A question I receive often is whether a certain task falls within the scope of practice.
Unfortunately, there is no blanket answer. Scope of practice varies state-by-state and institution to institution. Just because you are educated and even trained to perform a certain skill, that does not mean using that skill necessarily falls within your scope of practice. If you do not know or are just not sure, and even if you are sure, double-check!
If you perform an activity that is outside your scope of practice, it might cost you your license because that could be considered practicing medicine without a license.
So, how do you find out whether an activity is within your scope of practice?
Each state has its own Nurse Practice Act and you should make sure that you have reviewed the one for your state. Some Acts are intentionally vague. Here in Indiana, for example, it states: “failure to keep abreast of current theory or practice.”
Well, what does that mean? It does not give specific activities such as removing pacer wires or sutures and whether each is within your scope of practice.
Recently I had a nurse who drew blood from a Quinton catheter when she was a travel nurse in another state. Unfortunately, in that other state, that type of activity is outside of the scope of practice for nurses.
Some State Nursing Boards actually allow you to write in and obtain an advisory opinion. This is a great opportunity for you to ask the question and to receive assistance as to whether the activity is within your scope of practice.
You can check to determine whether the activity is within the scope of practice by looking at your facilities policies and procedures. Is there a policy and procedure on the activity that you plan to undertake? If there is, that’s a good indicator that it is within your scope of practice.
Another issue that comes up is whether you were adequately trained to perform that activity. What education requirements were you to have undertaken to ensure that you are safe to undertake that activity? Check your policy and procedure.
If you have not been certified or checked off on that particular activity and if you don’t feel comfortable performing the task … THEN DON’T DO IT! Your license is too important to risk.
I’d love to hear your comments below about how you familiarize yourself with your scope of practice in your state.
Jonathan Pierce says
I recently inquired the IN state board with a scope of practice question. I am an RN placing bedside PICC lines, ultrasound IVs, and midlines. I had asked the board if placing a central venous catheter, either in a subclavian vein, or an internal jugular vein at the bedside could be in our scope. According to a couple of our supply reps, RN placed central lines is a thing in many states. The nursing board director responded by saying that he recommended “contacting an attorney or your professional organization”, which led me to your site. He also gave me the link to the IN PLA statues and rules, which really doesn’t answer the question at all. The Infusion Nurses Society, with some data, published a position paper stating that the qualified RN could place these access devices, but of course must be in compliance with the state’s scope. Any insight into this topic would greatly be appreciated.