Nursing is a very flexible career. When you move, you can take it with you. Within the occupation, you also have the potential to move to a different work setting, specialize in a particular area or add new responsibilities within your current job or practice setting. Part of preparing for these changes is updating what you know about scope of practice.

States Set the Rules

Each state develops its own regulations around scope of practice issues, not only for RNs but for other nursing occupations and allied health personnel. In addition to the individual states, the American Nurses Association and specialty organizations also have standards of practice. While these are not regulations in the same sense that a state nurse practice act is, they do define the expected standard of care. If a patient suffers harm and you were not following the standard of care, you could be liable.

Supervision and Scope of Practice

RNs nearly always wind up supervising other staff, even if they aren’t officially in a management role. That means you need to know the scope of practice for the people you supervise. You can’t delegate a task that’s outside a subordinate’s scope of practice, even if you’ve trained them in a procedure and feel confident about their competence. Although nurses fall under the jurisdiction of state nursing boards, other regulatory agencies may oversee allied health personnel. The scope of practice for medical assistants, for example, is usually defined by the state medical board or the American Association of Medical Assistants.

Advanced Practice

Advanced practice registered nurses — nurse anesthetists, nurse practitioners, nurse midwives and clinical nurse specialists — have a greatly expanded scope of practice compared to the average RN. APRNs can prescribe medications, order lab and diagnostic tests and perform many functions once reserved for physicians. However, some states require that APRNs have a supervising physician. Although the doctor is supposed to be the boss in that situation, the APRN may be more knowledgeable about scope of practice issues.

Do Your Research

Digging out the details on scope of practice is not always easy. The first place to start is with the board of nursing in the state where you practice. Most of these have websites that include specifics on the regulations under which you practice in that state and may also include information on supervising other nurses and allied health personnel. The state board of nursing may also offer telephone or email consultations if you have a specific question. Specialty organizations provide information on standards of care.

Allied Health and Unlicensed Staff

When it comes to those you supervise, you’ll have to do a little extra footwork. Start with the board of nursing and find out exactly who those regulations cover. Some states have had a separate board for licensed practical/vocational nurses. Many allied health occupations also have professional organizations that can answer your questions about scope of practice. In the long run, individual state regulations are likely to be the deciding factor.



Written By Independent 3rd party

2016-22734  Exp. 5/18