Your State's Nurse Practice Act

When your license arrives, it will probably be accompanied by a copy of your state's Nurse Practice Act (NPA). If not, you can obtain a copy from your state board of nursing. You can find this information online either from the National Council of State Boards of Nursing (www.ncsbn.org), or by an Internet search for your state board of nursing. If you have not yet taken your NCLEX or received your license, be sure to obtain a copy of your state's Nurse Practice Act. Some states offer a downloadable copy from their Web site that you can print for reference.

The Nurse Practice Act (NPA) is the group of laws set by each state to protect the public. It defines the scope of practice for nurses in that state. The NPA includes the requirements for education and licensing of the nurse. It also includes disciplinary and punitive measures for unsafe practice.

It is the responsibility of each licensed nurse to read and to know the contents of his own nurse practice act. The NPA will be different for R.N.s, LPNs, and APRNs (advance practice R.N.s). You will be held accountable for this information. If you make a mistake, your defense cannot include “I didn't know that I couldn't do that.” As a licensed nurse, you are expected to know. Read the NPA and understand it. If you have questions, ask. Your board of nurses is there to answer your questions and to help you to understand your scope of practice.

In general, your NPA will describe what you are allowed to do based on your education and license. Most have some sort of scope of practice algorithm or decision tree built in that follows a common sense approach. Some of the questions involved in this process may include:

  • Is the act or procedure allowed by the NPA?

  • Have you received the necessary training? Do you have the knowledge required?

  • Are you competent to perform the procedure or act?

  • Is the act or procedure considered to be an acceptable Standard of Care for a nurse to perform?

  • Do you have a valid order from a licensed physician to perform this act or procedure?

  • If any of these questions can be answered “no,” then it is not within your scope of practice to perform this act or procedure.

    Nurse Practice Acts change. As technology changes, the act is periodically updated to reflect these changes. As health care is legislated, your NPA may change. What you need to understand is that you may find that you are suddenly allowed to do something that you have not been trained to do. That does not mean that you can perform it. Nurses are required to continue their education. If your position requires you to perform new duties as the technology changes, be sure you keep yourself up-to-date with education, in-services, and certifications. And ask for a preceptor when learning new procedures.

    How will you know what is new with your NPA? Nurses need to stay informed. If you haven't read your NPA recently, get a new copy. Subscribe to journals. Join your state nurses association or at least subscribe to their e-mail alerts and be included on their mailing list. Read your local newspaper. Be informed of health care issues and how local and national legislation affects patient care as well as the nursing profession. Become an advocate. Write to your legislators. Vote and when you vote, be an informed voter.

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