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What Nurses Need to Know about Scope of Practice

Career News August 27, 2013

One advantage to establishing a career in the nursing industry is the variety of caregiver roles available. A healthcare facility may rely on nurse’s aides, licensed practical nurses, registered nurses and those with advanced degrees such as practitioners. With the varying certifications available in this field, it is necessary to define the practice criteria for each to alleviate confusion when it comes to treatment protocols. There are procedures that only a registered nurse can perform, and there are duties that anyone with basic training can do. The scope of practice clarifies the details of each job state by state.

The Board of Nursing

Every state in the union has a designated Board of Nursing or another administrative body that handles industry protocols. It is the job of the board to develop standards for nurses as they pertain to the state and formal education. The role of a licensed vocational nurse (LVN) may be different in Kansas then it is in Nebraska. It is the duty of a nurse to know what the laws and standards are for the job. That is the purpose of the scope of practice.

Setting Guidelines

Simply put, the scope is a guideline that defines the procedures and actions that each certification level can perform as determined by the state licensing board. What that means to nurses is there are some aspects of the work that require advanced training. A certified nurse’s aide would not try to start an intravenous line because it is beyond the skill set established for that level.

Nurses prove their competency via testing. In order to become licensed as a nurse, you must pass the NCLEX exam in your state. The testing and certification is based on educational standards. Licensed practical nurses take a different test than registered nurses because they have a different level of training.

The guidelines detail the role each nurse that passes the testing criteria at a specific level plays. In most states, licensed practical nurses (LPNs) require additional certification to start IVs, for example. The scope of practice might prevent a registered nurse from removing an arterial line in most states. In those areas, arterial line removal is not part of the registered nurses guidelines.

What Nurses need to Know

•It is the responsibility of a nurse to study the regulations in their state. Copies are available through the American Nursing Association or the licensing organization in the state.
•Nurses with advanced training such as neonatal or midwife certification have different guidelines than other healthcare professionals. When studying the protocols, ensure you have the proper document.
•Nurses should refer to the scope of practice for clarification, if necessary. This means conducting a self-assessment of your skills and responsibilities.
•Review the standards and law frequently to stay up to date on the scope of practice in your field.
•Each nurse is responsible for his or her own actions. Make decisions based on these guidelines. In other words, if asked to perform a procedure that you are uncomfortable with, check to ensure it falls within the rules for your field.

Scope of practice identifies the what, where, who and how of nursing procedures. Each state offers this doctrine to help define the role a nurse plays in the healthcare community. It encompasses all a nurse needs to know about his or her job and responsibilities when it comes to treatment protocols. That makes it a vital document to study when working in the nursing industry.

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