How do I ensure I’m within my scope of practice?

It is well-known that nurses are committed to safe and ethical practice – one of the reasons nurses are listed as the top-rated trusted profession for the past 20 years! One key part of safe and effective care, as well as protecting yourself as a health care professional, is ensuring that what you do aligns with your scope of practice. As psychiatric-mental health nurses, you have a duty to advocate for your patients, making sure that they receive care from appropriate providers who are practicing within their scope.

One key part of safe and effective care, as well as protecting yourself as a health care professional, is ensuring that what you do aligns with your scope of practice.

It is every individual nurse’s responsibility to ensure they practice within the bounds of their education, training, and expertise. Luckily, there are many resources available to help you in exercising that judgment. Sometimes nurses outside of PMH are asked to provide mental health care that is beyond their scope of practice. They can also use these tools to ensure that they are not being asked to provide care outside of their scope

Here is a roundup of several resources that you and nursing colleagues may find helpful:

Scope of Practice Resources

Psychiatric-Mental Health Nursing: Scope and Standards of Practice, 3rd Edition (FREE ebook for APNA members)

• This is the foundational resource that sets the scope of practice and standards for the entire profession.
• The scope statement defines the who, what, when, where, and why of PMH nursing, while the standards describe the how.

Your State’s Nurse Practice Act 

• Safe and competent nursing practice is based in the law. Your state Nurse Practice Act (NPA) and state rules regulate the practice of nursing in your state.
• This tool from the National Council of State Boards of Nursing lets you select your state or territory and takes you to your NPA. Pick your jurisdiction from the drop-down to see its nurse practice act and rules.

NCSBN Scope of Practice Decision-Making Framework

• This framework for decision-making is for all licensed nurses, no matter their education, role, function, and accountability within the scope of the practice of nursing. Four nursing organizations worked together on this tool: the American Association of Colleges of Nursing (AACN), the American Nurses Association (ANA), the American Organization of Nurse Executives (AONE), and the National League for Nursing (NLN), in collaboration with the National Council of State Boards of Nursing (NCSBN).
• To use the tool, identify the activity, role, or intervention, then follow the flow chart until you reach a decision.

When and How to Refuse a Nursing Assignment

• This article from Nursing Services Organization helps nurses understand the process of when it may be appropriate to refuse an assignment when confronted with an unfamiliar area or procedure or task beyond your scope of nursing practice.

For APRNs: APRN Consensus Model (pg. 9-12)

Understanding the additional licensure, accreditation, certification, and education of an APRN is important to the scope of practice. The PMH-APRN scope of practice is distinct and different from other health care providers who specialize in psychiatric-mental health and it is distinct and different from other APRN roles.

• In the APRN Regulatory Model, advanced practice registered nurses (APRN) are educated in one of 4 roles and in at least 1 of 6 population foci. PMH is a population focus in the APRN model, not a specialty, which means that PMH-APRN education and certification meet national accreditation standards and that PMH-APRN competence is assessed and regulated by boards of nursing.
• APRNs may specialize but they cannot be licensed solely within a specialty area.

 

About APNA: The American Psychiatric Nurses Association is a national professional membership organization committed to the practice of psychiatric-mental health nursing and wellness promotion, prevention of mental health problems, and the care and treatment of persons with psychiatric disorders. APNA’s membership is inclusive of all psychiatric-mental health registered nurses including associate degree, baccalaureate, advanced practice (comprised of clinical nurse specialists and psychiatric nurse practitioners), and nurse scientists and academicians (PhD). APNA serves as a resource for psychiatric-mental health nurses to engage in networking, education, and the dissemination of evidence. The American Psychiatric Nurses Association is accredited as a provider of continuing nursing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.