Section 4723.43 | Scope of specialized nursing services.
A certified nurse-midwife, certified nurse practitioner, clinical nurse specialist, or certified registered nurse anesthetist may provide to individuals and groups nursing care that requires knowledge and skill obtained from advanced formal education and clinical experience. In this capacity as an advanced practice registered nurse, a certified nurse-midwife is subject to division (A) of this section, a certified nurse practitioner is subject to division (B) of this section, a clinical nurse specialist is subject to division (C) of this section, and a certified registered nurse anesthetist is subject to division (D) of this section and section 4723.433 of the Revised Code.
(A) A certified nurse-midwife, in collaboration with one or more physicians, may provide the management of preventive services and those primary care services necessary to provide health care to women antepartally, intrapartally, postpartally, and gynecologically, consistent with the nurse's education and certification, and in accordance with rules adopted by the board of nursing.
No certified nurse-midwife may perform version, deliver breech or face presentation, use forceps, do any obstetric operation, or treat any other abnormal condition, except in emergencies. Division (A) of this section does not prohibit a certified nurse-midwife from performing episiotomies or normal vaginal deliveries, or repairing vaginal tears. A certified nurse-midwife may, in collaboration with one or more physicians, prescribe drugs and therapeutic devices in accordance with section 4723.481 of the Revised Code.
(B) A certified nurse practitioner, in collaboration with one or more physicians or podiatrists, may provide preventive and primary care services, provide services for acute illnesses, and evaluate and promote patient wellness within the nurse's nursing specialty, consistent with the nurse's education and certification, and in accordance with rules adopted by the board of nursing. A certified nurse practitioner may, in collaboration with one or more physicians or podiatrists, prescribe drugs and therapeutic devices in accordance with section 4723.481 of the Revised Code.
When a certified nurse practitioner is collaborating with a podiatrist, the nurse's scope of practice is limited to the procedures that the podiatrist has the authority under section 4731.51 of the Revised Code to perform.
(C) A clinical nurse specialist, in collaboration with one or more physicians or podiatrists, may provide and manage the care of individuals and groups with complex health problems and provide health care services that promote, improve, and manage health care within the nurse's nursing specialty, consistent with the nurse's education and in accordance with rules adopted by the board of nursing. A clinical nurse specialist may, in collaboration with one or more physicians or podiatrists, prescribe drugs and therapeutic devices in accordance with section 4723.481 of the Revised Code.
When a clinical nurse specialist is collaborating with a podiatrist, the nurse's scope of practice is limited to the procedures that the podiatrist has the authority under section 4731.51 of the Revised Code to perform.
(D) A certified registered nurse anesthetist, in collaboration with a physician, podiatrist, or dentist actively engaged in practice in this state, and with a verbal or written request consistent with division (L) of section 4723.01 of the Revised Code, may perform the following patient care activities, in accordance with the nurse's education and certification, rules adopted by the board of nursing, and policies established and privileges delineated by the health care facility where the nurse and collaborating physician, podiatrist, or dentist practice:
(1) Obtaining informed consent for anesthesia care and performing preanesthetic preparation and evaluation;
(2) Administering anesthesia, by performing anesthesia induction, maintenance, and emergence;
(3) Performing epidural or spinal anesthetic procedures;
(4) Performing postanesthetic preparation and evaluation and providing postanesthesia care;
(5) Performing clinical support functions;
(6) As necessary for patient management and care, selecting, ordering, and administering treatments, drugs, and intravenous fluids for conditions related to either the administration of anesthesia or the performance of clinical support functions;
(7) Performing and documenting evaluations and assessments, which may include ordering and evaluating one or more diagnostic tests for conditions related to the administration of anesthesia or the performance of clinical support functions;
(8) Directing a registered nurse, licensed practical nurse, or respiratory therapist to do the following, but only if the nurse or therapist is authorized by law to do so:
(a) Provide supportive care, with such care to include monitoring vital signs, conducting electrocardiograms, and administering intravenous fluids;
(b) Administer treatments, drugs, and intravenous fluids for conditions related to either the administration of anesthesia or the performance of clinical support functions.
When a certified registered nurse anesthetist collaborates with a dentist, the nurse's scope of practice is limited to the anesthesia procedures that the dentist has the authority to perform under the dentist's conscious sedation or general anesthesia permit issued under Chapter 4715. of the Revised Code.
A certified registered nurse anesthetist may perform the induction, maintenance, and emergence of general anesthesia only if the collaborating physician, podiatrist, or dentist is present at the health care facility during such induction, maintenance, and emergence.
A certified registered nurse anesthetist shall not prescribe a drug for use outside of the health care facility where the nurse practices.
Last updated March 27, 2026 at 1:27 PM
Available Versions of this Section
- March 20, 2013 – House Bill 303 - 129th General Assembly [ View March 20, 2013 Version ]
- April 6, 2017 – House Bill 216 - 131st General Assembly [ View April 6, 2017 Version ]
- March 27, 2020 – Amended by House Bill 197 - 133rd General Assembly [ View March 27, 2020 Version ]
- June 9, 2026 – Amended by House Bill 52 - 136th General Assembly [ View June 9, 2026 Version ]