The History of Florida Nurse Practice Act


The legal history of nursing practice in the United States of America dates back to the last decade of the 19th century. During the Civil War, the scope of nursing practice expanded significantly, and policymakers in health care commenced to reconsider what the role of a nurse might involve. As education advanced, between 1909 and 1913, nurses and teachers of medical schools of Florida founded the Florida Nursing Association, which over the next several decades, would become the central policy-making entity of the state. Later, another institution – the Board of Nursing – emerged to enact bills and perpetuate medical ethics. This essay will discuss the most relevant bill regulating the nursing profession – Florida Nurse Practice Act, its provisions, and implications for nurses.

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Background and Contents of the Florida Nurse Practice Act

In Florida, nursing practice is regulated by Title XXXII Regulation of Professions and Occupations, Florida Administrative Code Division 64B9, and Chapters 456 and 464 of Florida Statutes. The Nurse Practice Act makes part of the latter legal document and contains provisions pertaining to the classification of nurses, their scope of practice, and minimum requirements for providing services safely and responsibly (The Florida Legislature, 2018).

As of now, the nursing field is confronted with some challenges, for instance, the uncertainty as to what educational background a nurse should have to enter practice. Other pressing issues include the accelerating rate of retirement in registered nurses and legal misconduct (Buerhaus, Skinner, Auerbach & Staiger, 2017). Alongside the other bills, the Florida Nurse Practice Act aims at addressing these issues and providing a comprehensive legal framework.

According to the Florida Nurse Practice Act classification, a medical assistant is not obliged to have any formal training whereas a registered nurse should be licensed to seek employment in the field. The next position in the FNPA gradation is an advanced registered nurse who on top of standardized formal training, obtained specific qualifications. As for the scope of practice, the respective section covers the entire variety of roles assigned to nurses.

It explains that nurses do not only observe, assess, and make a diagnosis within their competencies, but they also educate patients on health issues and counsel them in the case of psychological distress. Moreover, nurses are key agents in health promotion and have the leverage to influence their patients (The Florida Legislature, 2018). The third main section covers different types of misconduct in the nursing field. For instance, it discusses fraud cases, inappropriate sexual contact, and impairment.

Stakeholders, Supporters, and Opponents

The key stakeholder of the Florida Nurse Practice Act is the Board of Nurses (BON) in Florida. The organization’s mission is to ensure patients’ safety by regulating the nursing profession. Thus, FNPA and its proper implementation are of tremendous importance and one of the duties of BON. An obvious advantage of the FNPA is easier regulation on a small scale whereas among the disadvantages is the lack of standardization nationwide. As far as one can fathom, the passing of the Florida Nurse Practice Act has not generated any great controversy in the state or on the federal level. However, one may still find those who may support or oppose the present bill.

Many provisions of the FNPA are in line with the health objectives of the Institute of Medicine of National Academies (IOM). For instance, IOM promotes lifelong learning in nurses so that their skills would not be limited to those acquired through initial formal training (Madden, Hundley, Summers, Villanueva & Walter, 2017). According to the FNPA, one of the roles that nurses should assume is to teach and supervise personnel, which is only possible through continuous education.

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Moreover, the FNPA emphasizes the importance of advanced licensed nurses in the workforce of the USA and, alongside IOM, compels practitioners to increase their level of education. Some physicians and members of such organizations as the American College of Physicians and the American Medical Association opposed the expansion of nurses’ scope of practice (National Academies of Sciences, 2016). They claimed that the process was better organized in physician-lead teams.

Implementation and Implications for Nurses

One may envisage what issues might arise or are already arising by the application of the FNPA. For instance, the enactment may be stalled because of negligence and lack of awareness. Nurses should expand the scope of their knowledge beyond medicine and study the legal basis of their practice. Thus, if a nurse is familiar with the FNPA provisions, he or she will no longer lean on their understanding of what is right.

Nurses will be more aware of the impact they have on patients and the healthcare system in general and heed safety guidelines. One of the most significant contributions a nurse can make to aid the implementation is to detect misconduct. The FNPA clearly defines what is unacceptable in the workplace, be it sexual contact or alcohol and drug intake. Thus, nurses are encouraged to become better observers and intervene when a situation calls for it.


It is imperative to regulate the nursing profession since the integrity of the healthcare system and patients’ well-being are at stake. In Florida, practitioners in the nursing field are obliged to comply with the Nurse Practice Act that provides minimum requirements for employment and outlines the scope of practice. Key stakeholder, Board of Nursing states ensuring safety and accountability and its mission and thus, takes a full interest in the implementation of the bill. If enacted adequately, the law will facilitate the replacement of retiring nurses by providing a clear framework for those wishing to enter the field. The FNPA is also of great use in addressing misconduct at which nurses may help significantly by reporting violations promptly.


Buerhaus, P. I., Skinner, L. E., Auerbach, D. I., & Staiger, D. O. (2017). Four challenges facing the nursing workforce in the United States. Journal of Nursing Regulation, 8(2), 40-46.

Madden, L. K., Hundley, L., Summers, D., Villanueva, N., & Walter, S. (2017). 2017 White Paper: Full report of AANN progress on the IOM report. Web.

National Academies of Sciences, Engineering, and Medicine, Institute of Medicine, & Committee for Assessing Progress on Implementing the Recommendations of the Institute of Medicine Report The Future of Nursing: Leading Change, Advancing Health. (2016). Assessing progress on the Institute of Medicine report The Future of Nursing. Washington, DC: The National Academic Press.

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The Florida Legislature. (2018). The 2018 Florida statutes. Title XXXII Regulation of professions and occupations. Chapter 464. Nursing. Part I Nurse Practice Act. Web.

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