The Nursing Scope of Practice Explained

nurse feeling unsure about her scope of practice — It's important to be clear on your scope of practice as a nurse

Learning about common nursing terms like “nursing scope of practice” can sometimes be confusing and even tedious. However, understanding tasks, functions, and responsibilities is necessary to feel competent as a healthcare provider.

This includes being familiar with the ins and the outs of the scope and function of a nurse.

The American Nurses Association (ANA) defines the scope of nursing practice as the “who,” “what,” “when,” “where,” and “why” of nursing practice.

To break it down, think of the nursing scope of practice as a roadmap that defines how nursing responsibilities should be executed according to a registered nurse’s license.

Are you still feeling slightly lost, or dare we say—yawn—bored?

That’s okay. Learning about nursing's scope of practice may feel repetitive and monotonous at times. So, grab a strong coffee or hot cup of tea and carve out a few minutes to yourself.

Here’s a quick and interesting overview of standards of practice in nursing.

The Who, What, When, Where, and Why of Nursing Practice

“The ANA provides building blocks so clear,

That it’s easy to understand the who, what, when, and where,

Of nursing practice that can sometimes feel so square,

Here’s a list of the roles that certain nurses play,

That can help them be better nurses every day.” —by Miranda Kay, RN

Are you still with us?

Great–that was the idea. Now, onto the serious stuff.

Answering the following questions can help a healthcare professional understand what is the scope and function of a nurse.

Who?

The “who” of nursing scope of practice refers to registered nurses (RNs) and advanced practice registered nurses (APRNs) who have finished their studies at an accredited nursing school.

They must have met state requirements to engage in clinical practice and have an active license to work with patients.

What?

The “what” of nursing scope of practice refers to how nurses must accept, protect, implement, and promote the best nursing practices. This will lead to the best possible health outcomes for their patients.

Where?

The “where” of the scope of practice in nursing refers to wherever a patient is in need of care, a nurse will be there. (There we go rhyming again.)

When

The “when” of nursing scope of practice means when there is a need for nursing knowledge, compassion, and expertise.

Why

The “why” of nursing scope of practice refers to the main objective of the nursing profession, which is to achieve the most positive patient outcomes.

Now that this idea is clearer, how do nurses implement this in real-life clinical situations?

We are glad you asked; let’s move on.

How do nurses deliver high-quality care?

Nurses are the backbone of the healthcare system. Many even call them superheroes. While they don’t wear a cape, nurses put on their scrubs every day and tend to patients, delivering high-quality care.

But with this comes standards—we’re back to the serious stuff again.

All nurses are responsible for providing accurate, ethical, and quality nursing care.

The American Nurses Association also created standards that govern nurses’ professional practice when carrying out their duties.

ANA Standards of Practice

The following Standards of Practice should be adhered to when delivering patient care:

Standard 1: Assessment: A nurse assesses a patient to examine their medical history and symptoms thoroughly. This data should be relevant to the patient’s present health situation.
Standard 2: Diagnosis: A nurse will analyze and evaluate a patient’s history and initial assessment and determine, to the best of their abilities, an actual or potential diagnosis.

Standard 3: Outcomes identification: A nurse will identify all possible patient outcomes to individualize a treatment plan for the patient.
Standard 4: Planning: A nurse will develop a treatment plan that will include specific actions and interventions that will achieve the best expected outcome.
Standard 5: Implementation: A nurse will implement the treatment plan and document it on the patient’s electronic health record. This will involve coordination for treatments, and providing a safe environment for healing.
Standard 6: Evaluation: A nurse will continuously evaluate a patient’s progress toward expected outcomes.

