Understanding Nurse Practice Acts: Definition and Impact

Instructor: Sheila Bouie
This lesson gives an overview of Nurse Practice Acts. It takes a short look at the history leading up to enactment of Nurse Practice Acts, defines Nurse Practice Acts, and Boards of Nursing.

History of the Nurse Practice Act

Would you give your pet drugs that were offered by someone who wanted to be a veterinarian but was not actually a veterinarian? What about if you had severe pain in your tooth? Would it matter if the person offering to fill your cavity was a dentist or just pretending to be a dentist? Of course it matters, and it matters that patients receive nursing care from real nurses, not imposters. Without the rules set forth in a Nurse Practice Act, there would not be a way to determine if the people practicing nursing were actually educated as nurses!

Before nursing organizations were established and before regulations governing the practice of nursing existed, nurses were more or less freelance artists. Anyone could offer their services as a nurse without having previous training or a recognized skill set. This was a dangerous practice, and it endangered the health of the public.

In the early 1900s, there were over 400 training schools for nurses. Individuals who were actually trained as nurses started to organize. The New York State Nurses Association was one of the first organizations of trained nurses. It was this organization that championed the idea that trained nurses should be registered as a matter of public safety.

In 1904, North Carolina became the first state to enact a nurse practice act. One of the tenants of the act was to protect the title of Registered Nurse.

What Is a Nurse Practice Act?

Each state has an obligation to ensure public safety, health, and the welfare of it's citizens. The licensing of healthcare providers helps to ensure public safety by identifying standards that potential applicants must meet before becoming licensed. It forbids those without the appropriate training and education to perform in that role and violation of those rules is breaking the law.

Every nurse who practices, regardless of the area in which they practice is governed by a Nurse Practice Act (NPA) of the state where they practice.

An NPA is enacted by state legislation and its purpose is to govern and guide nursing practice within that state. An NPA is actually a law and must be adhered to as law. Each state has a Board of Nursing (BON) that interprets and enforces the rules of the NPA.

What Do NPAs Cover?

All NPAs minimally address the following areas:

  • Pre-licensure education program standards

This means that any program offering nursing education must comply with the rules outlined in that state's NPA.

  • Title protection

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