House Bill 793

earlier this year and signed into law by Governor Ralph Northam at the start of April. It went into effect on April 9, 2019.

The bill allows nurse practitioners in Virginia to receive a license to practice autonomously without collaborating physicians.

Until the passage of that law, even nurse practitioners with more than five years of clinical experience needed to have a contract under a physician in order to work, though physicians can only supervise up to six nurse practitioners at a time.

People in the medical field in the Shenandoah Valley

the law could have a big effect because of a shortage of health providers that could be addressed by letting nurse practioners operate independently.

Now, the very first nurse practitioner to get the new Virginia license, Susan Adamson, works at the Free Clinic in Harrisonburg.

Adamson has been a nurse practitioner for 26 years and said that this is a huge win for the nursing community.

"It's been something we've hoped and dreamed for at least 20 years, and have been working aggressively towards for at least the last decade," said Adamson.

She said previously nurse practitioners have had to sign practice agreements with doctors and often lost their ability to practice if the doctor on that agreement moved or passed away. Adamson had both circumstances happen to her, which resulted in a move to find a collaborating physician.

Nurse practitioners must have worked with collaborating physicians or nurse practitioners for 9,000 hours or five years in full-time practice to apply for the new license.

"It just opens up the future. It won't change the way that I practice. My care will not change with my patients, but it gives me the ability in the future. If I want to volunteer, say for example there's a RAM Clinic, a Rural Area Medicine Clinic, I can go and not have to worry about having a practice agreement," said Adamson.

Adamson said nurse practitioners will still collaborate with doctors if a patient's need requires it.

She said although some oppose the idea of nurse practitioners practicing autonomously, they will show that they are capable and have very high standards of care to uphold.

More than half the state's affected nurse practitioners have already met the five-year experience requirement.