NY Educ L § 6902 (2021)
2021 New York Laws EDN - Education Title 8 - The Professions Article 139 - Nursing 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,  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. 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.  (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  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.  (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.  (e)  (i)  In  conjunction  with  and  as a condition of each triennial registration, the department shall  collect  and  a  nurse  practitioner shall  provide  such  information  and  documentation  required  by  the department, in consultation with the department of health, as  necessary to enable the department of health to evaluate access to needed services in  this  state,  including  but not limited to the location and type of setting  wherein  the  nurse  practitioner  practices;  if   the   nurse practitioner  has  practiced  for  fewer than three thousand six hundred hours and is practicing pursuant to a written practice agreement with  a physician; if the nurse practitioner practices pursuant to collaborative  relationships  with  a  physician or hospital; and other information the department,  in  consultation  with  the  department  of  health,  deems relevant. The department of health, in consultation with the department, will  make  such  data  available  in aggregate, de-identified form on a publicly accessible website.  (ii) The  commissioner,  in  consultation  with  the  commissioner  of health,  shall issue a report on the implementation of the provisions of this section, along with information that includes, but is  not  limited to:    the number of nurse practitioners practicing for fewer than three thousand six hundred hours that practice pursuant to a written  practice agreement  with  a  physician;  the  number  of nurse practitioners that practice pursuant to collaborative relationships with physicians or with hospitals;  and  other  information  the  department   deems   relevant, including  but  not limited to, any recommendations for the continuation of or amendments to the provisions of this section relating  to  written practice  agreements  or  collaborative  relationships. The commissioner shall submit this report to the governor, the speaker of  the  assembly, the  temporary  president  of the senate, and the chairs of the assembly and senate higher education committees by September first, two  thousand eighteen.   * NB Effective until June 30, 2022   * 3.  (a)  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. 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.  (b) Prescriptions for drugs, devices  and  immunizing  agents  may  be issued  by  a nurse practitioner, under this subdivision and section six thousand nine hundred ten  of  this  article,  in  accordance  with  the practice  agreement and practice protocols. 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 subdivision. 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 subdivision.  (c)  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.  (d)  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.  (e) 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.  (f)  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.  (g) 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.   * NB Effective June 30, 2022