Is 'scope of practice' not taught in school?

wooh, BSN, RN · Feb 27, 2012

People aren't willing to put in the limited amount of legwork necessary to find something out for themselves. A quick google of my state plus "nurse practice act" would get them the info they need (or to get a license in another state, state plus "board of nursing").

sarahlee23, LPN · Feb 27, 2012

We were taught what is and isn't in our scope of practice throughout the nursing program. Then during the very last week one morning they gave us a printed copy of what's in our scope of practice, went through it with us, made sure we knew where to find the nurse practice act for our state, and told us that we should always stay up-to-date on what our scope of practice is.

Jolie, BSN · Feb 27, 2012

There seems to be so much lacking regarding basic professional issues.

In my program, we were required to take a "leadership" course our final semester. It included both classroom and clinical sessions and covered topics such as methods of delivering nursing care (team, primary nursing), advanced education and advanced practice, obtaining and maintaining licensure, continuing education, the NPA, professional organizations, Liability Insurance, mentoring, resume and interview skills, how to approach new employee orientation, how to maintain professionalism in the workplace as a new grad, etc.

I am now a business owner in another profession. I interview, hire and train new employees on a regular basis, some with formal education, some with years of experience, some 16 year olds new to the workforce. I have found that most potential employees come to us with solid basic skills such as the ability to communicate clearly, handle basic math and computer skills. Sadly lacking in that setting is also basic knowledge of the application/interview/hiring/new employee process.

I have conducted interviews where I have learned in 20 minutes about the candidate's baby daddy drama, abusive parents, drug using lover, communal living arrangements and reasons for being fired from previous employment. What is really remarkable is that this all came out in response to, "Tell me about yourself." The candidate did not spend one second highlighting her job skills. And she was old enough to have known better.

So yes, there is a lack of basic job related skills and it is not confined to young employees or nurses.

Epic_RN · Feb 27, 2012

we went over RN scope of practice in nursing school twice, the first and the last semester. we were also told where to find it online.....

On Allnurses.com, of course!

We were given printed copies of our NPA in our last semester and tested on it.

nerdtonurse?, BSN, RN · Feb 27, 2012

It depends on the state. Some NPAs are very clear, LPN can do this, RN must do that, etc. Others are just shy of useless -- we've gotten into discussions at night about them, and it seems to me that the "fire at will" states tend to be the ones that don't specify things, making it easy for the employer to use the nurse as they see fit, and the nurse has little recourse to say, "I can't do that." Some states an LPN can't hang blood, others they can't spike it, but can monitor it once the RN's spiked the bag. Some states the LPN can't do a push IV med or narcotics. In mine, if you can fog a mirror, they'll let you do anything as an LPN except pronounce death or do an initial assessment (RN has to countersign it). I've seen them admin chemo at my hospital -- I started out as an LPN, and other than be charge, those were the only 3 things I couldn't do that the RNs did, but I think that was basically the hospital's rules, not the state's. In other states, the LPN is limited to what a CNA does in my state.

Our NPA basically says, the RN does what the LPN can't, and the LPN does what the CNA can't. Very helpful.

Esme12, ASN, BSN, RN · Feb 27, 2012

I think it's difficult to be taught scope of practice in your state when you are online learning in another. :rolleyes:

CT Pixie, BSN, RN · Feb 27, 2012

I see so many questions posted asking 'Is ______ within in my scope of practice as a ____ in ?'.
Is this not taught in school anymore?
Is it a rarity that a license application/renewal includes a statement that the applicant understands their NPA and agrees to abide by it?
At my program back in the dark ages we were given a copy of the NPA (for the state the school was located in) for both LPNs and RNs during first term. It was on the required materials list for every term after that, it was discussed in class and we were actually tested on the contents.
I hold licenses in multiple states, I read and understood the LPN and RN NPA before I even applied for a license. I've gone so far as to write the BoN when I didn't clearly understand something.

My school taught about our scope of practice as an LPN but not indepth. That's because our BON Scope of Practice document is so vague. Our instructors advised us that if we had a question that wasn't answered in the document from the BON, the best place to get the answer is from the BON directly. There are no real specifics on what you can and can't do, with the exception of a few things.

I have never seen anything on my original application or renewal that I signed that said I understand the NPA and agree to abide by it.

The procedure we needed to follow in order to register for the NCLEX with PearsonVue was spelled out over and over and over. And yet people still had no clue, claimed no one ever told them etc. We were told from day one that the NCLEX fee was $--.00, that you needed to have this, that and the other once you got to the testing facility. Again, this was something that was told to us over and over. If you're short on money, start saving now for the $---.00 fees that are involved with being able to take the NCLEX. Ohh, you should have heard our class yelling and complaing about the fees the day we were filling out our paperwork..NO ONE TOLD ME I needed $--.00! I don't have that kind of money! A passport sized picture?? Where? How? Why didn't anyone tell me?! (these same people are the ones who expected and demanded to be spoon fed everything.

I've noticed during my years of school thata lot of information is given that is important in our classes (NCLEX info, info on upcoming test content, etc) but 1/3 of the class pays attention, takes notes and asks questions, the other 1/3 isn't paying attention but screams and freaks when the time comes and they realize they have NO idea whats going on, the other 1/3 doesn't care.

Twinmom06, ASN, APN · Feb 27, 2012

I'm in my 2nd semester and so far we haven't touched on it...just that there is an NPA that outlines what we can and can't do but not what is in it...

100kids, BSN, RN · Feb 27, 2012

When I went to college studying Nursing we did touch on Scope of Practice but we were not taught it in depth or tested on it most probably because most of us were not going to become Nurses in the State we went to college. I would expect in a local Nursing setting that this would be covered more in depth but we were told to make sure we understood what the scope was in the state we would be applying for licensure and practicing.

hiddencatRN, BSN, RN · Feb 27, 2012

Sorta. My school's feeling on that was that since not all of us would end up working in the state the school was in, and since things were different from state to state, ultimately it was our responsibility to research and discover what was within our scope of practice. We talked about the concept, but not a ton of specifics other than pretty general, across the board stuff.

Same with the NCLEX issues- we were responsible for researching the requirements and procedure for whichever state we were applying for initial licensure in and getting the appropriate paperwork to the school for the education verification.

dudette10, MSN, RN · Feb 27, 2012

Do I have to take the NCLEX again to move my license in StateA to StateB?
My license expires on my birthday, what does that mean?
How do I renew my license?
Is this stuff no longer covered?

For these three particular questions, no, it wasn't, and I don't think it has to be covered. We can find the answers for ourselves, as arduous as it may be.

As for the NPA, some things just aren't stated clearly in it. License renewal is mentioned in the NPA for my state, but the exact process isn't included in it. The number of CEUs for renewal is included, but it conveniently leaves out that first renewals do not require any CEUS. I

In general, I feel that writing to the BON for clarification would take weeks to months to obtain a clear answer. Government isn't known for its expediency or efficiency. Many of my classmates told me they couldn't even get through to the licensing department after graduation; they got the old fashioned busy signal during business hours or no answer at all off hours.

I think you are ignoring the idea that finding answers to some of these things can be frustrating, even for the most industrious of people.

MyMystudentRN · Feb 27, 2012

i graduated feb 2011 my school ALWAYS let us know what was in our scope of practice whenever a student asked if they are allowed to do something. They reminded us every clinical and gave us a packet with what was in an VN scope of practice compared to an RN