Is This Function Within My Scope of Nursing Practice?

Carolyn Buppert, MSN, JD

Disclosures

July 20, 2017

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Question

Is This Within My Scope of Practice?

The following question was submitted by a registered nurse (RN):

When I triage patients and give advice based on our department policy/standard protocols, like recommending over-the-counter medications and antibiotic ointments, am I practicing within my scope of practice? How about when we follow the Centers for Disease Control and Prevention's schedule for vaccinating adult patients, even though the physician has not physically examined the patient? Is this a safe thing to do?

Response from Carolyn Buppert, MSN, JD
Healthcare attorney

Anything that you do that is not within the scope of practice for an RN needs to be supported by one of the following:

  • An order from a clinician authorized to order treatments and therapies;

  • A document in which a physician or, in some states, an advanced practice nurse or physician assistant delegates to you the authority to perform a medical act, usually within specified circumstances;

  • A protocol developed within the organization or adopted from an outside organization and signed by a clinic administrator, a physician, or other clinician authorized to delegate, and usually by you as well.

Some states allow facilities and clinics to have protocols (or in California, standardized procedures) that allow RNs to perform medical acts under specific circumstances. A nurse protocol is a written document mutually agreed upon and signed by a nurse and a licensed physician, in which the physician delegates to that nurse the authority to perform certain medical acts. While some states allow nurse protocols for vaccinations, most states' laws don't address RN triage, and specifically, not the giving of advice about over-the-counter medications.

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