If you’re a nursing professional, you undoubtedly understand the differences between a registered nurse (RN) and a nurse practitioner (NP). What’s less frequently discussed is how licensing fundamentally shapes and limits the scope of practice, and how that interplay can be critical when facing a nursing board complaint or disciplinary action.
A misunderstanding of your scope of practice can place you in a nursing license defense scenario. Here’s what you need to know to protect your license and your right to work in the medical field.
What is the Scope of Practice for Nurses?
The scope of practice describes the services a qualified health professional is permitted to provide under the terms of their professional license. In nursing, this means that the state’s nurse practice act and board of nursing set the boundaries for what an RN can do, as well as what an NP (or APRN) can do.
Your license is your legal authority to practice. Any nursing license defense situation is therefore directly linked to your scope of practice. When you know your scope and stay within it, it becomes much easier to protect yourself from liability.
The Main Differences Between Registered Nurses vs. Nurse Practitioners
The RN licensing process involves completing an accredited nursing program and passing the National Council Licensure Examination (NCLEX). RN license recipients must also meet state board requirements.
A registered nurse’s scope of practice typically involves the assessment, planning, implementation, and evaluation of nursing care. Patient teaching and coordination of care also fall within their scope. The RN license doesn’t include prescriptive authority or the ability to diagnose. RNs can’t practice independently, either.
A nurse practitioner/advanced practice registered nurse license requires a master’s or doctoral degree. Nursing professionals must also undergo advanced clinical training and obtain the appropriate national and state licensure to work in these roles.
The NP or APRN scope often includes:
- Diagnosing illnesses
- Ordering/interpreting diagnostic tests
- Prescribing medications
- Managing patient care
Some states grant nurse practitioners full practice authority, meaning they can practice independently. Others require NPs to be supervised by a physician.
How Licensing Defines the Boundaries of Practice for Health Care Professionals
Licensing is the legal instrument that enforces the scope of practice. When you obtain your license, the issuing board will define the rights, responsibilities, and restrictions that you must operate under. If you cross those boundaries, your license is at risk.
Regardless of the nature of a nursing license defense scenario, one of the first steps is typically to determine whether the license holder remained within their scope of practice. If you act beyond your scope of practice, you could face additional liability, especially if a patient was harmed.
Why the Distinction Matters, and Where the Risk Lies
NPs and RNs face different exposure to liability. A registered nurse who steps beyond their scope and performs NP responsibilities could be subject to discipline, up to and including license suspension or revocation. That’s because they worked beyond the constraints set forth by the board of nursing.
NPs aren’t immune to the dangers of stepping outside their scope. For example, a nurse practitioner who operates without physician oversight in a state that requires it could put their license at risk. Similarly, RNs must avoid assuming NP functions.
Regulatory scrutiny is another concern for nursing professionals. State boards examine whether a practitioner has practiced within their authorized scope. If there are suspected oversteps, it could trigger an investigation. A successful nursing license defense means proving that you adhered to the scope that applies to your license.
Scope boundaries exist for a reason. The primary purpose is to protect patients.
Violations of the scope of practice are often uncovered when a patient or one of their loved ones complains about a nurse conducting themselves inappropriately. The nurse practice act frequently uses “standard of care” language to outline these standards.
If you face an allegation of misconduct, the board will compare your actions to the accepted standard of care. Egregious or intentional violations can result in particularly harsh penalties.
Tips for Protecting Your Nursing License
You’ve devoted years of your life to obtaining your license and building your professional reputation. Now, you need to protect it. Here are a few tips for helping you do so:
- Know Your State’s Rules: Be clear about what your state allows you to do with your particular license
- Review Your State’s Nurse Practice Act: Familiarize yourself with concepts like autonomous practice and collaborative practice agreement
- Avoid Role Confusion: If you’re an RN, don’t perform NP-level duties, and be wary of gray areas
- Document Everything: If it’s not in the chart, it didn’t happen, so make sure you document everything
- Get Legal Advice Early: Contact an attorney with experience in nursing license defense if you receive a notice of a board complaint
- Educate Your Team: Make sure everyone understands the boundaries of their role to prevent inadvertent scope violations
Taking a proactive approach is the best way to stay within your scope of practice and reduce the risk of a major violation.
Mounting a Strong Nursing License Defense
Despite your best efforts, you could still face accusations of stepping outside of your scope of practice. If you’re notified of an investigation or complaint, seek the support of a nursing license defense lawyer immediately.
An experienced attorney will help you protect your nursing license by taking the following steps:
- Reviewing the nature and severity of the complaint
- Gathering evidence on your behalf
- Responding to the board’s inquiry
- Keeping track of important deadlines
- Representing you during a disciplinary hearing, if required
If disciplinary action is unavoidable, your lawyer will lobby for a lesser punishment, such as a shorter suspension or mandatory retraining instead of a loss of your right to work. The goal is to keep you in the profession you love while defending your reputation.
Contact Unlock Legal for an Effective Nursing License Defense
If you have legal questions regarding your scope of practice or are facing disciplinary action from the California Board of Registered Nursing, Unlock Legal is here to stand with you. Our experienced attorneys have been defending healthcare professionals from allegations that threaten their right to work since 1997.
Contact us today to schedule a consultation.