What is Nursing Scope of Practice?

Instructor: Bethany Lieberman

Bethany is a certified OB/GYN nurse who has a master's degree in Nursing Education.

In this lesson, you will learn about the scope of practice in nursing. We will discuss the importance of knowing the scope of practice governed by your state and those endorsed by professional nursing organizations and specialties.

What Is a Scope Of Practice?

Jen is super excited; she just graduated from nursing school and is on her way to becoming a professional registered nurse (RN). There is only one major hurdle left in her way: she must pass the NCLEX nursing exam. Jen decides to pick up a study guide; the very first topic is entitled: 'Understanding Your Scope of Practice as a Nurse.' In school, Jen learned that there are many different types of nurses, including licensed practical and registered nurses, nurse anesthetists, clinical nurse specialists, and nurse practitioners. Different types of nurses fulfill completely different role and must comply with a set of rules called scope of practice, which tells them what they can and cannot do as professionals.

State Requirements

Scope of practice defines what types of care that nurses are legally allowed to perform, and it differs from state to state. For example, when Jen applies for a nursing license in a particular state, she must abide by the rules and regulations set forth by that state's board of licensure or her license may be suspended or revoked. For instance, in the state of Washington, only nurses trained in the field of anesthesia may regulate an epidural pump, with the exception of trained obstetrical nurses. Therefore, if Jen does not have anesthesia training, or is not working as an obstetrical nurse, she cannot regulate her patient's medication with an epidural pump.

Organizational Requirements

Professional organizations and specialty organizations, such as those for obstetrical or operating nurses, also have their own scopes of practice that they endorse and expect their members to follow. For example, if Jen decided she wanted to work as an obstetrical nurse and applied for membership to the Association of Women's Health, Obstetrics, and Neonatal Nursing (AWHONN), she would have to adhere to their specific position statements for members.

AWHONN's rules state that registered nurses may not initiate or regulate epidural medication. The rules are also very specific about what nurses can do, such as monitoring patients and changing their medication bags. If Jen were to act outside AWHONN's recommended scope, she could lose her membership and be liable in court for practicing outside her scope of care.

Care Teams

Once Jen becomes a registered nurse, she'll have to review the scope of practice for the members of the care team that she'll be working with or even supervising, which may require delegating some activities to others. Delegation means that Jen will make others responsible for completing patient care tasks at her discretion, such as asking a medical assistant to give a bed bath or a licensed practical nurse to administer insulin.

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