2023 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 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, 2026
* (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, 2026
(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, 2026
* (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, 2026
(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.