Career Resources / Nursing Scope of Practice
Nurses rarely claim boredom with their profession given the limitless opportunities that are available. From the variety of patients and healthcare settings to the nursing specialties you can pursue, there is nary a dull moment. Nurses can develop their craft, learn new skills, and challenge their knowledge every time they put on their scrubs and head to work.
One thing that never changes about nursing is the rules and regulations by which every nurse agrees to abide, or the nursing scope of practice. Once issued your nursing licensure and credentials, nurses must commit to continuing education and nursing best practices that ensure quality healthcare for their patients.
In this article, we will explore:
- What is the nursing scope of practice?
- What is the nursing scope of practice by nursing licensure?
- Why is the nursing scope of practice important?
- What is the future of the nursing scope of practice?
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What is the nursing scope of practice?
When we talk about the nursing scope of practice, we are not referring to the stethoscope you carry around your neck. The nursing scope of practice is a guidepost for professional nursing activities and best practices. Think of it this way: nursing scope of practice is the who, what, where, when, and why of nursing. That is how the American Nurses Association describes it. Here is how they explain each of the 5Ws included in the scope.
The “Who”
The “who” in the nursing scope of practice refers to Licensed Practical Nurses (LPNs), Registered Nurses (RNs), and Advanced Practice Registered Nurses (APRNs). Your nursing scope of practice depends on your education level, licensure, and credentialing.
The “What”
When you become licensed, you agree to protect and promote the health and well-being of your patients (among other things). That is the “what” of your service and commitment as a nursing professional.
The “Where”
This is the truly versatile part of the nursing scope of practice. We alluded to this earlier when we said nursing is never boring. You can work anywhere there is a patient in need of their care.
The “When”
You know from experience there is not much downtime in your profession. Whenever your compassion and expertise are needed, you are there.
The “Why”
This is very personal for nurses. You may choose to enter the profession because of your desire to help people, while others see it as an exciting and rewarding career choice. Regardless of your reason, nursing’s purpose is to deliver positive patient outcomes while delivering quality care.
What is the nursing scope of practice by nursing licensure?
The nursing scope of practice varies by nursing licensure and state. Checking with your state Board of Nursing is a reliable way to ensure you are following all regulations. Here are some commonalities many states share under their nursing scopes of practice by nursing licensure.
LPN
LPNs assist RNs and doctors by providing basic medical care to patients. Among the scope of services, most states deem LPNs competent to perform changing bandages, catheters, and IVs; checking vital signs; maintaining detailed records of patient health and progress; helping patients with daily living tasks like eating and bathing; reporting any changes in a patient’s condition to RNs or doctors. Some states permit LPNs to administer intravenous medications and fluids under the direction of an RN.
RN
RNs have both administrative and care duties. Among the scope of services for RNs in most states is administering and monitoring medications; developing care plans; taking vital signs and recognizing abnormalities; caring for wounds; performing basic life support. RNs who choose a specialty will have additional duties and expectations under the nursing scope of practice.
APRN
APRNs have many of the same responsibilities as doctors. As such, they are expected to perform complex patient care tasks like making diagnoses; ordering and interpreting diagnostic testing; managing patient care; prescribing medications. The American Association of Nurse Practitioners provides an outline of the nursing scope of service for APRNs. As with other licensures, APRNs may need to meet additional competencies under individual states’ scopes of nursing practice.
[MORE: Nursing Scope of Practice by State]
Why is the nursing scope of practice important?
Why is the nursing scope of practice important? Well, it is the gold standard for a nurse’s professional responsibilities and duties. While you may have heard this phrase at some point in your education or career, you may not fully understand its importance.
Some employers can push the limits of what nurses can legally do, which compromises patient safety and jeopardizes your nursing career. It is imperative you fully understand your nursing scope of practice and live by it to the letter.
What happens if you work outside the nursing scope of practice?
Knowing your duty of care not only keeps your patients safe but also keeps you out of hot water. Nurses who act outside the scope of service of the licensing or certifying body that governs their professional licenses risk losing their job, facing punitive damages, or possibly having their licenses revoked. They can also be held liable for negligence, malpractice, or breach of patient confidentiality. It is that serious.
Examples of working outside the scope of practice
Keep in mind that just because your employer says you can do something (or asks you to do something) does not mean you should do it. For instance, let’s say you are an LPN and your employer directs you to administer medication to a patient because they are short-staffed with RNs and having difficulty meeting patient care obligations. You have no formal education and have not consulted with an RN, which is the standard scope of practice for LPNs. Most states do not permit LPNs to administer prescription medications, making this a major breach of your nursing scope of practice. If you are caught, you will suffer penalties right along with your employer. It is simply not worth the risk.
The same applies to RNs who may execute certain procedures like X-rays or give medication without an order.
What is the future of the nursing scope of practice?
Nursing is a dynamic and complex healthcare profession. It only makes sense that as best practices for the delivery of healthcare services change, the nursing scope of practice will evolve. It is important to stay on top of your continuing education requirements so you can practice to the fullest extent of your education and abilities.
FAQ
The nursing scope of practice is a guidepost for professional nursing activities and best practices. It is the who, what, where, when, and why of nursing.
It is the gold standard for a nurse’s professional responsibilities and duties. Nurses who act outside the scope of service risk losing their job, facing punitive damages, or possibly having their licenses revoked.
Nurses who work outside their scope of practice and do not follow their state’s Nurse Practice Act face a range of repercussions ranging from a reprimand to revocation of license. They can also be held liable for negligence, malpractice, or breach of patient confidentiality.
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