...The professional nurse's scope of practice is defined and outlined by the State Board of Nursing that governs practice” (Nettina, 2013, p.16). In order to practice nursing in the State of Texas, registered nurses (RNs) “must know the scope of practice as defined by Texas law so that they may meet minimum acceptable levels of practice” (Murphy, 1995, p. 37). The nurse’s duty is to assure the safety of his/her patient. The Board of Nursing (BON) developed at six-step decision making flowchart to assist nurses to determine whither a particular action is within their scope of practice. The questions include: 1. Is the act consistent with the Texas Nursing Practice Act (NPA)? Do the Board’s rules or positions statements address this specific act? 2....
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...primary caregivers who provided nursing services, which formed the basis of modern nursing. The passage of time witnessed the evolution the nursing profession where the scope of nursing expanded with the advancement in technology and the changes in the healthcare and politics. Earlier, nurses were prohibited from using thermometers and interpreting results (Sandelowski, 2000), taking blood pressure reading and interpreting readings (Mee, 2006; Sandelowski, 2000), carry out measurements of the pulmonary artery wedge Mee, 2006), removal of peripheral arterial sheaths (Capasso, Codner, Nuzzo-Meuller, Cox, &Bouvier, 2006), or take chest x-rays after peripherally inserting central catheters (Davidson, Bloomberg, &Burnell, 2007; Royer&Earhart, 2007). All the former activities are considered to be within the scope of modern nursing. As is the norm with any other practice changes, evidence has to support the adoption. However, evidence cannot be only component for an evidence-based practice model (LoBiondo-Wood&Haber, 2010). Nurses have to take into consideration the Health Professions Act (HPA) (CRNBC, 2005), the rules and regulations of provincial board of nursing, organizational procedures and policies, and standards that are recommended by professional organizations. These recommendations are offered with respect to clinical competence, educational preparation, patient preferences, and practice setting and environment. The scope of practice is not only responsive and...
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...handbook on your job. These actions are usually within the scope of the “nurse practice act” and “board of nursing”. Most questions are focused on safety. Safety depends on the nurse’s knowledge, training, and skills. A nurse has a duty of obligation to her patients and to herself. She has to protect her license and integrity as a nurse and deliver competent and knowledgeable services to her clients. One rule of the RN is to delegate duties to other registered nurses and licensed practical nurses and nursing assistants. Many times the nurse questions if the assignment is within the scope of practice, especially delegating activities to the nursing assistant. (Kathleen R. Weinberg, n.d.) According to (DL, 1994), the purpose of nursing center influenced the scope of practice in nursing in different areas. These areas are, how nursing affects the faculty, the community, or specialty in nursing practice. The nurse managed center “requires high quality nursing services, public and community support, healthy relationships with other health care providers, and documentation of patient’s outcome through the nursing managed center based on nursing research”. (DL, 1994) The American nursing association describes how nurses should think when deciding what factors are within the scope of practice. Questions to be asked are “who”, “where”, “why”, “what” and “how” of nursing. The guidelines are embodied in the nurse practice acts, rules and regulations, guidelines of the state and in...
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...identified actions are within the domain of nursing practice? One’s scope of practice is ever evolving as experience is gained working in an area of expertise. The American Nurses Associate gives a simple description when thinking about determining scope of practice it is the “who," "what," "where," "when," "why," and "how" of nursing practice. Consideration must be given to the guidelines of the Nurse Practice Act, rules/regulations/guidelines of the state in which the nurse is working, the policy and procedures of the facility in which the nurse is working, community standards of professional organizations, the nurses own educational preparation and clinical experience. Texas Board of Nursing has an algorithm to assist nurses in making a determination of an activity falls in the general scope of practice called the Six-Step Decision-Making Model for Determining Nursing Scope of Practice (TBON, 2010). Six-Step Decision-Making Model for Determining Nursing Scope of Practice 1. Is the activity consistent with the Nursing Practice Act (NPA), Board Rules, and Board Position Statements and/or Guidelines? Yes → Continue No → STOP 2. Is the activity appropriately authorized by valid order/protocol and in accordance with established policies and procedures? Yes → Continue No → STOP 3. Is the act supported by either research reported in nursing and health-related literature or in scope of practice statements by national nursing organizations? Yes → Continue No → STOP 4...
