The legal boundaries of advanced practice nursing are established by individual state professional practice legislation and may be more limiting than the scope of practice and standards established by national and state professional associations, practice councils, and certifying boards. Like all nurses, they diagnose, manage, and treat human responses to actual and potential illness and disability. They also diagnose, manage, and treat acute and chronic medical problems in collaboration with physicians. NPs are licensed jointly by the Virginia Board of Medicine and the Board of Nursing. NPs may prescribe medications after submitting a practice agreement to the State Board of Nursing.
Prescriptive privileges are site-specific.
Clinical nurse specialists are registered nurses with graduate education in a specific clinical area of nursing. They are recognized as clinical experts and have responsibility for direct and indirect patient care. Practice options are as vast as are practice settings. CMs coordinate the activities of other members of the health care team in order to obtain maximum satisfactory care with minimum duplication of resources. CMs practice in both in- and outpatient settings.