Nursing Scope of Practice and Delegation

00:01 So, now, let's talk nursing scope of practice. First of all, what is that? All that means, it's what we are legally allowed to do as a nurse.

00:09 So, just know that this is gonna vary from state to state, so, make sure you keep that in mind.

00:14 Here's a great example about scope of practice.

00:17 A registered nurse or an RN can hang blood products but most states, a licensed practical nurse or LPN cannot.

00:25 So, also consider, we have professional license we are accountable to and know that the activities we can perform are defined under each state law.

00:36 Now, how do we get this license? To obtain it, we have a national exam called the NCLEX.

00:42 Boy, if you're in nursing school, as soon as you hit day one, you're gonna hear about the NCLEX.

00:48 This gives nurses cold sweats, backflashes about the trauma we had, don't worry.

00:54 These videos are there to help you with that but the NCLEX exam is basically what you need to pass to get your professional license.

01:03 So, and again, just know, once you pass your exam and you pass that big NCLEX, it's gonna vary from state to state what you're able to perform.

01:11 So, now, let's look at scope and who can actually prescribe meds.

01:16 So, let's look at the question, who can write a prescription for medication? So, first of all, no, as a registered nurse without a shadow of a doubt, we have no prescriptive authority.

01:30 Sorry guys, we are not to write scripts. That's a big nursing no-no.

01:35 Let me give you an example of this nursing no-no.

01:38 So, as a nursing student, I got to sit on the board of nursing practice.

01:43 So, basically, what that means, we got to view when nurses messed up or did something that was against their nursing practice act.

01:51 Well, we got to watch a case where a nurse basically wrote her own prescriptions with a prescription pad that was not hers.

01:59 Well, you can imagine, she got in a lot of trouble, lots of fines, but just know again, a registered nurse has no prescriptive authority.

02:09 We cannot prescribe meds.

02:11 So, only advanced practice registered nurse or what we call nurse practitioners, them and physicians can prescribe medications.

02:20 So, you may hear APRN, nurse practitioner, it's all the same thing.

02:27 Commonly, we usually call them a nurse practitioner in the healthcare setting and they can allow for medication prescriptions within their state's scope of practice.

02:37 And of course, don't forget about your physicians.

02:40 They definitely have prescriptive authority as long as they have an MD or a DO behind their name.

02:46 So, now, let's talk about delegation.

02:50 So, what's the scope regarding this with us as a registered nurse? So, we define delegation as the process for a nurse to just give another person a task.

03:01 Now, we've gotta make sure that stays within their scope of practice.

03:06 So, let's look at this grid here. Pretty simple, right? But really important.

03:10 So, at the top of this triangle, you see a registered nurse or an RN.

03:14 So, notice it goes out on both ways that we can delegate either to a licensed practical nurse or a nursing assistive personnel.

03:23 So, what's interesting about this triangle is know that RN's are equally both to delegate to both of these and we're responsible for that delegation.

03:33 So, now, let's look at each role of delegation. Let's look at the RN.

03:38 So, we're the only ones that are allowed to evaluate, assess, or teach a patient otherwise known as EAT.

03:46 As you know, nurses love to eat, I love to eat, we often get patient treats or snacks.

03:52 It's a favorite nursing pastime. So, don't forget, EAT when you're talking about delegation with an RN.

03:58 Next, let's look at the LPN or licensed practical nurse.

04:03 Now, here's the difference. They cannot admit or discharge the patient.

04:08 They can only care for patients that are stable such as we say the patient can monitor, the LPN can monitor a patient and they cannot do any initial treatment.

04:18 So, here's an example of that.

04:20 Let's say a patient transfers from the emergency room to your unit on the med-surg unit.

04:26 So, as the RN, if a patient is assigned to this LPN, I am the one to have to actually admit the patient and do the initial assessment and initial teaching.

04:36 And next off, we have the nursing assistive personnel.

04:40 So, they can be delegated standardized procedures within their certification but again, no initial assessments.

04:47 What this is probably gonna look like is like I said, a vital signs or maybe a blood glucose.