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...Nursing Practice Act Rules Cindy Hersey Fortis College November 05, 2013 A professional nurse who lacks the knowledge, ability to understand, and competence to delegate care appropriately not only Puts the patient at risk for injury, but also puts his or hers license in jeopardy. The practice of nursing requires specialized Knowledge, skill, and independent decision making. The purpose of delegation was put into perspective when Corazzini et al. (2010) said delegation by RNs is a primary mechanism for ensuring that professional nursing standards of care reach the Bedside. RNs must be made aware of which nursing tasks can be delegated and which cannot. Most importantly , they must know that basic delegation skills will be expected in their first nursing job (Huston, 2008). Nursing Practice Acts are set up in each state to protect individuals who are being taken care of by nurses from unprofessional or unsafe nursing practices. Although the Nursing Practice Acts vary from state to state they all include information on the board of nursing, education standards, requirements for titles and licenses and grounds for disciplinary action. Also included are the standards and scope of nursing practice, these are the sections that will be focused on here (Nurse Practice Act Rules and Regulations, 2013). In the nursing field delegation is the process of transferring a selected task to another individual who is competent to perform the selected task. It is very...
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...Nursing practice is an act of providing care to the patients. In providing care to the patients, the nurses implement a nursing care plan which is based on initial condition of the patient. It is based on a specific nursing theory. Following nursing theory and nursing research side by side is a must for patient care and nursing practice. Nurse Practice Act ascertains the protection of the public from harm. The Nursing Practice Act (NPA) sets out the scope of practice and responsibilities for RNs and formulates the rules ands regulations which specify the implementation of the law. Certain Formal training is required for licensure which is checked by the Nursing practice act. Each state board of nursing in the U.S. develops different NPA for that state. The scope of nursing practice includes the sets of duty that a nurse needs to perform in her job which can vary from place to place and state to state. It is necessary for travel nurses to learn the nurses' scope to perform their work properly. Familiarization with NPA and nursing scope is necessary to perform the work properly. It is necessary for the nurses to familiarize with the new changes in NPA and scope within their state. Just acquiring degree or medical qualifications is not enough for the nurses to perform their job. Also, experience or observation in the course of your job is a must. In addition to your NPA you also need to be familiar with your present job description and the rules of your facility. There...
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...becomes familiar with the role of nurses. How do the media positively or negatively influence the public’s image of nursing? What other avenues may better educate the general public on the role and scope of nursing as well as the changing health care system? The media is known to have immense influences on the public perception from body images to what kind of car people should buy. And the nursing image is not immune to these influences. What Hollywood transmits to the public about nurse’s works much like an advertising industry. Television has represented nurses in varying degrees and not all of them are flattering. We have been portrayed as handmaidens, angels to naughty nurses, crusty battle-axes, incompetent nurses, or drug addicted nurses. Television shows such as House, Nurse Jackie, Hawthorne, Gray’s Anatomy, and Scrubs frequently draw on nursing stereotypes that have the potential to damage the professional nursing image. Just as people are influenced by commercial or political ads, they will be influenced by these shows as well. These images of nursing on medical shows can affect roles in recruitment and retention for the profession. In a survey of student perceptions of nursing image on television, one student noted, “the public could be influenced by nursing on television and draw attention to the consequences of negative depictions of nursing because the public can develop a false view of the profession, where people may believe nurses are simply the doctor’s...
