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My nurse practice act in Georgia is vague with regard to supervision/collaboration issues. There is no state where the law requires physicians to sign every one of a nurse practitioner's (NP's) charts. In Tennessee, a physician must sign 20% of an NP's charts every 30 days. In Arkansas, there is a requirement for physician cosignature of NP orders. Practice protocols or facility requirements must specify when NP's orders must be cosigned.
Certification and Licensing. Employers require that acute nurse practitioners be licensed registered nurses. Depending on the employer, a critical care nurse may need to have a state-specific advanced practice registered nurse (APRN) credential. Acute care nurse practitioners may need state authorization to prescribe medications.