registered as an Autonomous Advanced Practice Registered Nurse.
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