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...The Nursing Practice Act (NPA) is the body of California law that mandates the Board to set out the scope of practice and responsibilities for RNs. The Practice Act is located in the California Business and Professions Code starting with Section 2700. Regulations that specify the implementation of the law appear in the California Code of Regulations ("Board Of Nursing", n.d.). What is the NPA? How does it affect nurses? What are the requirements for getting a nursing license from the Board of Nursing? All of these are important questions for someone to ponder when considering joining the nursing profession. Let us explore the ins and outs of becoming and being and registered nurse in California. Nurse Practice Act Samantha Kelly NSG/320 November 21, 2011 Jen Millar University of Phoenix Nurse Practice Act The Nursing Practice Act (NPA) is the body of California law that mandates the Board to set out the scope of practice and responsibilities for RNs. The Practice Act is located in the California Business and Professions Code starting with Section 2700. Regulations that specify the implementation of the law appear in the California Code of Regulations ("Board Of Nursing", n.d.). What is the NPA? How does it affect nurses? What are the requirements for getting a nursing license from the Board of Nursing? All of these are important questions for someone to ponder when considering joining the nursing profession...
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...considered when determining the actions of nursing practice. These five domains are clinical skills and knowledge, therapeutic relationships, professional relationships, professional development and the advancing practice through innovation and research (UMHS). As nurses it is our responsibility to know our scope of practice in our home state and any state we practice in. Also, we must continue to educate ourselves in our profession as health care continues to change and stay current with the professional development framework of nursing. As an agency nurse and working in different states it is emperative to know the scope of practice. Even though hospitals have their own policy and procedures, it is always best to refer to scope of nursing practice for that state. I have found in my travels that more times than not, I was asked or told it was okay to perform a practice outside of my scope. Employers as well are responsible for providing nursing with policy and procedures, orientating nursing adequately to ensure the nurse understands her role and responsibilities and given the resources to maintain the ability to provide safe patient care. (CRNM). It is the framework of the domains that guides nurses to keep on the path of continuum care and also up to date on technology and education. Ultimately, it is the responsibility of the nurse to determine what is within the nursing practice based on the scope of practice, standard of practice, nurse practice acts, legal regulations an policy...
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...Case Study 3: The Scope of Practice Decision Making Framework Case Study 2 An enrolled nurse was delegated the task of removing a patient’s wound drain. Although educationally prepared , the enrolled nurse had not performed the procedure before but was prepared to undertake the procedure. Choose one of the scenarios above and use the Scope of Practice Decision Making Flowchat, evaluate each step to determine if the action take was appropriate 1. Identified client need/benefit 2. Regulated nursing practice 3. Accepted nursing or midwifery practice 4. Organisational support 5. Within the scope of practice 6. Appropriate to proceed Answer In Healthcare environment where change is a constant feature, nurses are expected to be flexible and to respond to change in ways that benefit health consumers. When making decisions nurses need to consider that individual have differences in the education , experience and competnece and their respective profession’s scope of practice. According to Nursing practice decisions summary guide by Nursing and Midwifery Board of Asutralia first the nurse need to identify client need /benefit and nurse need to reflect on scope of practice and nursing practice standards before making decision and nurse need to consider context of practice/ organisational support and last not the least nurse need to select appropriate and competent person to perform the activity. In this case study the enrolled nurse was educationally prepared but...
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...you would apply to determine whether the procedure falls within the RN scope of practice and how you would go about introducing the new procedure with physicians and fellow nurses. The Registered Nurse scope of practice is determined by specialty and level at which you are practicing. Therefore, the initial step to take in investigating the new procedure that will be introduced is to be aware of the scope of practice of the stakeholders as well as the policy and procedures of the facility. This is done to ensure that the new policy falls within the scope of practice and is in compliance with the policies and procedure of the facility. The scope of practice defines the who, what, where, when, why and how of nursing practice (rn.com). Following the verification regarding scope of practice I would take the following steps: * Meet with hospital administration to brief them on the physician’s request and give them a time line in which I plan to present to them my findings on the procedure. * Follow up with the the state board to ensure that this is within the nursing process of: : • Assessment—gathering and validating client health data, strengths, risks, and concerns • Diagnosis—analyzing and processing client data to identify appropriate nursing diagnoses∗ • Planning—developing interventions to solve identified problems and build on client strengths • Implementation—delivering nursing interventions and documenting the planned care • Evaluation—determining...
