Nurse Practice Acts are legal regulations put forth by each state to provide provisions regarding multiple aspects of nursing (Westrick, 2014). Nurse Practice Acts incorporate the nurse’s scope of practice which are broad provisions that provide guidelines for appropriate actions performed by nurses (Westrick, 2014). Provisions common to many states include that nurses can, “diagnose human responses to actual or potential health problems and to assess needs of patients” (Westrick, 2014. Page 10). Nurses are expected to practice within the state defined scope of practice for nurses. When a nurse performs duties outside of this scope of practice, legal action can ensue; criminal, administrative, civil, and/or disciplinary; such as malpractice, tort, or fraud (Westrick, 2014). Another caveat when a nurse acts outside of the state define scope of practice, the nurse can be held to the standard of care of the practitioner whose scope the action was included (Westrick, 2014). First and foremost, a nurse must be familiar with the Nurse Practice Act of the state of employment. If a nurse is requested to perform a duty that is outside the defined scope a practice, there are criteria that must be questioned. According to Westrick (2014), in figure 4-2 on page 24 of Essentials of nursing law and ethics:
“Determine if the activity falls within scope of nursing practice; nursing activity should meet all criteria:
- Is the act consistent with your scope of practice as defined by the Board of Nursing’s statutes and regulations?
- Is the activity authorized by a valid order, and in accordance with established institutional/agency or provider protocols, policies, and procedures?
- Is the act supported by research data from nursing literature and/or research from a health-related field? Has a national nursing organization issued a position statement on this practice?
- Do you possess the knowledge and clinical competence to perform safely?
- Is the act to be performed within accepted “standards of care” that would be provided in similar circumstances by reasonable, prudent nurses with similar education and clinical skills?
- Are you prepared to assume accountability for the provision of safe care?” (Westrick, 2014. Page 24)
If the action falls out of these criteria, the nurse has the right to refuse to perform the action.
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