The practice environment for nurse practitioners (NPs) in Maryland is highly influenced by three dynamic components:

  • Clinical practice
  • Professional relationships
  • The political system

Each of these three components interacts with the others to create the setting in which the NP role has developed.

Clinical Practice

The clinical practice of nurse practitioners in Maryland has been influenced by educational standards adopted by national organizations, including the:

  • National Organization of Nurse Practitioner Faculties (NONPF)
  • American Association of Colleges of Nursing (AACN)
  • National Council of State Boards of Nursing (NCSBN)
  • American Association of Nurse Practitioners (AANP)

A master’s degree with preparation in an accredited nurse practitioner program has been set as the minimum education for entry into practice and licensure in Maryland. Doctoral degree preparation is becoming increasing popular, particularly the Doctor of Nursing Practice degree, which highlights clinical practice and the application of research into clinical practice.

Early nurse practitioner programs were developed for adult, pediatric, and geriatric specialties in the 1970s. The more generalist family nurse practitioner programs were implemented beginning in the mid-1990s.

Nurse practitioners do not practice with protocols but develop strong assessment and critical thinking skills; the ability to work through the diagnostic process; and comprehensive treatment planning based on the latest guidelines, consensus statements, and evidence-based recommendations.

Professional Relationships

Nurse practitioners have cooperative and collaborative relationships with a wide variety of health care professionals. Nurse practitioners practice wherever health care can be provided, including prison, occupational health centers, Johns Hopkins University, and the National Institutes of Health. Nurse practitioners meet the same practice standards as physicians within these health care settings. Nurse practitioners have the legal authority to form independent practices but most practice as part of the health care team.

Political System

The day-to-day practice of nurse practitioners is also influenced by the political environment. Nurse practitioners in Maryland have been politically organized, legislatively active, and widely effective. NPs have returned to the legislature to wage strong campaigns to increase the NP role so that they might more fully advocate for patients and increase access to health care. Click here for the most recent legislative report.

Professional lobbyists who are especially knowledgeably about the NP role help facilitate this legislative success. Click here for an overview of lobbyists Bill Pitcher and Julia P. Worcester.

A strong legislative committee meets with legislators to educate them about the NP role and helps members to respond to critical issues by contacting legislators across the state.

NPAM advocates for all NPs. We invite all nurse practitioners in Maryland to join NPAM and help in supporting the NP role. The burden to advocate for Maryland NPs is lighter when more people are involved, politically active, and providing financial support.

If you are not a member of NPAM, help us finance the legislative efforts of the organization through a donation to the NPAM Political Action Committee (PAC). Please note: The Maryland Board of Elections requires that PAC donations come from individuals and not employers.




NPAM website 2017: