Each state is responsible for creating legislation regarding laws related to the practice of nursing. These laws are defined as the Nurse Practice Act (NPA). Each state's Board of Nursing (BON) is charged with further clarifying and defining the NPA so nurses know their role and how to practice in the state(s) in which they practice. The scope of practice is a dynamic set of regulations within the NPA.

The purpose of the Nurse Practice Act legislation is to:

  • Ensure the public is protected from unprincipled, incompetent and immoral practitioners
  • Offer reassurance to the public that the licensed nurse is competent to provide care in a safe and prudent manner
  • Provide standards and a means to discipline should the licensed nurse violate the standards

RELATED: RN Scope of Practice

The nursing scope of practice describes the services that a qualified nurse is permitted to perform and has been determined as competent in that area. For example, Florida's BON defines the practice of professional nursing as the "Performance of those acts requiring substantial specialized knowledge, judgment and nursing skill based on applied principles of psychological, biological, physical and social sciences."

The scope of employment for a nurse is set by individual organizations and can be described in a job description or policy and procedure manual. Details of a nurse's role and responsibility can also be documented in a Collective Bargaining Unit (CBU), also referred to as a "union" contract. A scope of employment cannot reach beyond the boundaries of the state's scope of practice regulations in the Nurse Practice Act.

RELATED: How is the Scope of Practice Determined for a Nurse?

For example, an employer cannot add to a policy and procedure document that a nurse will intubate a patient in the emergency room IF the NPA of that state prohibits nurses from intubating patients. Conversely, the scope of employment can be more restrictive than the scope of practice. This could occur if an organization chooses to not allow a nurse to place an intraosseous catheter in spite of the fact that the NPA does allow for such placement in the scope of practice laws.

To clarify the nursing role for procedures or tasks assigned to the nurse, the National Council of State Boards, who oversees the Boards of Nursing, published the Scope of Practice Decision-Making Framework tool that nurses can utilize to determine nursing practice responsibilities.

RELATED: Assignment, Delegation and Supervision: NCLEX-RN

The practice of nursing requires knowledge, skill and autonomous decision-making skills. That said, there will be areas within the role of the nurse that require more clarity to ensure the nurse is working within their scope of practice as well as their scope of employment. Nurses are expected to know the Nurse Practice Act for the state in which they practice. Nurses must also be aware of their written job description, CBU contract (as applicable) and policies/procedures to ensure they are working within their full scope.

What is Meaningful Use?Technology is an essential part of healthcare. One of the most significant advanced in healthcare is the use of electronic…

RN to Medical Doctor (MD)The field of nursing can be used as a stepping stone to the next level of the care delivery model.…

What is Integrative Healthcare?Integrative healthcare is a trending term that has been used in the medical setting for the past two decades. Also…

What Advanced Certifications Are Available for Nurses?Nurses are lucky. Because there are so many facets of healthcare and a variety of care specialties, nurses have a…

What Should a Nurse Do If They Suspect a Patient Is a Victim of Abuse?Being on the front lines of healthcare, nurses have unfortunately needed to report cases of abuse and neglect. As mandated,…

What Happens If a Nurse Gets a Needlestick or Other Type of Exposure?Sustaining a needlestick injury or other type of exposure is scary. According to the CDC, there is an average of…

What Are Some Ways Nurses Can Influence Healthcare Organization Costs?Nurses are not just limited to the tasks of bedside care. Many nurses are creative and come up with innovative…

Hospital Nursing vs Clinical NursingDepending on the setting, hospital nursing and clinic nursing can be very different. One of the most significant differences is…

What is the Difference Between a Scope of Practice and a Scope of Employment?Each state is responsible for creating legislation regarding laws related to the practice of nursing. These laws are defined as…