The scope of nursing practice refers to the range of roles, functions, responsibilities, and activities which a registered nurse is educated, competent, and authorized to perform. The specific details of what encompasses a nurse's scope of practice can vary significantly depending on several factors, with one of the most crucial being the state in which they practice.
In the United States, the regulations and laws governing nursing practice are established at the state level. Each state has its own board of nursing which sets the standards for nursing practice within that state. These standards are designed to ensure that safe and competent care is delivered to patients and can include specific rules regarding procedures, treatments, and the level of supervision required.
For example, the authority for a nurse to prescribe medications can differ markedly from one state to another. Some states allow Advanced Practice Registered Nurses (APRNs) full practice authority, which means they can evaluate patients; diagnose, order, and interpret diagnostic tests; initiate and manage treatments; and prescribe medications under the exclusive licensure authority of the state board of nursing. In contrast, other states may require APRNs to have a collaborative agreement with a physician, limiting their ability to prescribe or perform other tasks independently.
Furthermore, the scope of nursing practice can also be influenced by other factors such as the policies of individual healthcare institutions and the nurse's level of education and certifications. However, the fundamental and most significant determinant remains the state regulations. Therefore, a nurse must be well informed about the specific laws and guidelines in their state of practice to ensure compliance and provide the best care possible.