Nurse Practice Guidelines

Nurse practice guidelines are established by the governing board of nursing in each state. These guidelines make up the state's nurse practice act (NPA), which is a set of rules outlining what a nurse may or may not do in the course of the safe practice of nursing in that specific state. There are separate guidelines for registered nurses (RNs) and for licensed practical or vocational nurses.

Advance Practice Nurses

• Advance practice RNs such as nurse practitioners have additional guidelines under which they can practice. These guidelines are specific to the advanced education and knowledge base and may vary from state to state. For example, nurse practitioners have slowly won the right to prescribe medications in all states, but there may be very specific restrictions on the types of medications and the circumstances for prescribing them, which can vary widely from one state to another.

Nurse Guidelines Protect the Public

• The basic premise of all nurse practice guidelines is to protect the health and wellness of the public by establishing a Do No Harm philosophy. This same philosophy applies to all licensed health care professionals.

  The nurse practice guidelines are a set of laws that spell out, among other things, the amount and level of education the nurse must possess from an accredited school of nursing. They dictate the number of hours of hands-on care a nursing student must perform to complete the nursing education. These guidelines also establish the standards for the type and number of continuing education hours a nurse must have in a set period of time for licensure renewal. The NPA also sets disciplinary guidelines for any nurse who fails to comply.

Scope of Practice

• These practice guidelines establish what is known as a scope of practice under which the nurse can safely provide patient care. Each nurse receives a copy of the NPA when he passes the National Council Licensing Exam (NCLEX) and obtains his nursing license. It is the responsibility of each nurse to read, understand and stay within this scope of practice at all times.

Review Guidelines Periodically

• Nurses should review their state NPA at least yearly to keep it fresh in their minds and to note any changes. These NPAs are available online at the state's board of nursing website. Each state's board of nursing is listed at the National Council of State Boards of Nursing website, www.ncsbn.org.

  In addition to the nurse practice guidelines, nurses need to know their specific job description as well as the policies and procedures for their facility, agency or employer.

Advocate for Patient Safety

• Nurses must be aware of their practice guidelines and advocate for patient safety by challenging anyone asking them to perform outside their scope of practice. The guidelines clearly state that it is the responsibility of the individual nurse to know and understand her scope of practice and to stay within that scope despite what she may be asked to do by a colleague, physician or employer. The nurse must Do No Harm.