How to Determine if a procedure falls within the RN Scope of Practice

Nurse’s scope of practice is defined by the Nursing Practice Act. Furthermore, in our state of NC, the scope of practice is also defined by the NC Administrative Code Rules. (NCBON 2013). Nursing roles are influenced by our healthcare system that is ever changing. This is why it is important for nurses to make valid and reliable decisions regarding their scope of practice. In the state of NC, there is a “decision tree” to help nurses decide if something is in their scope of practice. The so called decision tree is as follows: First a nurse should define, describe and clarify the activity being asked of them. Then is the activity prohibited by any law or Nurse Practice Act. If the answer is yes, immediately stop. If no, then continue to ask yourself more questions, such as, would a reasonable prudent nurse perform this activity in this setting? Of course, if your answer is no, stop, if yes, continue.

Furthermore, does your facility have policies and procedures in place? Moreover, has the nurse had education and documentation of competency? Also, is the nurse prepared to accept responsibility for any outcomes? If all your answers are yes, then according to the NCBON, a nurse may proceed with the activity according to acceptable standards of safe nursing care. (NCBON 2013). Besides making sure I was cleared with my BON, I would make sure my facility is comfortable with the activity as well. I would want go through the proper channels of management to have clearance for such an activity. Also, I would want to there to be policies and procedures in place. Not only would I want my facility to be prepared, but I would too.

I would want to ensure I have the competency to perform this activity in a safe manor for the patient. I would introduce this new procedure with education and if possible demonstration. I would want evidence based practice research to be able to show the benefits and risks and get the word out about new technology. If it was ever possible, I would love to have a demonstration or a lab set up to show how it works with the benefits as well as hopefully the cost savings that accompanied the procedure. NC Board of Nursing (2013). Scope of Practice Decision Tree for the RN and LPN. Retrived from: www.ncbon.com