scope of practice and delegated tasks to RN's

classicdame, MSN, EdD · Dec 16, 2010

"comfortable with" means the nurse must know your own scope of practice and know when an order is outside that scope. The foremost thing is to protect the patient. So if an MD orders you to give a med or do a therapy that you believe is not in the best interest of the patient you need to question it, or refuse. Better to lose a job than a license. I think it would be good to have a conference with the business manager and the MD (or all of them) and determine what is and is not within your scope of practice. The Texas Nurses Asso. prints an annotated version of the NPA to show how rules have been interpreted in the past (and put it in lay language). Perhaps your state association, if any, does the same??

RN_MishMish · Dec 17, 2010

Dear classicdame! Thanks for your response. The nursing scope of practice in my state is determined by weather the nurse has been trained to perform the task which has to be a "reasonable and prudent" task to the standard of nursing. The tasks in question are straight forward document review for the purpose of triaging not treating or diagnosing (for example-a pathology report finding - does the patient need to follow up with the doc and within how long), so there is no hands-on or putting a patient at risk. Any finding that is not in the facility's written protocol is discussed directly with the provider. Also, do you know if any type of a nurse signature on verbal or telephone order (on rx refill for example) must be co-signed by the MD? I have discussed the issue with MD and was told co-signing all V.O's defetes the purpose of delegating in the first place when there is a protocol with standing orders. kind-of, sort-of makes sense from the physician's stand point, my problem is I am having difficulty coming up with accurate answers which cover the nursing stand point :confused: Thanks again and have a pleasant evening!