The following Standards of Professional Performance are a continuation of the practice standards:

Standard 7: Ethics: Nurses should practice their roles ethically.
Standard 8: Advocacy: A nurse advocates for their patients’ needs.
Standard 9: Respectful and equitable practice: Nurses demonstrate respect to their patients, peers, and other professionals. They provide quality care that is fair and consistent for all their patients.
Standard 10: Communication: Nurses must be effective communicators.
Standard 11: Collaboration: A nurse will collaborate with the patient, the patient’s family, and other healthcare professionals.
Standard 12: Leadership: A nurse within the profession and a clinical setting is a leader
Standard 13: Education: A nurse seeks up-to-date knowledge and competence that is directly reflected in their clinical nursing practice.
Standard 14: Scholarly inquiry: A nurse provides value to the profession with research and scholarly inquiry.
Standard 15: Quality of practice: A nurse contributes daily and consistently to the quality of practice in nursing.

Standard 16: Professional practice evaluation: A nurse will analyze their own professional practice and that of their peers seeking to grow their capabilities.
Standard 17: Resource stewardship: A nurse uses helpful and important resources to provide and plan safe and responsible care services.
Standard 18: Environmental health: Nurses carry out their roles in an environmentally safe way.

If you’ve held on this long, you’re awesome. Educating yourself about nursing terms is like learning a whole new language. If you feel a bit fuzzy, that’s okay too. Get a refill, and let’s forge on.

What is the nursing scope of practice for an LPN, RN, or APRN?

Now that we have highlighted the main–and abstract idea of the scope of practice in nursing—let’s get to the tangible stuff.

How will the scope of practice affect your position as a nurse?

Whether you plan to be an LPN, RN, or APRN, here is a rough overview of what each position’s scope of practice entails:

Licensed practical nurses

LPNs are the busy bees of healthcare, doing everything from observing patients to reporting data about their health status.

Never underestimate the power of an LPN. Their dedication ensures that patients get high-quality and thoughtful care every day.

LPNs typically work under the supervision of a registered nurse and can perform the following duties:

Observe, record, and report data about a patient’s current health status.
Perform clinical procedures like wound dressing changes and urinary catheterizations.
Supervise unlicensed staff members such as certified nursing assistants (CNAs).

Registered nurses

RNs are the first mates of the medical world, helping to navigate the treatments, patients, and colleagues with a steady hand and a moral compass.

RNs have a good amount of autonomy and routinely perform the following duties:

Perform assessments, diagnosis, planning, implementation, and evaluation of patient care.
Administer medications and treatments such as inserting intravenous (IV) catheters and wound dressing changes.
Provide education, counseling, and health promotion to patients and their families.
Document all patient progress and prepare patients for discharge.

Advanced practice registered nurses

APRNs are also like the captains of the healthcare system. They are registered nurses who have earned an advanced educational degree, such as a master’s or doctoral degree.

APRNs typically have the most amount of autonomy and can perform the following duties:

Perform health assessments and order diagnostic tests for patients.
Make clinical diagnoses.
Plan, develop, and implement treatment plans that list specific medications, therapies, and interventions.
Work with patients directly by monitoring patient plans and modifying them if necessary.
Manage a patient’s illness and provide education to patients and families to help them adhere to treatment plans.
Oversee staff, including RNs, LPNs, and CNAs.
Authority to prescribe medication (in some states).

Remember that every state will regulate a nurse’s scope of practice according to their licensure. It’s essential to stay updated on laws and regulations in the state you plan to practice as a nurse.

Why is nursing scope important?

As we said before, nurses are like superheroes. They have a set of powers that make them excellent caregivers. At the same time, nurses need standards that can help define who, what, when, where, and why (how) they can use their powers.

The scope of nursing practice is important because it helps clarify their duties and responsibilities as healthcare providers.

Whew—and just when you thought things were getting less serious. Honestly, we get it. Reviewing these practices can be a bit abstract and hard to comprehend in the beginning.

Once you get a grasp on these standards, however, they will be essential in keeping you ahead in your skill set as a nurse. They will also allow you to provide passionate, ethical, and efficient care to your patients.

Thanks for being the heart of healthcare and for all the hard work you do.

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