Nursing in Virginia and the Nurse Practice Act

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David Hucks
David Hucks
David Hucks is a 12th generation descendant of the area we now call Myrtle Beach, S.C. David attended Coastal Carolina University and like most of his family, has never left the area. David is the lead journalist at

When embarking on a professional career, it is crucial for individuals to undertake research to assist in making the best decisions about what direction to go in, where to study, and other qualifications that are necessary. For nurses, understanding the requirements regarding qualifications and licensure in the state they will be working is crucial to ensure they can access the necessary studies and relevant exams. 

The Nurse Practice Act

Each state and territory in the US has set laws to govern the practice of nursing which are defined in the Nurse Practice Act (NPA). These are interpreted into regulations by each nursing board with the authority to regulate the practice of nursing care and the power to enforce the laws.

The NPA is intended to regulate and protect the public from practitioners who could be a risk to the health and safety of citizens. This is done by assessing competence at licensure at the beginning of a nursing career and as they continue their work. Regulations can be updated yearly to reflect any changes in evidence-based practice. 

The origins of the NPA go back many years, but it was in 1902 that members of the New York Nurses Association – which had been recently formed – met to discuss the nation’s first nurse practice act. One year later, the first ‘permissive’ registration law for nurses was passed in North Carolina. The permissive licensure enabled nurses who met certain standards (such as graduating from nursing school and passing an exam) to work as a nurse but did not permit the use of the title ‘registered nurse.’ The state then became the first to pass a Nurse Practice Act in March 1903. Virginia, New York, and New Jersey passed nurse registration laws in the same year and by 1921, 48 states, the Territory of Hawaii, and the District of Columbia passed laws that regulated professional nursing.

It was not until 1935 that mandatory licensure for nurses became law, and it was not enforced until 1947 because of the impact of World War II. As a result, the terms Registered Nurse and Licensed Practice Nurse are now legally protected titles in all states.

Currently, each state initiates nursing regulation through NPAs. They are designed to provide a standardization for laws that regulate nursing practice, emphasizing the accountability of all nurses for providing and improving the safe care of patients. NPAs provide codes of conduct and practice standards for the continued privilege to practice nursing.

In Virginia, the specifics of the NPA can be found by visiting The Virginia Department of Health Professions Board of Nursing. NP practice in Virginia is regulated by the Board of Nursing and the Board of Medicine under a Committee of the Joint Boards. 

According to the Virginia Council of Nurse Practitioners ‘Licensed Nurse Practitioner’ or LNP is the term used for Nurse Practitioners (NPs), Certified Nurse Midwives, and Certified Registered Nurse Anesthetists.

To attain a Virginia Nursing License, candidates must have an ADN or BSN, pass the NCLEX-RN exam, and apply for a Virginia License through the Virginia Board of Nursing. They also must pass a criminal background check. It is also possible for holders of an eNLC multi-state nursing license to practice in Virginia. It can take 30 to 45 working days to get the license depending on whether candidates have an RN license.

Prescriptive authority requires a separate application to licensure and the paperwork can be obtained from the Virginia Board of Nursing. All applicants must hold a current, unrestricted license as an NP in the Commonwealth of Virginia and provide evidence of continued professional certification, practice as an NP for more than 1,000 hours, and 15 continuing education units related to the area of practice for each year immediately prior to the application’s submission. 

Alternatively, the candidate could have 30 contact hours of education in pharmacotherapeutics of pharmacology that are acceptable to the boards and taken within five years of the application. This could include satisfactory completion of a graduate level course obtained as part of their NP program in pharmacology or pharmacotherapeutics. Applicants will also need 30 contact hours which may be obtained in formal settings as non-credit or discrete continuing education. This includes prescription writing, applicable federal and state laws, drug selection, drug interaction, dosage and route, information resources and clinical application of pharmacology, or others related to a specific scope of practice. 

The role of RNs

RNs care for patients, working closely with physicians and other health professionals. There are a range of specializations and work settings but generally a typical day for a registered nurse could comprise:

  • Developing and implementing plans for patient care.
  • Monitoring and recording the patient’s condition and needs.
  • Administering prescribed medications and treatments.
  • Conducting procedures and screening tests.
  • Educating patients on health strategies and preventing illness and injuries.
  • Directing and supervising other nursing personnel.

RNs can be employed in hospitals, industrial and corporate sites, physicians’ offices, clinics, nursing homes, hospices, government or community health agencies, or patient’s homes. They can also pursue careers in teaching, consulting, research, health administration, and other specialties.

RNs could work with a group of other nurses for the same employer but be deployed in different work settings. Medical systems often provide a range of services and could, for example, operate their own home health services for patients who have been discharged from a hospital but still need assistance. Nurses working within hospices will provide palliative care, which may include administering pain medication as well as other possible interventions. They also support patient families as they deal with the passing of their loved one.

Health providers and health systems also need nursers who can bridge between settings and providers, evaluate the appropriate level of care for patients with continuing needs, and help the patients navigate the health system. They can provide case management, after-hours triage, and health services in the community too. RNs who are interested in population health may forge a career in community health nursing or health improvement programs. This could involve immunization, screening, and prevention programs or working on maternal-child health.

According to a survey published by Nursing Licensure monitoring where RNs work in Virginia, around 38% work in inpatients units in hospitals, with 7% working in hospital emergency departments, and 6% in hospital outpatients settings. 4% work in ambulatory service centers, primary care, or non-specialty clinics and physicians’ offices. 5% work in home health, 4% in nursing homes or long-term care, 6% in academic settings, and 2% in non-surgical specialty clinics, with school health services home to 3% of RNs in Virginia.

