A Nurse Practitioner (NP) is an advanced practice registered nurse (APRN) with a graduate-level education, prepared to provide comprehensive and specialized healthcare. Endotracheal intubation is the placement of a flexible plastic tube into the trachea, or windpipe, to maintain an open airway. This procedure is typically performed in urgent situations to allow mechanical ventilation for patients experiencing respiratory failure or during general anesthesia. The determination of whether an NP can perform this advanced skill is governed by their specialized training, state laws, and hospital policies.
The Direct Answer: NP Role in Endotracheal Intubation
The immediate answer to whether a Nurse Practitioner can intubate a patient is yes, but this capability is not granted to all NPs and is highly conditional. Intubation is an advanced, high-acuity procedure generally reserved for unstable or critically ill patients in settings like the emergency department or intensive care unit. NPs who work in these environments are the most likely to have the necessary education and clinical privileges to perform it.
The ability to perform this skill contrasts with the scope of practice for most primary care providers. While physicians, Certified Registered Nurse Anesthetists (CRNAs), and sometimes respiratory therapists are commonly associated with performing intubation, a subset of NPs is also trained for this intervention. The authorization hinges entirely on their specific specialty certification and the legal and institutional framework where they practice. This procedure must be explicitly included in the NP’s scope of practice.
State Regulation and Institutional Credentialing
The scope of practice for any Nurse Practitioner is determined by the Nurse Practice Act within the individual state where they are licensed. These state laws define the legal boundaries of the NP role, ranging from “full practice authority” to “restricted practice” requiring physician supervision. The state Board of Nursing clarifies whether advanced procedures like intubation fall under advanced practice nursing.
Even if state law permits the procedure, the final barrier is institutional credentialing. Every facility must grant the NP specific clinical privileges to perform intubation. This process involves a detailed review by a privileging committee, which examines the NP’s documented training, supervised experience, and demonstrated competency.
The hospital’s decision ensures patient safety and verifies the provider has sufficient documented case experience. For example, a hospital may require an NP to prove they have successfully performed a specific number of intubations under supervision before granting privileges. Without this explicit sign-off from the facility, the NP cannot legally perform the procedure within that hospital system.
Specialized NP Roles and Intubation Competency
An NP’s likelihood of possessing intubation competency correlates directly with their specialty education and clinical focus. Acute Care Nurse Practitioners (ACNPs), particularly those specializing in Adult-Gerontology Acute Care (AG-ACNP), are most often trained and authorized to perform invasive procedures. Their curricula are designed to manage the complex needs of critically ill patients, including advanced airway management.
Emergency Nurse Practitioners (ENPs) who work in high-acuity emergency departments are another specialized group where intubation skills are frequently utilized. Both ACNPs and ENPs work in settings where respiratory failure is common, necessitating the ability to secure an airway quickly to stabilize unstable patients.
In contrast, NPs focused on primary care, such as Family Nurse Practitioners (FNPs), generally do not receive or require this procedural training. Their scope focuses on wellness, health maintenance, and managing stable chronic conditions in outpatient settings. An FNP would not possess intubation privileges because the procedure is outside the typical clinical needs of their patient population.
Required Training and Maintaining Proficiency
For an NP to safely perform intubation, their training must extend beyond the standard core NP curriculum. Specialized education involves dedicated procedural training modules, often utilizing high-fidelity simulation labs to practice rapid sequence intubation (RSI). Initial training is followed by supervised clinical experience, where the NP performs the procedure on live patients under the guidance of an experienced provider.
Formal certifications, such as Advanced Cardiac Life Support (ACLS), are mandatory for critical care NPs but do not confer procedural competency alone. The hospital requires documented proof of specific training and supervised case log numbers to grant privileges. Maintaining proficiency is a continuous requirement due to the high-risk nature of emergency intubations. This involves regular re-credentialing, which may require documenting a minimum number of successful intubations annually or participating in periodic simulation-based refresher training.