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...whether or not actions are the domain of nursing practice. The Board of Registered Nurse, California define the term “scope of practice” is the actions and procedure, that are permitted by law for a specific profession. It outlines restrictions to what the law permits, based on specific experience and educational qualifications. It is important for each nurse to consider certain factors when considering whether or not actions are within their scope of practice. Nurse’s ability and within education to perform the action safely and effectively, if he or she is not trained enough to do then that is beyond the nurse’s individual scope of practice. We as a nurse, we must weigh all our options and remember not to do anything that is restricted by law. We must be cautioned not to confuse nursing policies and procedures with standardized procedures. (Lobbe. J. et al, 2014) Each of the licensed professions has its own legally defined scope of practice for nurses, as stated by the Board of Nursing in each state. According to California Board of Registered Nursing, The practice of nursing means those functions, including basic health care, which help people cope with difficulties in daily living which are associated with their actual or potential health or illness problems, or the treatment which require a substantial amount of scientific knowledge or technical skill. We as a registered nurses, we must recognize the application of nursing process. As a Registered Nurse in California...
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...Master Family Nurse Practitioner Name University Course Tutor Date Clinical competence requires a well defined professional scope of operation. In this aspect or line nursing education provides nurses with profession guidelines on how to handle many clinical issues and help provide quality service the society. In this definition it is important to have the details of each and every role to be played by people or members of the nursing profession. All these roles which pass wealth of skills and experience to the nurses is found in the basic nursing education. Professional scope of practice in the nursing profession is always detailed in documents which address roles, function, population to be served and the practice setting. Based on the guidelines provided by nursing education, the nursing have great roles which are considered very sensitive to the community (American Nurses Association, 2010). Clinical advanced specialist is the one who deals with patients directly by treating them. The non-clinical advanced specialists are specialists whose roles do not include the taking care of the patients directly. They have different expertise in health care areas and they provide the consultancy services. They offer problem solving skills and their opinions are mainly in demand. They usually have high levels of degree in medical services and several years of experience. The nurse practitioner is the one who is mandated to provide an extensive health care service...
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...Nurses The profession of nursing has a long history dating back to the ancient days. Formal education of nursing, using Florence Nightingale’s model, began in the United States after the Civil War. (Scope of Practice and Differentiated Practice Competencies) Nursing education took place in the hospital setting that used nursing students to care for patients. The students mainly learned the skills necessary to care for patients, but were deficient in curriculum learning. Later, some hospital nursing programs began a curriculum based program that issued students diplomas upon completion of the program. (Scope of Practice and Differentiated Practice Competencies) Nursing education began moving into the university settings in 1909 with the University of Minnesota opening a bachelor degree program. (Friberg, 2011 p.25) Many other universities began offering bachelor degree programs in nursing. However, hospital based programs were still the popular choice. After World War II, a nursing shortage began in the United States. Dr. Mildred Montag suggested training of registered nurses in the community college setting, which the graduating nurse would receive an associate’s degree. The program was intended to prepare nurses in a shorter amount of time to cover the growing need for nurses. At the time, this training was only supposed to be temporary. (Scope of Practice and Differentiated Practice Competencies) The associate’s degree nursing program became very popular...
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...what the state we are working in has established as a scope of practice of a register nurse. We are advocates of the patient and his family, and we are to promote patient safety by practicing within the national practice act and the board of nursing rules and regulations. The scope of practice for the register nurse utilizes the nursing process to establish the plan of care for the patient. The nursing process includes assessment, planning, implementation, evaluation and reassessment, communication, clinical reasoning, and employment setting. In practice we need to remember that we only practice what we are trained and educated to do. You cannot expect a floor nurse to function in an ICU or an Emergency room nurse to work on a medical floor and be able to function fully in the scope of practice for that unit. We need to know our level of competency and practice within that scope of practice that is set up by the unit and the hospital based on the state board of nursing scope of practice and the national practice act. If you are hired as a register nurse then you must practice as a register nurse even if you or an EMT, or a nurse practitioner. If you are on the floor and you are an ICU trained nurse your scope of practice has changed because of unit policies, what you can do in the ICU may not be acceptable on the floor and vice versa. No matter where we practice we need to know the scope of practice for each area we work in so that we can ensure safe,...
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