Guidelines for Nurse Practitioner Practice in Tennessee
Each state has laws and rules which regulate the practice of nursing and the role of the nurse practitioner. The Tennessee Nurses Association Council on Advanced Practice offers this information as a resource in describing the practice of nurse practitioner/physician collaborative practice in Tennessee.
Currently, there are more than 2,000 nurse practitioners working in the state of Tennessee. Tennessee’s nurse practitioners are working in a variety of settings including state and local health departments, primary care clinics, nursing homes, hospitals, physician practices, and in nurse-owned clinics.
Nurse practitioners are regulated in Tennessee by the Board of Nursing (BON) under Tennessee Code Annotated Title 63, Chapter 7 and the Administrative Rules (BON Rules 1000-1 and 1000-4). Complete copies of the law and rules are available from the Board of Nursing.
All nurse practitioners practicing in Tennessee must be licensed as a Registered Nurse (RN) in Tennessee and be prepared as a nurse practitioner in an advanced educational program.
In order to prescribe, the NP must obtain a “Certificate of Fitness (COF) to Prescribe and/or Issue Legend Drugs” from the Tennessee Board of Nursing. Requirements that must be met to obtain a COF include: 1) A master’s degree or a doctoral degree with preparation in specialized practitioner skills at the master’s, post-master’s, doctoral, or post-doctoral level which includes three (3) quarter hours, or the equivalent, of pharmacology instruction; and 2) Current national certification in the appropriate nursing specialty area as determined by the Board.
Having received a Certificate of Fitness, established joint protocols and filed a notice of formulary and name of supervisory physician with the Board of Nursing, the NP is authorized to prescribe and/or issue legend drugs.
A Temporary Certificate of Fitness to prescribe may be issued to graduates of nurse practitioner programs until the results of the national certification examination are received. An applicant who does not write or fails to pass the national certifying examination at the next scheduled examination date for which he/she qualifies shall return the permit to the Board. The permit will no longer be valid in this instance.
The holder of a Temporary Certificate of Fitness to prescribe and/or issue drugs who has not received the results of the national certification examination shall work only under the on-site supervision of a certified nurse practitioner who holds a certificate of fitness to prescribe or a physician.
Nurse Practitioners who wish to prescribe Schedule II through Schedule V Controlled Drugs must have a DEA number. To request an Application for Registration, DEA Form 224 (July 1998), call the DEA in Atlanta at 1-888-219-7898. Fee for a DEA number for midlevel practitioners is $210 for three years.
The following organizations may provide further information:
Tennessee Nurses Association
Deanna Menesses, Executive Director
545 Mainstream Drive, Suite 405
Nashville, TN 37228-1296
615/254-0350
Tennessee Board of Nursing
Elizabeth Lund, Executive Director
Cordell Hull Building
1st Floor
426 5th Avenue North
Nashville, TN 37247-1010
615/532-3202 or 5166
www.state.tn.us/health