In a major step toward modernizing healthcare delivery, New York State has finalized an emergency rule that allows registered nurses (RNs) to carry out non-patient-specific orders issued by physician assistants (PAs)—a privilege previously reserved for physicians and nurse practitioners.
What Changed?
Under the new rule, RNs can now follow standing orders from PAs for a wide range of clinical tasks, including:
- Immunizations
- Emergency treatment of anaphylaxis
- Tuberculosis, HIV, and hepatitis C screening
- Opioid overdose treatment
- STI screening and electrocardiograms for suspected acute coronary syndrome
- Point-of-care glucose testing for hypoglycemia
- IV access and diagnostic testing for suspected sepsis
- Pregnancy testing
- COVID-19 and influenza testing
This expansion is especially impactful in community settings like schools, shelters, mobile health units, and clinics—where access to physicians may be limited.
Why It Matters
The change reflects a broader trend in healthcare: maximizing the scope of practice for qualified professionals to improve access and efficiency. According to the American Academy of PAs, New York has also passed legislation to:
- Increase physician-to-PA ratios from 1:4 to 1:6 in private practices and 1:6 to 1:8 in correctional facilities
- Allow PAs to prescribe durable medical equipment
- Permit PAs to write non-patient-specific standing orders
- Expand eligibility for PAs to serve on county health boards
These reforms are expected to streamline care, reduce delays, and empower healthcare teams to respond more effectively to patient needs.
Voices of Support
Jonathan Sobel, President of the New York State Society of Physician Associates, called the legislation “a major milestone” and emphasized that it gives PAs “more tools to improve patient access to care”.
Meanwhile, nursing organizations like the American Nurses Association – NY have praised the move for allowing RNs to “practice to the top of their licensure” and optimize patient safety.
New York’s expansion of nurse and PA collaboration is a win for patients, providers, and public health.