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Change in Nursing Scope of Practice


hi everyone!

i am a forth year nursing student and i am currently working on a presentation on change in scope of practice for nurses. just wondering if anyone could share their experiences with me....how have you seen your scope of practice change in your nursing career? are you doing more now? doing less? who was doing these activities before you were? who is doing them now? and what is your prediction for the progression of nursing scope into the future?

any comments would be greatly appreciated!

classicdame, MSN, EdD

Specializes in Hospital Education Coordinator.

One thing I have observed is a refinement of the definition of nursing practice in my state. For instance, PA's, Medical Asst's, surgical scrub techs, etc have all tried to encroach on nursing practice. Thank goodness someone is protecting the public and the nurses by including in the NPA what can, and cannot, be done by a nurse. An addition has been that advanced practice nurses can get a special license to prescribe and to act as first assistant in surgery.


Specializes in LTC Family Practice.

I'm an LPN and graduated from school in '72, we had a fair amount of pharmacology but in order to pass meds we had to take an additional pharm course after we passed our boards. Back then there was no IV work other than to change the flow - counting the gtts (no machines back then ;)) Now as I return to nursing our scope of practice has changed about IV care, of course it does vary from state to state some but for the most part LPN's are allowed to start and maintain IV's unless there are push meds.

For instance, PA's, Medical Asst's, surgical scrub techs, etc have all tried to encroach on nursing practice.

Care to explain how PAs are "encroaching" on your nursing practice?

Lacie, BSN, RN

Specializes in jack of all trades.

I see more and more task being delegated to CNA's rather then nurses in some areas. When I worked burns the techs did dressing changes and whirlpools. In dialysis more and more of the techs being the ones to make decisions on treating complications related to dialysis such as hypotension, infiltrations, etc. Most arent even certified (changes next year must be certified). At same time I find myself doing more of the tech responsibilties due to cutting in staff put on top of my nursing responsibilites (mopping up spills, cleaning machines, mixing bicarb, etc). Techs pushing heparin when it's against the NPA in my state and get the "we just dont tell" attitude. Ugh.