In the nursing profession, different types of caregivers exist. You may work with unlicensed assistive personnel, licensed practical nurses, registered nurses, and/or advanced practice registered nurses. Each of the licensed professions has its own legally defined scope of practice for nurses, as stated by the Board of Nursing in each state.
What is the scope of practice?
The term “scope of practice” is used to define the actions, procedures, etc. that are permitted by law for a specific profession. It outlines restrictions to what the law permits, based on specific experience and educational qualifications.
It is imperative that you know not only your scope of practice. You should also know the scope of practice of the others who make up a part of your nursing team and provide patient care. Remember, if you delegate an activity or task to another caregiver, you remain accountable for the delegation in terms of its appropriateness.
Most—if not all—Boards of Nursing in the United States have information available on their websites about this. It includes the laws and rules which govern nursing practice, legal standards/scope of practice, etc.
How can you determine if an activity or task is within the scope of practice?
You can follow these 3 specific steps:
Define the issue.
You must clarify what the specific activity or task entails. Obtain any additional information that you may need, such as facility policies or procedures. You must also conduct a self-assessment with regards to your own skills and abilities, and your documented competency to perform the task. If you question your abilities, you must express this concern to the appropriate supervisor/staff person.
Once you accept an assignment, you are accountable for completing it in a safe and competent manner. If other options may be available to you, explore these. Obtain assistance if you are unsure as to how to proceed.
Review laws, rules, standards, etc.
What may be common practice in a facility may not be always appropriate or legal. For example, LPNs in a facility may do independent assessments and care planning without collaboration with the RNs, and may have done so for years. In some jurisdictions, this would be beyond the scope of practice for LPNs.
Working outside the scope of practice or delegating inappropriately to another person can be potential grounds for disciplinary action against nurses. It can be also the basis for medical malpractice claims filed by the Board of Nursing.
Make the decision.
Following consideration of the elements as stated above, you must also decide whether you are willing to accept the consequences of your actions as a nurse. If you are not, do not perform the activity or task. Only do the task after determining the following:
If a reasonably prudent nurse with similar education and experience would perform the task
If you have a valid written order from an MN, PA, or APRN
If you have documented competency in the skill required
Our primary concern must always be safe and proficient nursing care. As such, the scopes of practice for different nurses exist specifically for that reason. You must carefully understand each one to render the best and appropriate care for your patient.
Do you have any tips for nurses to help them remember their scope of practice? Share them in the comments section below.