Why work as an RN in Virginia

The job prospects for nurses in Virginia are very positive. According to World Population Review, the population of Virginia in 2023 was estimated at over 8,700,000, which is an increase of more than roughly 380,000 since the official census of 2010. The state enjoys a growth rate of 1.15% which ranks as 13th in the country. Furthermore, the ageing population of Virginia is another reason why healthcare workers will be in demand.

One of the main reasons people become nurses is that it is a career that provides a huge amount of personal fulfilment. Nurses make a big difference to people every single day. There are also many opportunities for advancement or working in a variety of different fields. Some nurses progress by earning specialized nurse certifications, while others move onto administrative fields where they can make an impact on the profession as a whole. 

Nursing positions can also offer flexible hours and scheduling, which can be very helpful to parents and guardians, and RNs also receive a competitive salary and often significant benefit packages.

Why become an NP in Virginia 

One of the reasons individuals choose to become an NP in Virginia is that it’s possible to work in specific areas of care. NP specializations are usually categorized by work environment and population. Working with a particular population involves dealing with a group with similar health characteristics or concerns, such as gender and age. This ability to focus on a particular area of medicine allows NPs to improve their skills and demonstrate expertise, building a deeper connection with patients by focusing on specific populations. 

The most popular specializations include pediatrics, family, adult-gerontology, neonatal, women’s health, and psychiatric. Because of their advanced training and education, NPs can work with more autonomy than an RN, as RNs work under clinicians while NPs can work more independently. 

What makes a good nurse?

Nursing is hugely rewarding and comes with a lot of responsibilities. There are many characteristics and qualities that combine to make a good nurse, but overall, they should bring their best qualities to work to help promote positive patient outcomes while working as an essential member of a healthcare team.  

Some useful skills for nurses include the following.

Verbal and written skills

Excellent verbal and written communication skills are vital. Utilizing active listening and having an awareness of non-verbal cues enable a nurse to understand how different people communicate. 


Empathy is crucial, as it allows a nurse to work with a patient-centered approach to caregiving by relating to what the patient is experiencing. It would be more difficult to understand the patient’s concerns without empathy – which is a step beyond sympathy.


Many patients in care may be scared, or concerned about their healthcare, so it is important for nurses to understand and to give compassion to their patients. Therefore, compassion helps nurses to aspire to ease the pain and suffering of others.


Critical thinking and problem-solving skills are hugely important, as nurses are often expected to work autonomously and under pressure. They must make decisions utilizing their knowledge and critical thinking expertise. 

Attention to detail

Nursing is a difficult and complex task which requires a lot of attention to detail – whether in terms of diagnosing, providing treatment, or discussing certain issues with patients. Whilst discussing their concerns, a patient may miss out on important details; the nurse should listen to the gaps in the information and make sure everything is covered in their treatment and diagnosis. A lack of attention to detail could be critical to patients and may have severe consequences. 

Integrity and advocacy

Integrity and advocacy are core nursing strengths. Nurses should have a strong moral compass while providing care and a focus on patient advocacy.

Continuous learning

A willingness to learn is vital as healthcare is constantly changing so nurses must be willing to improve and expand on nursing qualifications and skills as they move through their careers.

Career development

As well as attaining the correct qualifications and licensure, nurses hold the key to their own professional development through a commitment to lifelong learning. For some nurses, the workplaces help them maintain continuing education, but they also must be advocates for themselves and ensure their development continues throughout their career. 

Lifelong healthcare learning includes education on a new medication or medical equipment or researching a disease process when first encountering it. It can include a change of workplace or patient population to broaden their knowledge base and area of expertise. All this can be done by attending courses, taking webinars, reading medical papers or even simply reading more broadly to keep abreast of health and social matters in the general population through magazines and websites. 

Within healthcare itself, lifelong learning is essential. Healthcare is becoming more challenging and complex partly because of new knowledge that is emerging at pace. Both patients and their families have high expectations of the level of care they should receive, and an increasing number are educating themselves about their conditions and possible treatment. Yet they still feel that their healthcare professionals should know more than them in order to assist them. So, lifelong learning must be upheld by all medical professionals.

Lifelong learning is also a mandatory career advancement requirement and can include volunteering, mentoring, and participating in committees as well as formal learning. Commitment in every area of a nurse’s working life is the key to advancement and job satisfaction.

Getting the right qualifications

When considering employment options to take and where to study and work, candidates must ask themselves, is nursing a good career in Virginia? The US Bureau of Labor statistics ranks Virginia as one of the top paying areas for RNs and has employment rates high above the national average. Marymount University is the perfect place to start a career as a nurse, as they offer a range of accredited online nursing degrees enabling candidates to choose one that best aligns with the passions and goals. This includes the Bachelor’s Programs for Aspiring Nurses, and Master’s Programs for Psychiatric Mental Health Nurse Practitioners (PMHNPs) and Family Nurse Practitioners (FNPs). It also offers a Doctor of Nursing Practice for PMHNPs and Doctor of Nursing Practice for FNPS as well as Post-Graduate Nursing Programs. 

Marymount University’s nursing programs focus on advanced clinical education, service-orientated learning experiences, and compassionate care, with online programs that offer flexible, part-time learning. The faculty members are expert NPs who are focused on improving healthcare and leadership by meeting the needs of vulnerable populations. All faculty members have advanced training and education, with 85% holding the highest degree in their field of study.

To get more information about the programs and qualifications needed, as well as the different options available, interested individuals can complete the relevant form and a dedicated admissions advisor will be in touch to guide them through the application process. With guidance, they can progress their nursing career knowing that they have chosen the right path and the best course for them.

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